NURSING Homes Ireland has expressed huge disappointment key structural reforms to ensure lessons are learned from Covid19 have not been advanced by Government, on the first anniversary of the Covid19 Nursing Homes Expert Panel report. NHI accused the Government of apathy in bringing into effect proper support structures for nursing home residents and staff after the Covid crisis has been brought under control and of diverting its focus away from nursing home care. This will only exacerbate a crisis already presenting.
Calls from the nursing home providers, who are tasked with the implementation of 40 of the 86 recommendations, for the resources required to be put in place have been largely ignored to date, with many of the medium to longer term recommendations now stagnant. It is clear one year on from publication of the report, much remains still to be achieved by Government within the remaining six-month lifespan for recommendations to be implemented.
Tadhg Daly, NHI CEO states: “Covid19 must present a line in the sand moment for nursing home care in Ireland. Yet a different crisis is now the headline within the nursing home sector. Our sector is frustrated as the recommendations to achieve fundamental, long-standing reform have been left stagnant, with just six months remaining for them to be addressed.
“For example, the Expert Panel recommends integration of private nursing homes into the wider framework of public health and social care within a short-term basis. Yet there has been little engagement from the HSE with regard to ensuring this being achieved. An enhanced role for GPs within the nursing home environment is a key recommendation by the Panel. Yet, to date, the joint NHI and Irish College of General Practitioners position paper is the only progress that has been made.”
The State urgently needs to come to the table in this regard. Workforce recommendations are set out in relation to safe staffing levels, skill mix, and the necessity for a review of employment terms and conditions, with view to future capacity and supply of qualified staff. The Department of Enterprise, Trade and Employment is identified as a lead agent to progress this recommendation and, to date, no progress has happened. Progress has been made by the Department of Health in relation to a safe staffing framework, but achieving this is contingent on addressing the complete workforce recommendations. The Panel recommends relevant Government departments ensure that sufficient resources are assigned to ensure the timely implementation of the recommendations.
Calls from the HSE and HIQA for further resources have been addressed yet calls from the nursing home providers, who are tasked with the implementation of 40 of the 86 recommendations, have been largely ignored, they continued.
“The Panel advanced a reformed environment for nursing homes to operate in but it is hugely concerning no impetus is being presented by Government to address the fundamental issues identified by it for redress. It cannot be countenanced the recommendations, which were delivered after Covid19 brought long-standing structural issues to the fore, will be left hanging by the State.”
To coincide with the anniversary, NHI has published a report which it commissioned Accenture to undertake, COVID-19 Nursing Homes Expert Panel Impact Assessment. Accenture engaged key stakeholders to assess the structural and sectoral challenges required to deliver upon the recommendations and underpin system wide transformation in care for older persons. It identifies three themes that require State redress and prioritisation if nursing home care is to undertake the transformation required to implement real reform required post Covid19.
Integration: Covid19 highlighted access to community care services for nursing home residents is inconsistent, fractured and unstructured. An updated integrated model of care is required to ensure nursing home residents have access to community care services that are vital to support their health and social care needs.
Resourcing: The report identifies over a five-year period from 2015 to 2020 operating costs for nursing homes have risen by 37.6% while Fair Deal Rates have increased by 11.12% over the same period. A model that ensures funding is based on an assessment of resident needs and dependency levels has long been ignored and must be brought into effect to reflect the rising costs to deliver high-quality, person-centred, specialised care in nursing homes.
Workforce: The challenge of private and voluntary nursing homes ‘losing’ staff to both the wider healthcare system and other sectors needs to be addressed within a comprehensive nursing home workforce strategy. It needs to concentrate on attracting and retaining staff within gerontological care and to ensure appropriate staffing mixes are maintained to support high quality resident-centric care. Recruitment and retention, education and training, and options for career development within nursing home care urgently require a dedicated strategy.
Mr Daly further states: “There is requirement for Government to ensure this defining moment for nursing home care delivers real change for nursing home residents. There is commitment within the sector to ensure a fitting legacy emanates from the Covid19 tragedy but the State must refocus on achieving the recommendations.”
