Mary Butler (Waterford, Fianna Fail)
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As this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

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".

In 2024, the Department of Health is focused on continuing the development of a regulatory framework for providers of home support services which aims to ensure that service users are provided with regulated care. Work is ongoing within the Department across four broad areas to progress this commitment: Regulation of home support providers; working with the HSE to develop a reformed model of service delivery for home support; the examination of future funding options for home-support services; Implementation of the recommendations of the Strategic Workforce Advisory Group.

Regulation of home support providers

Development of a General Scheme to regulate home support services is now at an advanced stage with the Heads of Bill currently being finalised in advance of submitting to Government.

The Health (Amendment) (Licensing of Professional Home Support Providers) Bill is expected to be enacted in 2024 and will establish a licensing system for providers of home support services (public, private and not-for-profit). The regulations will set out the minimum requirements that a home support provider must meet to obtain a license and will confer on the Health Information and Quality Authority (HIQA), the authority to grant, amend and ultimately revoke a license if home support providers fail to meet minimum requirements set out in regulations and quality standards.

Transitional timelines are currently being finalised for the registration of home support providers under this framework. Additionally, HIQA is currently developing standards for home support providers which are planned to go out for public consultation in 2024.

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.

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/en/publication/66dd1-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-healthcare-assistants/.

Stephen Donnelly (Wicklow, Fianna Fail)
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The Health Service Executive (HSE) provide an extensive range of aids and appliances to individuals living with a wide variety of different medical conditions. These support individuals to continue living within their communities and to enjoy a greater quality of life than would otherwise be the case. The Community Funded Schemes is the collective name for the provision of these products and services.

The overall ambition of the Community Funded Schemes is to utilise technology to its fullest extent to support people living in their communities and in their homes where they may require healthcare assistance.

The HSE established a National Service Improvement Programme for the Community Funded Schemes. This Programme has been working on the development of standard operating procedures and guidelines with the aim of ensuring value for money, equity of access, and a management system that ensures compliance with those guidelines. The scale of this Programme is enormous given that many thousands of items are provided from community-based services across the country.

The Programme has produced a national list of aids and appliances and associated prescribing criteria. This is available at:

www.hse.ie/eng/services/list/2/primarycare/community-funded-schemes/aids-and-appliances/.

This should improve the equity of access to appropriate aids and appliances, following assessment, for all eligible persons, including those requiring care in their homes.

My Department will continue to examine both the expenditure and activity under the Community Funded Schemes.