Homecare is an essential service to support people to live in their own homes and their own communities for as long as possible. The allocation of funding for home supports across the system, though significant, is finite and services must be delivered within the funding available. The 2020 National Service Plan provides for 18.9m home support hours to be delivered to 53,700 people and Intensive Home Care Packages delivered to approximately 235 people with approximately 360,000 hours delivered in the full year.
An additional €150 million is being provided for home support in 2021. The very significant additional funding will provide a further 5 million hours over this year’ target aimed at keeping older people healthy and happy, in their community, for as long as possible. This represents about a 26% increase in home support hours over the 2020 NSP target.
The Programme for Government (2020) commits to the introduction of “a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care.” In this regard, the Department is in the process of developing a statutory scheme for the financing and regulation of home-support. It is intended that the new scheme will provide equitable and transparent access to high-quality services based on a person’s assessed care-needs, and that it will also provide transparency about service-allocation while ensuring that the scheme operates consistently and fairly across the country.
Work is on-going within the Department to determine the optimal approach to the development of the new scheme within the broader context of the on-going reform of Ireland’s health and social care system, as envisaged in the Sláintecare Report. This work encompasses the development of the regulatory framework for the new scheme; the examination of the options for the financing model for the scheme; and the development of a reformed model of service-delivery.
The Sláintecare Implementation Plan commits to the establishment of the statutory scheme for the financing and regulation of home support services by the end of 2021. Work planned in 2020, including the planned testing of a reformed model of service delivery, was adversely affected due to the impact of COVID-19 on delivery mechanisms for home support and the requirement for the diversion of resources to deal with COVID-19. This has had an impact on the final timeline.
The successful development of this scheme is an ambitious programme of reform and is a key priority for me, and the Minister for Health. In order to accelerate this work, the Department is working closely with the HSE to ensure that the required resourcing including personnel, governance structures and other requisite resources are scaled up to ensure that significant progress is achieved by the end of 2021.
Within this context funding was secured in 2021 for the HSE to progress the roll out of InterRAI as the standard assessment for care needs in the community, the testing of a reformed model of service delivery for home support services and the establishment of a National Office for Home Support Services. All of this work throughout 2021 will progress the development of a reformed model of service delivery to underpin the statutory scheme.
In parallel, the increased investment in home support services in 2021 will contribute to meeting the Programme for Government commitment to providing equitable access to home care.