Pádraig O'Sullivan
Question:325. Deputy Pádraig O'Sullivan asked the Minister for Health when a person (details supplied) will receive a date for surgery; and if he will make a statement on the matter. [33265/23]
View answerHospital Waiting Lists
Questions (325)
Written answers
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Departmental Websites
Questions (326)
Catherine Murphy
Question:326. Deputy Catherine Murphy asked the Minister for Health to clarify whether at any point over the past ten years the SSL certificates for his Department’s websites expired for a period of time; if so, the reason this occurred; and the duration they remained expired. [33275/23]
View answerWritten answers
The situation described has not arisen in the Department of Health.
Nursing Homes
Questions (327)
Fergus O'Dowd
Question:327. Deputy Fergus O'Dowd asked the Minister for Health if any consideration has been given to the provision of a capitation grant or low-interest loan scheme for small- to medium-sized nursing homes to meet the cost of required upgrades/building works in order to satisfy HIQA regulations, where that nursing home can show that it does not have the capacity to meet the financial requirements on same, and where there is a clear and identified need for beds in the area in question; and if he will make a statement on the matter. [33286/23]
View answerWritten answers
Options to provide additional support to nursing homes are being explored, such as to help with the often costly nature of compliance for nursing homes under necessary Health Information and Quality Authority (HIQA) regulations. I expect the proposed options to be examined in the Estimates process of Budget 2024, as they are currently under development.
The Government is conscious of the financial challenges faced by the nursing home sector, especially smaller and voluntary nursing homes that may not have access to the same economies of scale as larger homes or groups. The Government has provided substantial support to the private and voluntary nursing home sector over the course of the pandemic. Over €150m of financial support has been provided to private and voluntary nursing homes through the COVID-19 Temporary Assistance Payment Scheme (TAPS) and the provision of free PPE and oxygen to private nursing homes continues, costing over €77 million to date.
A new €10 million scheme (TIPS) was established last year to support private and voluntary nursing homes with increases in energy costs, covering 75% of year-on-year cost increases up to a monthly cap of €5,250 per nursing home. This scheme has been extended for a second time to the end of June 2023.
Budget 2023 saw over €40 million in additional funding for the Nursing Home Support Scheme (NHSS) which will provide for an uplift in the maximum prices chargeable by private and voluntary nursing homes, as negotiated. Anyone who has had a scheduled renegotiation of their Deed of Agreement this year with the National Treatment Purchase Fund (NTPF) has seen a significant uplift. I am conscious of private and voluntary nursing homes that are not scheduled to renegotiate their Deed of Agreement in 2023 and other options are being considered. One of the options under consideration is for nursing home providers to agree to a shorter contract duration with the NTPF.
Important strands of reform to the nursing home sector are being, or have been, brought forward. The Government remains committed to delivering on:
• The nine recommendations that emerged from the Value for Money Review on Nursing Home Costs,
• The 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform,
• The four recommendations of the NTPF Review of Pricing System for Long Term Residential Care Facilities, and
• The 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants.
Work continues within the Department of Health to deliver on all of these recommendations, as well as analysing the outcomes of the Skills Mix and Safe Staffing pilots which will serve to inform future policy.
Given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review. The Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings.
Nursing Homes
Questions (328)
Róisín Shortall
Question:328. Deputy Róisín Shortall asked the Minister for Health to provide an update on the implementation of the review of the pricing system for long-term residential care facilities; the timeline he is working towards; and if he will make a statement on the matter. [33288/23]
View answerWritten answers
Fair Deal was designed to protect and support vulnerable older people, to ensure equal access to nursing home care based on what they could afford. This gives certainty to people and families. Government funding for Fair Deal is to support vulnerable older people at a time in their lives where full time care is essential.
The long-established statutory mechanism through which private and voluntary nursing homes are funded was established by the Oireachtas under the Nursing Homes Support Scheme Act 2009. This legislation outlines the process for private and voluntary providers to negotiate the prices for their services with the designated State agency, the National Treatment Purchase Fund (NTPF).
Maximum prices for individual nursing homes are agreed with the NTPF following negotiations and based on the NTPF’s cost criteria. These criteria include costs reasonably incurred by the nursing home, local market prices, historic prices and overall budgetary capacity.
The NTPF carry out this role independently under the NHSS Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations. The Department of Health published a review of the NTPF pricing system in June 2021 and continues to work on bringing forward the recommendations that emerged from this review.
A steering group has been established to oversee the delivery of the recommendations; this group continues to meet on a regular basis since publication of the review. The group made four recommendations:
• Recommendation 1: formal assessment of using a formulaic approach in the pricing system as set out in Section 4 of the Report.
• Recommendation 2: formal assessment of amending the approach to the assessment of “Local Market Price” to reflect prices within other nursing homes within a certain distance of the nursing home rather than within the same county.
• Recommendation 3: NTPF to engage with nursing homes and their representatives in relation to enhancing the internal NTPF Review process.
• Recommendation 4: amending the process for allowing for high dependency residents when the necessary systems are in place.
The delivery of recommendations 1-3 primarily sit with the NTPF. As per the recommendations of the review, the NTPF is reporting periodically to the steering group on progress in implementing the recommendations. It is recognised, however, that recommendation 4 has dependencies going well beyond the scope of the pricing review. This recommendation is therefore being addressed within the broader context of the reform of older persons' services, with appropriate links established between the pricing review steering group (including shared membership) to ensure that appropriate links are made between this recommendation and the others.In addition to progressing the recommendations that emerged form the Pricing Review, Important strands of reform to the nursing home sector are being, or have been, brought forward. The Government remains committed to delivering on:
• The nine recommendations that emerged from the Value for Money Review on Nursing Home Costs,
• The 86 recommendations of COVID-19 Nursing Homes Expert Panel, especially those recommendations related to long-term sectoral reform,
• The 16 recommendations of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants.
Work continues within the Department of Health to deliver on all of these recommendations, as well as analysing the outcomes of the Skills Mix and Safe Staffing pilots which will serve to inform future policy.
Given the size, complexity and cost of the NHSS, implementation is complex and any changes in policy direction need to be carefully assessed and kept under review. The Department of Health is consistently seeking to identify improvements and introduce enhancements to the scheme, where feasible, which aims to ensure that long-term nursing home care is sustainable, accessible and affordable for everyone and that people continue to be cared for in the most appropriate settings.
Covid-19 Pandemic Supports
Questions (329)
Fergus O'Dowd
Question:329. Deputy Fergus O'Dowd asked the Minister for Health to outline with respect and reference to the TAPS payments which issued to private nursing homes throughout Covid, whether any public nursing homes received such payments under a similar scheme; if so, the name of the scheme; if governance and oversight were measured, similar to that of the audit undertaken on the TAPS scheme; and if he will make a statement on the matter. [33289/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Care of the Elderly
Questions (330)
Fergus O'Dowd
Question:330. Deputy Fergus O'Dowd asked the Minister for Health if he will provide an update on the progression and the timeline for the establishment of a commission on care for older people, establishment of a commissioner for ageing and older people; and if he will make a statement on the matter. [33290/23]
View answerWritten answers
The Government is committed to supporting healthy and positive ageing throughout the lifecourse; to meeting the challenges—and seizing the opportunities—that arise from Ireland’s ageing population; and to ensuring that the Sláintecare vision of ‘the right care, in the right place, at the right time’ is realised for all citizens as they age. Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’.
In 2022 preliminary desk research was undertaken within the Department of Health in preparation for the establishment of the commission on care. In 2023 the scoping and planning for the commission (inclusive of timelines) is being further advanced as a priority, with a view to its establishment by the year-end. While the scope of the commission on care has yet to be determined, the Government is committed to ensuring that our policy, legislation, and service provision is fit-for-purpose to meet the evolving needs of older persons in Ireland.
Community Care
Questions (331)
Fergus O'Dowd
Question:331. Deputy Fergus O'Dowd asked the Minister for Health to provide an update on the expansion of community-based care, bringing it closer to home, in line with the Sláintecare Implementation Plan, since the establishment of the current Government; and if he will make a statement on the matter. [33297/23]
View answerWritten answers
The HSE published its Annual Report and Annual Financial Statements for 2022 on the 4th July 2023. The report highlights the activity carried out across our health service during the year and giving an analysis of progress on reform, operations, budget management and governance.
The report is available at
www.hse.ie/eng/services/news/media/pressrel/hse-publishes-2022-annual-report-and-annual-financial-statements.html
I would also refer the Deputy to the recent progress made under Sláintecare and to view the most recent meeting minutes of the Sláintecare Programme Board, available at
www.gov.ie/en/press-release/bfe4f-minister-for-health-publishes-slaintecare-progress-report-2022-and-action-plan-2023/#
and
www.gov.ie/en/publication/fbc36-slaintecare-programme-board/
Home Care Packages
Questions (332)
Fergus O'Dowd
Question:332. Deputy Fergus O'Dowd asked the Minister for Health if he will provide an update on the expected timelines on the establishment of a new statutory home support scheme; how he plans to scope and plan for such a scheme; and if he will make a statement on the matter. [33303/23]
View answerWritten answers
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’. Work is ongoing within the Department across four broad areas to progress this commitment: (i) Regulation of home-support providers; (ii) the examination of future funding options for home-support services; (iii) working with the HSE to develop a reformed model of service delivery for home support (iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.
A key step in this process is to regulate home support services so that no matter where or how care is provided, service users can be assured that their provider meets minimum standards of quality. The Department of Health is currently preparing primary legislation to accompany regulations. It is envisaged that this will be brought before the Oireachtas this year.
In order to help in drafting the legislation and regulations a 6-week public consultation was completed in August 2022. The department has also been consulting with HIQA, the HSE, legal counsel, and representative groups to help improve the regulations further. Regulations are now at an advanced stage. Legal advice and engagement with key stakeholders will assist with final revisions.
Funding Options: How home support will be funded in the future will be an essential factor of the new Statutory Scheme. With this in mind the Department is researching different funding models. The Economic and Social Research Institute (ESRI) also undertook a programme of work on behalf of the Department on the potential demand and cost of home support which culminated in two reports:
www.esri.ie/publications/demand-for-the-statutory-home-care-scheme
www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding
A rapid response from the European Observatory on Health Systems was commissioned and published in March of this year.
eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option
This research will form an important part of the evidence base for the development of a sustainable funding model for home care services. No final decision on future funding has been made and further research is currently underway to enhance the evidence base.
Reformed Model of Service: In 2022 a Pilot for testing of a reformed model of service for the delivery for home care became fully operational in 4 Community Healthcare Organisations. Evaluation of the pilot has been completed and a final report is expected in the coming months.
The national roll-out of interRAI as the new standard assessment tool for care-needs in the community is underway and the recruitment process for 128 interRAI Care Needs Facilitators has commenced.
The HSE is in the process of recruiting key posts to enable the establishment of a National Home Support Office. Funding is provided for 15 full time jobs. Four WTEs are, including the Head of Service of the new National Home support Office have been appointed, with the remaining posts to be filled as soon as possible.
In March 2022, Minister Butler established the cross-departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. It set out to examine the challenges in front-line carer roles in the home support and long-term residential care sectors. The Group is chaired by the Department of Health and comprised of representatives from seven government departments, the HSE, HIQA and SOLAS.
The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022.
A link to the report is below: www.gov.ie/en/publication/492bc-report-of-the-strategic-workforce-advisory-group-on-home-carers-and-nursing-home-health-care-assistants/
It presents 16 recommendations to address these challenges. A group has been established to drive the implementation of the recommendations. The first meeting of the implementation group took place on 29 June 2023. Recommendation 9 has been fully implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home care workers was signed in December 2022. These permits will be for full-time positions with a minimum salary of €27,000 per year. Work is underway on all recommendations with a further four at an advanced stage. It is envisaged that the implementation group will meet quarterly and publish progress reports thereafter.
Health Services
Questions (333)
Fergus O'Dowd
Question:333. Deputy Fergus O'Dowd asked the Minister for Health to provide a progress update on the expansion of community intervention teams to prevent unnecessary hospital admissions and to support the timely discharge of patients to their homes, since the establishment of the current Government; and if he will make a statement on the matter. [33305/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Departmental Records
Questions (334)
Colm Burke
Question:334. Deputy Colm Burke asked the Minister for Health to set out in tabular form the total number of people on HSE physiotherapy waiting lists in Cork from 1 January 2022 to 31 December 2022, and 1 January 2023 to date; and if he will make a statement on the matter. [33306/23]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
Health Services Staff
Questions (335)
Colm Burke
Question:335. Deputy Colm Burke asked the Minister for Health what action his Department is taking to address the current shortage of physiotherapists in the HSE; and if he will make a statement on the matter. [33307/23]
View answerWritten answers
Health and Social Care workforce planning and ensuring an appropriate pipeline of suitably qualified healthcare professionals is a top priority my department.
Department of Health officials engage on an ongoing basis with officials in the Department of Further and Higher Education, Research, Innovation and Science and other relevant stakeholders to ensure that we train enough graduates with the skills necessary to support the delivery of health and social care services and to develop a strategic approach to workforce planning for the health sector.
My department works with the Department of Further and Higher Education to increase the supply of health and Social Care graduates in the short term to medium term through the immediate provision of additional places, and the longer-term planning being undertaken around future skills needs in the context of future demand for health and social care services.
The Department of Health, working with Department of Further and Higher Education, Research, Innovation and Science and the HSE, has secured increases in training numbers for 2023, including physiotherapy and this is set to expand further over the next number of years.
To address critical skills shortages the Department of Health Officials engage with the Department of Enterprise Trade and Employment regarding employment permits for certain health professionals who are in short supply. In June 2022 changes were made to provide access to the Critical Skills Employment Permit for non-EEA nationals wishing to take up employment in Ireland in the health sector for a number of health and social care roles including physiotherapy.
Over the last three years, the HSE has increased its overall headcount by over 20,500 WTE of which 2,947 WTE are Health and Social Care Professionals and of which over 400 WTE are Physiotherapists.
The HSE has directly targeted all final year physiotherapy students in Irish Universities for employment in the HSE and the Section 39 organisations. The HSE has guaranteed permanent job offers to all graduates who are successful at interview. To supplement the national pool, the HSE has launched an international campaign to source physiotherapists from overseas. The HSE is directly targeting Irish trained physiotherapists who travelled overseas for employment in the Irish publicly funded health services.
Departmental Records
Questions (336, 337, 338)
Colm Burke
Question:336. Deputy Colm Burke asked the Minister for Health to set out in tabular form the total number of trained physiotherapists from the United States who applied for international recognition through the CORU regulation process from 1 January 2022 to 31 December 2022, and 1 January 2023 to date; the number of applications that were refused during this timeframe; the number of applicants who submitted appeals on foot of initial refusal and the number of those approved and refused on foot of an appeal; and if he will make a statement on the matter. [33308/23]
View answerColm Burke
Question:337. Deputy Colm Burke asked the Minister for Health to set out in tabular form the total number of foreign-trained physiotherapists who applied for international recognition through the CORU regulation process from 1 January 2022 to 31 December 2022, and 1 January 2023 to date; the number of applications that were refused during this timeframe; the number of applicants who submitted appeals on foot of initial refusal and the number of those approved/refused on foot of an appeal; and if he will make a statement on the matter. [33309/23]
View answerColm Burke
Question:338. Deputy Colm Burke asked the Minister for Health the timeframe for the processing of appeals for foreign-trained physiotherapist applicants who applied for international recognition through the CORU regulation process in 2021, 2022, and 2023 to date; if these appeals are processed in chronological order; and if he will make a statement on the matter. [33310/23]
View answerWritten answers
I propose to take Questions Nos. 336, 337 and 338 together.
Officials in my Department have been in touch with CORU to obtain the information requested by the Deputy. The information below has been provided and the outstanding information requested will be sent to the Deputy as soon as it becomes available.
Recognition applications from US qualified physiotherapists
|
Date range |
Number of applications |
Number of appeals |
|
01/01/2022 to 31/12/2022 |
5 |
2 |
|
01/01/2023 to date |
4 |
0 |
Recognition applications from internationally qualified physiotherapists
|
Date range |
Number of applications |
Number of appeals |
|
01/01/2022 to 31/12/2022 |
209 |
28 |
|
01/01/2023 to date |
225 |
17 |
Please note, applications are not refused by CORU unless the applicant is ineligible to apply. If an application does not meet the standards of proficiency for physiotherapists, the applicant is given an opportunity to undertake compensation measures to address any deficits in their application. A compensation measure is put in place as an opportunity for the applicant to demonstrate the required standard of practice as upheld in Ireland to ensure protection of the public. The applicant is given two opportunities to address deficits. But if they fail on both occasions they can still reapply for recognition.
All appeals made to CORU across all professions are progressed as soon as reasonably practicable. The relevant decision makers are external to CORU to ensure independence and integrity in the decision-making process. The timeframe for completion of appeals has typically been in the region of 4-6 months. Unfortunately, following a very high increase in appeals since late 2021 that timeframe has extended to approximately nine months. CORU appreciates the importance of addressing appeals as quickly as possible and makes every effort to ensure that applicants are supported through this process.
Question No. 337 answered with Question No. 336.
Question No. 338 answered with Question No. 336.
Qualifications Recognition
Questions (339)
Colm Burke
Question:339. Deputy Colm Burke asked the Minister for Health what action his Department is taking to improve the application process for applicants in the CORU regulation process; and if he will make a statement on the matter. [33311/23]
View answerWritten answers
As the Deputy will appreciate, health professional regulators must apply high standards to the assessment of applications for registration from those who wish to work in our health services. This process must be robust to ensure patient safety but must also be fair to applicants.
CORU strives to reach their decisions in the shortest timeframe possible and officials in my Department continue to engage with them on a regular basis regarding recognition and registration timelines generally. In 2022, CORU’s Registration Boards made 48% more decisions on applications for recognition of international qualifications than they had in 2021 and the number of recognition applications has continued to increase in 2023.
Applicants are given extensive guidance notes on CORU's website and online application portal to assist with the process. CORU's phone lines are open daily from 10am to 1pm and emails are responded to as per service level agreements as set out in CORU's customer charter (2 days). Telephone calls are also facilitated outside of these times where necessary.
CORU has undertaken numerous measures aimed at reducing timeframes including:
• Work has been ongoing to identify possible new approaches for recognition of international qualifications. In addition, new systems operable within the law as it stands are being researched and tested to speed up the process.
• CORU invite applicants whose recognition applications are considered complete to apply for registration at that time so that the recognition and registration tasks can be processed in parallel.
• The frequency of Registration Board meetings has also been increased to allow for quicker decision-making.
CORU has been provided with substantial additional resources over the past number of years to assist it fulfil its functions as set out under the Health and Social Care Professionals Act 2005 and of course this will continue to be kept under review.
Health Services
Questions (340)
Fergus O'Dowd
Question:340. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment on the target of community services assigning a case manager for older people with chronic conditions to assist them with accessing the care they need, since the establishment of the current Government; and if he will make a statement on the matter. [33313/23]
View answerWritten answers
Ireland’s population is ageing rapidly, and for the most part, our older population clearly indicates their preference to age in place, in their own homes, for as long as possible. One of the Government's key priorities, as outlined in the Programme for Government, is to support older people to live in dignity and independence in their own homes and communities for as long as possible. This is in line with the Sláintecare vision for receiving the right care, in the right place, and the right time.
The Government remains committed to supporting older people to age in place at home, in their communities, with access to wraparound supports, including day care and dementia-specific day care services, Meals on Wheels, and home care services.
In 2021, the HSE commenced the implementation of the Enhanced Community Care (ECC) Programme, which aims to deliver increased levels of healthcare, with service delivery reoriented towards general practice, primary care, and community-based services.
The ECC programme will ensure maximum impact for citizens in avoiding hospital admission as far as possible through initiatives that will see care delivered within the community, at or near a person’s home, where appropriate.
ECC funding will support the ambitious, programmatic, and integrated approach to the development of the primary and community care sector which, amongst other initiatives, includes the development of primary care teams within 96 Community Healthcare Networks across the country, alongside 30 Community Specialist Teams for Older People, 30 Community Specialist Teams for Chronic Disease, and national coverage for Community Intervention Teams.
As part of the ECC programme, the Integrated Care Programme for Older Persons (ICPOP) aims to shift the delivery of care away from acute hospitals towards a community based, planned and co-ordinated care model which is closely aligned to Primary Care and Acute sector partners.
The objective of the programme is to improve the quality of life for older people by providing access to integrated care and support that is planned around their needs and choices. The programme seeks to ensure that older people with complex care needs can access care quickly, at or near home, through care pathways specifically designed for older people and targeting Frailty, Falls and Dementia. ICPOP has worked with acute hospitals and their local community older person’s services to develop end-to end care pathways for older people with complex care needs.
Each Community Specialist Team will service a population on average of 150,000 across an average of 3 Community Healthcare Networks (CHNs). The teams will be co-located together in ‘hubs’ located in or adjacent to Primary Care Centres, reflecting the shift in focus away from acute hospitals towards general practice, primary care, and a community-based service model.
As of April 2023, 23 ICPOP teams have been established across the country. It is envisaged that the full complement of 30 ICPOP teams will be established by Q4 2023.
In line with HSE national guidance, each Community Specialist Team (CST) provides for case management. Case Management is a complex function that involves organising and coordinating care. It forms a cornerstone of a new way of working that proactively identifies and delivers secondary care in the community for older adults with complex needs and long-term conditions such as frailty. Whilst case management has a broad function, care coordination at a minimum involves proactively supporting patients to access services, avoid duplication, and optimises outcomes.
A case management function involves collaborative and multi-disciplinary approaches to organising and coordinating care for the individual. It typically comprises of a case finding, needs assessment, care planning, care coordination and case closure. Each member of the CST Older People team, irrespective of discipline, undertakes a care co-ordination function. The case management function with CSTs for Older People is based on Comprehensive Assessment. As well as undertaking comprehensive assessment, CSTs team members will case manage care until outcomes are optimised.
This will include teams agreeing with other care provides (primary and secondary care) how meeting care needs are shared. The needs of people with complex care needs requires proactive care co-ordination, with Multi-Disciplinary Team members sharing that function (referred to as assertive case management). The clinical management of people attending the service is focused on being person-centred and may include enhanced management/interventions in people’s own homes or in other community settings.
Health Services
Questions (341)
Fergus O'Dowd
Question:341. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment on the development of the role of advanced nurse practitioners in older person services and chronic disease management, since the establishment of the current Government; and if he will make a statement on the matter. [33314/23]
View answerWritten answers
As the Deputy points out there is a Programme for Government commitment to develop the role of advanced nurse practitioners in older person services and chronic disease management.
Advanced Nurse / Midwife Practitioners (ANMPs) provide complete episodes of care and timely access to healthcare and earlier interventions. Creating a critical mass of advanced practitioners will contribute effectively and efficiently to addressing population health needs and has demonstrated improved patient experience, reduced waiting times and reduced admissions to hospitals. ANMPs contribute to service reform by providing the right care, at the right time, and in the right place.
Government has invested heavily in Advanced Practice for Nurses and Midwives, particularly since the publication of the Policy on the Development of Graduate to Advanced Nursing and Midwifery Practice for Nurses and Midwives (Department of Health, 2019). The role of ANMPs and the allocation of ANMPs across the various service areas is aligned with policy priorities. This includes Chronic Disease Management and Older Persons Services.
In 2020, 52 new ANP posts were created. Of these, 12 were allocated to Older Persons Services and a further 16 to Chronic Disease Management. In November 2021, I decided to increase the number of nurses and midwives practicing at an advanced level across the health service from 2% of the workforce to 3%, a 50% increase.
In 2022, I allocated €11m to the HSE to recruit 149 ANMPs, of which 12 ANPs were allocated to Chronic Disease Management and 15 to Integrated Care Programme for Older Persons.
In 2023, I announced the creation of a further 80 ANMP posts. The HSE is now in the process of allocating and recruiting for these posts. 27 are being allocated to Chronic Disease Management, 10 are being allocated to Older Persons. The table below sets out the total number of new ANP posts allocated to Older Persons Services and Chronic Disease Management since 2020.
New ANP posts since 2020 for Older Persons Services and Chronic Disease Management
|
Older Persons Services |
Chronic Disease Management |
|
|
2020 |
12 |
16 |
|
2022 |
15 |
12 |
|
2023 |
12 |
27 |
|
Total |
39 |
55 |
The HSE advise that currently there are 951 WTE Advanced Nurse and Midwife Practitioners in the workforce. Within the Older Persons service there are currently 104 ANP posts, which consists of 52 posts in Acute services, 52 posts in Community services and 11 posts in Mental Health Psychiatry of Later Life. For Chronic Disease Management there are currently 78 ANP posts, which consists of 62 Acute posts, 16 Community posts and in addition to the above, Intellectual Disability Services have 7 ANP posts to manage chronic disease management.
These numbers will be added to when the allocated 37 posts for 2023 take up post in September 2023.
Healthcare Infrastructure Provision
Questions (342)
Fergus O'Dowd
Question:342. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment on the development and targeted expansion and availability of step-down facilities across each of the CHO areas, since the establishment of the current Government; and if he will make a statement on the matter. [33315/23]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Health Services
Questions (343)
Fergus O'Dowd
Question:343. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop and support eHealth and the increased use of assistive technologies, supporting people to live independently across each of the CHO areas, since the establishment of the current Government; and if he will make a statement on the matter. [33316/23]
View answerWritten answers
The provision of digital health solutions is a fundamental enabler for the reform of the health service and the implementation of Sláintecare.
Digital health solutions played a key role during the Covid-19 pandemic with solutions developed to facilitate monitoring and managing the spread of infection as well as the administration of vaccines when they became available. Many other digitally enabled services were deployed such as electronic referrals from GPs for those who needed testing and electronic transfer of prescriptions to reduce close contacts and support social distancing. EU digital covid certificates were issued and people had the option to store these in their digital wallet in the Covid Tracker App.
Government has continued to support eHealth in recent years by increasing both capital and revenue funding provide for ICT and eHealth. ICT resources have also doubled over the past 4 years.
Threats associated with cyberattacks have also increased as evidenced by the criminally motivated and devastating ransomware attack in May 2021. The need to build cyber resilience drives some of the additional investments since 2021.
To develop a clear direction for future years, the Department of Health, in in collaboration with the HSE, are currently developing the digital health framework (2023-2030), which is intended as a refresh to the existing eHealth strategy that is now almost 10 years old. This framework is supported by a corresponding implementation plan, being developed by the HSE. The refreshed strategy will leverage lessons learned from the pandemic, the 2021 cyberattack, and will benefit from what we have seen work successfully in other countries.
The Digital Healthcare Strategic Framework will put a greater focus on empowering patients to take greater control of their own health and wellbeing by providing access to their digital health record. It is intended to provide patients with the choice to access more health services through digital channels, where it is safe to do so.
A key underlying enabler of the new Digital Strategic Framework will be the Health Information Bill. The purpose of the Health Information Bill is to provide a clear, certain, and consistent legislative framework to transform the health information system into one that is fit for purpose and best serves the individual patient, healthcare practitioners and society as a whole. The Bill is focused on delivering patient-centred integrated care; improving performance and innovation in the health service; and supporting digital and data initiatives in healthcare.
A telehealth steering group has been established that will focus on lessons learned in deploying technical solutions during the pandemic. A public procurement process is underway to establish a framework from which services may draw down using suitable telehealth platforms. Two smaller telehealth projects are already underway with sponsorship from the Slaintecare Integrated Innovation Fund.
Under the National Dementia Strategy, the Government has funded a national network of 25 Memory Technology Resource Rooms (MTRRs) which provide free occupational therapist assessments and advice on assistive technology, to help people adapt to their condition and maintain a degree of independence for as long as possible, while also providing support to family carers. The MTRRs are an important component of the post-diagnostic support framework set out in the Model of Care for Dementia which was published in May this year.
Health Services
Questions (344)
Fergus O'Dowd
Question:344. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop and deliver a carers guarantee proposal that will provide a core basket of services to carers across the country, regardless of where they live, across each of the CHO areas since the establishment of the current Government; and if he will make a statement on the matter. [33318/23]
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The Programme for Government commits to delivering a ‘Carers Guarantee’ to provide a core basket of services to carers across the country, regardless of where they live.
New funding of €2 million was provided in Budget 2021 under the National Carers' Strategy with a view to improving equity of access to supports for carers across the country. This funding is being provided on an ongoing basis and contributes substantially towards delivering the Carers’ Guarantee, providing a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. €1.9 million of this funding is being channelled through Family Carers Ireland, while the remaining €100,000 is supporting the development and delivery of online supports for family carers through Care Alliance Ireland by means of an online support group. Both organisations have a service level arrangement with the HSE for the delivery of the support services associated with the carers' guarantee funding.
The €1.9m allocation to Family Carers Ireland aims to enhance carer wellbeing and quality of life by improving access to carer supports across the country. The funding is extending services to approximately 5,000 additional family carers through a mixture of individual and community support services. Family Carers Ireland is delivering these supports through its network of Support Hubs countrywide using a three-tier public health model of carer support: universal access supports, targeted community supports, and intensive supports.
Care Alliance Ireland is using its €0.1 million allocation to provide a professionally moderated online support group for family carers. The group is supported by a team of experienced volunteers and focuses on improving carer wellbeing and reducing isolation and loneliness, as well as signposting to carer support services.
Mental Health Services
Questions (345)
Fergus O'Dowd
Question:345. Deputy Fergus O'Dowd asked the Minister for Health to provide on update on the Programme for Government commitment to develop and increase access to talk therapies and improve access to specialist expertise, when it is required, in line with Sharing the Vision - a Mental Health Policy for Everyone., across each of the CHO areas since the establishment of the current Government; and if he will make a statement on the matter. [33319/23]
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Access to counselling supports and talk therapies is a key priority under Sharing the Vision, our national mental health policy. Under the oversight of HSE Primary Care, as of end Q1 2023, a Talk Therapies working group has finalised a synopsis for a position paper on a layered care service delivery model, incorporating subject matter expertise from primary and specialist mental health services, as well as from the community and voluntary sector. In parallel, this working group is in the process of completing a mapping of current talk therapy offerings alongside a review of recent evaluation reports into existing talk therapy services. The position paper will be informed by meaningful engagement with service users, family members and carers, as well as with service providers and talk therapy staff, and all other relevant stakeholders.
The Mental Health in Primary Care Specialist Group was stood up in June 2022, tasked with delivering a thematic set of policy recommendation relating to the development of mental health supports in primary care settings, including talk therapies, as well as with promoting a shared care between primary and specialist mental health services. The Specialist Group meets approximately every 4-6 weeks and has stood up two working groups focusing on enhanced access to talk therapies and shared care respectively, in order to ensure timely delivery of these critical policy recommendations. Work is progressing to finalise a shared care implementation plan and to scope a structured approach to meeting the physical health needs in primary care of those with severe and enduring mental illness, which will be informed by lived experience, as well as the experiences of staff, services and other key stakeholders.
The Counselling in Primary Care service was launched in 2013 and is available to adults with medical cards who are experiencing mild to moderate psychological and emotional difficulties, such as depression, anxiety, panic reactions, relationship problems, loss issues and stress.
In addition, more than €80m a year is provided by my Department to Section 38 and Section 39 agencies to provide mental health services to those who require them on behalf of the HSE.
As part of this question relates to services, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.