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'Crisis' in nursing home sector as government slow to act on reforms, says Nursing Home Ireland

Nursing home providers are “frustrated” as they wait for progress on recommendations made by an expert panel last year.

THE NURSING HOME sector is in a “crisis” as it waits for the government to put reforms in place that were recommended over a year ago.

Nursing home providers are “frustrated” as they wait for progress on recommendations issued by an expert panel last year, according to representative group Nursing Homes Ireland.

NHI has accused the government of apathy towards bringing in improved support structures for residents and staff and of shifting its focus away from nursing home care.

Last year, the Covid-19 Nursing Homes Expert Panel Report issued 86 recommendations for improvements and reform in the nursing home sector.

However, NHI says that “much remains still to be achieved” by the government in the six-month window that remains for recommendations to be implemented.

A new report – commissioned by NHI and conducted by Accenture – identified that the pandemic should “be considered as a catalyst for strategic change”.

The report gives three key solutions to meeting challenges in delivering on the expert panel’s recommendations.

Firstly, it said, older people need an updated integrated model of care to address inconsistencies or fractures in access to community care services for nursing home residents.

Secondly, the funding model for nursing homes needs to be reviewed to make sure that funding is based on an assessment of residents’ needs and dependency levels.

“The funding model also needs to take account of the rising operational costs for nursing homes, coupled with the significant additional costs that will arise in meeting the Expert Panel Recommendations on an ongoing basis,” the report said.

And finally, a nursing home workforce strategy must be implemented to attract and keep staff in the sector long-term and support high-quality care for residents.

In a statement, NHI CEO Tadhg Daly said that “Covid-19 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,” Daly said.

He said there has been “little engagement” from the HSE on integrating private nursing homes into the broader framework of public health and social care – one of the expert pane’s recommendations.

“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,” Daly said.

He said there was “no progress” on workforce recommendations such as safe staffing levels, ensuring a mix of skills, and reviewing employment terms and conditions.

Those measures would be aimed at increasing future capacity and the supply of qualified staff for nursing homes.

“The panel recommends relevant government departments ensure that sufficient resources are assigned to ensure the timely implementation of the recommendations,” Daly said.

“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.”

In Ireland, more than half of all Covid-19 deaths have come from nursing homes.

The report points to three factors driving the high proportion of deaths – “focus on the hospitals and discharges of older persons to nursing homes”; “inadequate supplies of personal protective equipment”; and “lack of Covid-19 testing prior to admission to nursing home/discharge from hospitals”.

The requirement for long-term care admissions is expected to increase by 50% in Ireland over the next 12 years.

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