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; and (iv) implementation of the recommendations of the Strategic Workforce Advisory Group.

Regulation

The Department of Health continues to develop a regulatory framework for home support providers. This will consist of primary legislation for the licensing of providers, secondary legislation in the form of regulations, and HIQA national standards who, along with the Chief inspector will have the legal authority to grant, amend or revoke a license. Consultation on the draft HIQA standards for home support will go out for public consultation in 2024 when the scope and content of regulations have been finalised.

Drafting of the primary legislation has been added to the priority list for the Spring Legislative session and the General Scheme is expected to be published this quarter.

Funding

The Department of Health is currently examining a range of funding options for home support. The Economic and Social Research Institute (ESRI) undertook a programme of work on behalf of the Department of Health on the potential demand for, and cost of, home support.

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

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

A rapid response from the European Observatory on Health Systems was commissioned and published in March 2023. It is titled: “Improving Home Care Sustainability in Ireland. Are user charges a promising option?”

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

Further research is currently underway to enhance the evidence base.

Workforce

Delivering this enhanced capacity requires substantial recruitment and strategic workforce challenges are in evidence in the sector. The Government has started implementing the 16 recommendations of the Strategic Workforce Advisory Group set up to examine these challenges in the sector.

Implementation of the 16 recommendations is underway by a cross departmental group, chaired by the Department of Health. The group meets quarterly and publishes progress reports thereafter. A meeting was held on 1st February 2024 with updates to be published shortly. The most recent progress report 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.

Reformed Model of Service Delivery

The DoH is working in partnership with the HSE and others on the continuing reform of the model of service delivery for home support. Funding has been provided for establishment of a National Home Support Office and the Head of Service, and a number of other posts have been recruited. Work is ongoing regarding the development of an IT system which will enhance the quality and efficiency of service delivery.

The HSE will prioritise implementation of interRAI care needs assessment as the single assessment tool for home support services and have included 18,100 interRAI assessments in the 2024 HSE Service Plan. The testing of interRAI in 4 pilot sites provided learning regarding operational aspects of home support services. The Centre for Effective Services evaluation report May 2023 included a list of recommendations to support interRAI rollout nationally. The Department of Health are monitoring implementation plans in order that a single assessment tool will underpin person centred services and appropriate, equitable and timely resource allocation.