The Nursing Homes Support Scheme, commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
As outlined in the HSE's National Service Plan for 2019, the NHSS is expected to support 23,042 people in 2019. The NHSS budget for 2019 is €985.8m which is an increase of €24.3m over its 2018 budget.
The HSE has noted that the number of residents in nursing homes whom are supported by the NHSS is ahead of forecast for the year to date. The latest available performance reports indicate that there are 23,236 people supported in the Scheme at the end of July this year. This is significantly more people than forecast and this creates a challenge. The HSE has also advised that the cost of care continues to rise and the average weekly cost per bed is higher in 2019 than anticipated.
Having regard to the available budget and the demand for support, the HSE releases funding in a managed way to ensure that the operation of the NHSS remains within the budgetary allocation. To manage the available funds throughout the year, a national placement list for the release of funding is operated by the HSE, to enable it to operate within budget. Funding issues to applicants in chronological order, to ensure equity nationally. Approved applicants are placed on the national placement list in order of their approval date and funding is released to applicants in order of their place on this list. The length of time spent on the placement list depends on the number of applicants currently receiving financial support and the number of new applications. Where demand is higher, the time spent on the waiting list may increase having regard for the prudent management of the Scheme's budget.
My Department and the HSE are working to ensure that the resources that are available are deployed in the most effective way possible and deliver the best outcomes for older people, and are also engaging extensively with the HSE in the context of planning for winter, including consideration of the response to dealing with the current challenges such as the high-level of delayed transfers of care. While this engagement continues the HSE has been authorised to undertake immediate action to mitigate the challenges. Engagement will continue over the coming weeks having regard to the Estimates 2020 process.
Delayed Transfers of Care continue to represent a significant challenge to the Health Service as a whole, and for some hospital patients their ultimate destination will be into transitional care or long term residential care supported by the NHSS. However, there are a number of challenges apart from those related to the NHSS, that lead to delayed transfers of care. The Delayed Discharges Implementation Group has been established to address these challenges through the implementation of the recommendations emanating from the Report of the Independent Expert Review of Delayed Discharges.