David Cullinane (Waterford, Sinn Fein)
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2973. To ask the Minister for Health the status of the safe nurse staffing and skill mix review; and if he will make a statement on the matter. [39729/21]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Safe Staffing Framework is an evidence-based methodology to determining the nursing workforce required based on patient acuity and dependency. The Framework was launched by Minister Harris, on 16 April 2018, on publication of the Final Report and Recommendations of the Taskforce on Staffing and Skill Mix for Nursing, on a Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals www.gov.ie/en/publication/2d1198-framework-for-safe-nurse-staffing-and-skill-mix-in-general-and-speci/. To date there have been three phases of the Safe Staffing Framework Development:

Phase 1 - Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals.

Phase 2 - Framework for Safe Nurse Staffing and Skill Mix in Emergency Care Settings.

Phase 3 - Framework for Safe Nurse Staffing in Community settings, including (a) Long-Term residential care settings for older persons, (b) Community care settings, and (c) Step-down and Rehabilitation settings.

Phase 1 of The Framework was handed over to the HSE in October 2019 for national roll-out. This phase of the Framework considered the skill mix levels across general and specialist medical and surgical patient care settings in acute hospitals. Phase 1 was implemented and tested through a pilot project across three hospital sites; Beaumont Hospital, Our Lady of Lourdes Hospital, Drogheda and St Columcille's, Loughlinstown.

The impact reports, using the data collected over two years with the support of a specific ICT system, have validated the initial findings from the pilot test. There is evidence of sustained improvements to patient outcomes, service and financial efficiencies and a number of positive workforce outcomes, including increased retention in areas where the Framework has been fully implemented. Implementation is being progressed by the HSE with €10m assigned in Budget 2021 to fund the associated staffing costs.

Phase 2 focuses on the nursing workforce requirements of emergency care settings (A&E). This stage of the Framework has been piloted in four Emergency Care Settings since Q4 2019. Due to the impact of the pandemic, the pilot was extended to examine the impact of COVID-19 on nursing workforce requirements in these care settings. The final impact report is due to be examined by the Taskforce in the coming weeks and, following endorsement, it will be presented to me. Phase 2 has led to the employment of an additional 77 whole time equivalent nursing staff in emergency care settings.

Phase 3 of the Framework relates to community care settings and due to its scale is sub-divided into three distinct stages. The first stage focuses on the long-term residential care setting for older persons and is a recommendation of the COVID-19 Nursing Homes Expert Panel (NHEP). The Framework will determine, through an evidence-based approach, appropriate nurse staffing levels and skill mix to meet residents' needs first; and will focus on delivering positive resident outcomes. A Safe Staffing Taskforce for Phase 3 has been established and it will work collaboratively with key stakeholders to meet the NHEP recommendations. Phase 3 will consider care in both public and private settings in urban and rural locations. Pilot site selection is currently underway with testing due to commence in Quarter 4 of 2021.