David Stanton (Cork East, Fine Gael)
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556. To ask the Minister for Health the situation with regard to mandatory hotel quarantine regarding persons, in particular Irish citizens, who intend to travel to Ireland and who are fully vaccinated with versions of a vaccine (details supplied) that are manufactured under licence by other companies which are not currently approved by the European Medicines Agency; if he has requested or will request the European Medicines Agency to consider approving such vaccines; and if he will make a statement on the matter. [22799/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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I have been given to understand that the vaccine known as Covishield gives equivalent protection to the version known as Oxford-AstraZeneca or Vaxzevria, as approved by the EMA. I have therefore asked that individuals vaccinated with Covishield be treated in the same way as those vaccinated with Oxford-AstraZeneca/Vaxzevria for the purposes of mandatory hotel quarantine.

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 557 and 559 together.

The Nursing Homes Expert Panel was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort. The Expert Panel report, which was published in August 2020, has added further to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date. The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified.

Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across health agencies and stakeholders. The recommendations of the report are varied and complex, requiring a mix of ongoing operational response to COVID-19 and a longer-term strategic reform. Those strategic reforms are, by their nature, complex and relate to whole of system issues. It is important to note that any such reforms require careful consideration and substantial policy development work. In the case of some recommendations, major legislative reform is required, something that must be approached in a measured and considerate way, to ensure reforms are delivered as intended.

Two progress reports have been published to date, with the third report due to be completed in the coming months. These reports are available on the COVID-19 Nursing Homes Expert Panel Report: Implementation Oversight Team webpage at . Additionally, survey work of nursing home providers has now commenced.

Continued learning and understanding of progression of the disease in Ireland is an integral part of those recommendations. Residents of nursing homes are vulnerable because of their age, underlying medical conditions, the extent of their requirement for direct care involving close physical contact and the nature of living in congregated settings. The very infectious nature of COVID-19 makes it difficult to prevent and control in residential care settings. The transmission of the virus into and within nursing homes is multifactorial. As identified by the Nursing Homes Expert Panel, where there is ongoing community transmission, settings like nursing homes are more vulnerable to exposure.

The State’s responsibility to respond to the public health emergency created the need to set up a structured support system in line with NPHET recommendations. This has been a critical intervention in supporting the resilience of the sector in meeting the unprecedented challenges associated with COVID-19. The Expert Panel highlighted the value of those supports and recommended their continuation. These supports continue to be provided.

The range of supports provided to nursing homes include:

- Enhanced HSE engagement

- Multidisciplinary clinical supports at CHO level through 23 COVID-19 Response Teams

- Supply of precautionary and enhanced PPE, free of charge

- Serial testing programme for all staff of nursing homes

- Where possible, access to staff from community and acute hospitals

- Suite of focused public health guidance and training resources

- Temporary accommodation to nursing home staff to support measures to block the chain of transmission

- HIQA implemented a Regulatory Assessment Framework of the preparedness of designated centres for older people for a COVID-19 outbreak and published an Infection Prevention and Control Assurance Framework for Nursing Homes

In addition, a temporary financial support scheme established for private and voluntary nursing homes, has provided over €88.8m in additional funding support as of 29 April. The Scheme opened in April 2020 and was extended until 30 June 2021.

Mary Butler (Waterford, Fianna Fail)
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The Nursing Homes Expert Panel was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort. The Expert Panel report, which was published in August 2020, has added further to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date. The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified. Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across health agencies and stakeholders. The recommendations of the report are varied and complex, are both short-, medium- and longer-term in nature, and require a mix of ongoing operational response to COVID-19 and a longer-term strategic reform. Those strategic reforms are, by their nature, complex and relate to whole of system issues.

It is important to note that any such reforms require careful consideration and substantial policy development work. In the case of some recommendations, major legislative reform is required, something that must be approached in a measured and considerate way, to ensure reforms are delivered as intended. Costing of the implementation of recommendations is ongoing, along with the implementation of the recommendations. As noted, longer-term consideration is necessary in costing many of the recommendations, due to the major developmental work that is required in order to accurately cost the defined policy objective and the full range of actions needed to deliver same.

In line with the Government commitment to progress the recommendations of the Expert Panel, up to €40m in funding has been secured to directly progress national recommendations in 2021. Up to €5 million in funding has been allocated to HIQA for 2021 for the implementation of the Panel’s recommendations, with €3.8 million approved for draw down for the recruitment of substantial additional staff required to progress recommendations, including additional inspectors required to increase the frequency of inspections. Given the significant service and policy reforms recommended, many recommendations are currently in the developmental stage, including considerations of the role of the Community Support Teams, Integrated Infection Prevention and Control Strategy and a range of legislative reform analysis. It is anticipated that proposals will be considered by the implementation structures in due course and separately, business cases will submitted to the Department for review.

It is also important to note that significant supports have been provided to nursing homes throughout the pandemic and these supports have been recognised by the Expert Panel in its recommendations. They include:

- Enhanced HSE engagement

- Multidisciplinary clinical supports at CHO level through 23 COVID-19 Response Teams

- Supply of precautionary and enhanced PPE, free of charge.

- Serial testing programme for all staff of nursing homes.

- Where possible, access to staff from community and acute hospitals.

- Suite of focused public health guidance and training resources.

- HIQA COVID-19 quality assurance regulatory framework.

- Temporary accommodation to nursing home staff to support measures to block the chain of transmission.

The inter-agency Implementation Oversight Team, which was established by the Minister for Health, oversees the implementation of the relevant COVID-19 Nursing Homes Expert Panel recommendations, and reports regularly to the Minister for Health and the Minister for Mental Health and Older People. Many of the short- and medium-term recommendations have been commenced or delivered on to date, with work continuing to progress other recommendations. Two progress reports have been published to date, with the third report due to be completed in the coming months. These reports are available on the COVID-19 Nursing Homes Expert Panel Report: Implementation Oversight Team webpage at .