Martin Browne (Tipperary, Sinn Fein)
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209. To ask the Minister for Health if his attention has been drawn to plans to reduce the number of step-down facilities in smaller communities across Ireland. [46941/21]

Martin Browne (Tipperary, Sinn Fein)
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210. To ask the Minister for Health if he foresees a situation in which health and step-down facilities in local communities could be closed due to changes in spatial requirements in facilities brought on by Covid-19 infection prevention requirements; and if so, the factors that would be taken into account when deciding to upgrade or close these facilities. [46942/21]

Martin Browne (Tipperary, Sinn Fein)
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211. To ask the Minister for Health if he will expand on the comments made by the Minister of State with special responsibility for Mental Health and Older People that as many as 350 beds could be lost in district hospitals and step-down facilities in the near future; the rationale for the comments; and if he will make a statement on the matter. [46943/21]

Mary Butler (Waterford, Fianna Fail)
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I propose to take Questions Nos. 209 to 211, inclusive, together.

I am assuming that the deputy is referring to short-stay/rehabilitative beds when using the phrase 'step down beds'. These traditionally include respite, convalescent, rehabilitation, assessment and palliative care beds.  In recent years transitional care beds have been made available in areas where acute hospitals are experiencing service pressures with delayed transfers of care. These beds have proved to be extremely effective for easing pressures on the acute hospital services and facilitating the planning and management of older peoples’ health needs in a more appropriate environment.  As outlined in the National Service Plan for 2021,  funding in the order of €125m has been provided by the Department of Health for an additional 1,110 rehabilitation and short stay/intermediate care beds in 2021.  

In relation to the issue of a reduction of long term residential care beds, the HSE recognises the importance of providing a quality service experience for residents even in the challenging environment of ageing infrastructure where many of our public units are between 100 – 150 years old. In order to fully address this challenge and to bring all of its units to the required HIQA and legislative standards, the HSE, with the support of the Department of Health, are working through a systematic programme of development through the Community Nursing Unit Programme.  

The emergence of the Covid-19 pandemic has impacted the timeline for the implementation of the CNU Programme. However, it has also provided an opportunity to incorporate some of the learnings from the Covid-19 pandemic, including the recommendations of the Nursing Home Expert Panel Report into the overall Reform Programme. The current programme of works provides for nearly 90% compliance by the end of 2024 with the remaining 11 projects being completed in 2025.   

A key priority of the 2021 HSE Service Plan is to implement the recommendations of the Covid-19 Nursing Homes Expert Panel Report and to progress the overall reform and development of both residential care and home support services to ensure that a wider range of options are available within the community in supporting older people. As a result of the Covid-19 pandemic and the requirement for enhanced infection control measures together with the necessity to improve compliance with HIQA standards there has been a reduction in the order of over 240 long stay beds in the service with a further 10 beds to be reduced during 2021.  

The HSE will continue to support older people and their families across the health service to ensure that people are accommodated as close to their homes and local communities as possible and will continue to work with the Department of Health on the overall programme which is referenced in the NSP 2021 and in the associated Capital Plan.