Stephen Donnelly (Wicklow, Fianna Fail)
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The Programme for Government commits to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care’. Work is ongoing within the Department across four broad areas to progress this commitment: (i) Regulation of home-support providers; (ii) the examination of future funding options for home-support services; (iii) working with the HSE to develop a reformed model of service delivery for home support (iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.

A key step in this process is to regulate home support services so that no matter where or how care is provided, service users can be assured that their provider meets minimum standards of quality. The Department of Health is currently preparing primary legislation to accompany regulations. Primary legislation has been prioritised for drafting in the Autumn Legislative Programme.

In order to help in drafting the legislation and regulations a public consultation was completed in August 2022. The department has also been consulting with HIQA, the HSE, legal counsel, and representative groups to help improve the regulations further. Regulations are now at an advanced stage. Legal advice and engagement with key stakeholders will assist with final revisions.

Funding Options: How home support will be funded in the future will be an essential factor of the new Statutory Scheme. With this in mind the Department is researching different funding models. The Economic and Social Research Institute undertook a programme of work on behalf of the Department on the potential demand and cost of home support which culminated in two reports:

www.esri.ie/publications/demand-for-the-statutory-home-care-scheme

www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding

A rapid response from the European Observatory on Health Systems was commissioned and published in March of this year.

eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option

This research will form an important part of the evidence base for the development of a sustainable funding model for home care services. No final decision on future funding has been made and further research is currently underway to enhance the evidence base.

Reformed Model of Service: In 2022 a Pilot for testing of a reformed model of service for the delivery for home care became fully operational in 4 Community Healthcare Organisations. Evaluation of the pilot has been completed.

The national roll-out of interRAI as the new standard assessment tool for care-needs in the community is underway. The HSE is in the process of establishing of a National Home Support Office. Four WTEs, including the Head of Service of the new National Home support Office, have been appointed.

In March 2022, Minister Butler established the cross-departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. It set out to examine the challenges in front-line carer roles in the home support and long-term residential care sectors.

The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022. It presents 16 recommendations to address these challenges. A group has been established to drive the implementation of the recommendations. The first meeting of the implementation group took place on 29 June 2023. Recommendation 9 has been fully implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home care workers was signed in December 2022. These permits will be for full-time positions with a minimum salary of €27,000 per year.

Work is under way on all recommendations with a further four at an advanced stage. A new and improved HSE Home Support Tender has been in place since August. This delivers on commitments for sectoral reform such as payment for travel time for home support providers, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding.

It is envisaged that the implementation group will meet quarterly, with the next meeting scheduled for January 2024. An updated progress report of the Strategic Workforce Implementation Group on Home Carers and Nursing Home Healthcare Assistants was published in October 2023 which can be viewed below:

www.gov.ie/pdf/?file=https://assets.gov.ie/275876/c0889fbf-3f9c-4235-9e79-e1240790fac7.pdf#page=null