Mary Butler (Waterford, Fianna Fail)
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The NHSS covers the cost of the standard components of long-term residential care which are:

• Nursing and personal care appropriate to the level of care needs of the person
• Bed and board
• Basic aids and appliances necessary to assist a person with the activities of daily living
• Laundry service

It excludes other costs such as therapies, more specialised aids and appliances, social activities, transport and individual items and services such as specialised laundry, newspapers and hairdressing. Many of these items were excluded from the definition of long-term residential care because they relate to services covered under the medical card or other eligibility schemes.

In mid-October, the HSE issued a directive to Chief Officers to provide all nursing homes, both public and private, with details on access to aids and appliances within their Community Healthcare Organisation. The memo also underlines that basic aids and appliances necessary to assist a person with the activities of daily living are included in the National Treatment Purchase Fund deed of agreement for private nursing homes. It is hoped that this communication will emphasize that eligibility for these services is the same, whether older people reside at home or in a public or private nursing home.

In addition, from 30th October 2023, it is expected all patients transferring from acute hospitals to nursing homes will be assessed by, and necessary care interventions delivered by, ICPOP and the wider primary care team, as appropriate. It is anticipated these interventions will have an impact on unnecessary transfers from nursing homes to acute hospitals.

The Department intends to work proactively with the HSE to improve equity of access to primary care services for private nursing home residents. The flexing of the ECC model and memo in relation to aids and appliances is a first step in this process.

Finally, a focused piece of work to examine various policy options in relation to additional charges in nursing homes is now underway. There are a number of separate factors driving this issue and potential actions to address each of these are being actively considered.

The Department has no baseline data on additional charges in private nursing homes in Ireland. To address this gap and to inform the above analysis, Department officials devised an anonymous provider survey, in collaboration with HIQA and representatives of private nursing home providers, to obtain a data sample. The survey closed on 20 December 2023 and the data submitted is currently being reviewed.