I recognise the important role that voluntary nursing homes play in the care and welfare of older people in Ireland, and the important contributions nursing home operators and staff make to local communities
The National Treatment Purchase Fund (NTPF) are the body designated, under Section 40 of the Nursing Homes Support Scheme Act 2009, to negotiate with persons carrying on the business of a private and voluntary nursing home, for the purposes of reaching an agreement on the maximum prices to be charged for nursing home care, and are 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 Nursing Homes Support Scheme Act 2009. The NTPF has statutory independence, and there is no role for Ministers or the Department of Health in these negotiations which are conducted and agreed between individual nursing home providers and the NTPF.
There is no other mechanism for funding from the public purse for nursing home residents outside the Nursing Home Support Scheme. It is imperative that private and voluntary providers continue to engage in the process as set out in the Nursing Homes Support Scheme Act 2009.
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 has met 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.
On 19 December 2023, I announced a new €10 million scheme to improve infection prevention and fire safety in private and voluntary nursing homes. The Nursing Home Resident Safety Improvement (RSI) Scheme will provide funding towards structural works carried out in compliance with standards published by the Health Information and Quality Authority (HIQA) under Regulation 27 (Protection against infection) and Regulation 28 (Fire precautions).
Up to €25,000 will be available to each qualifying nursing home for eligible works under this scheme. Nursing homes may also claim retrospectively for works covered by this scheme if they were carried out since 1 January 2020. The commencement date for the RSI scheme is 1 January 2024 and the closing date for receipt of applications is 15 November 2024.
This scheme is a vouched scheme which is open to all operational voluntary and private nursing homes registered with HIQA and the National Treatment Purchase Fund (NTPF) as of 1 January 2024 and in receipt of payment under the national Nursing Homes Support Scheme (NHSS) for the provision of long-term residential care services.
The HSE will administer the scheme and make payments to the nursing homes. The National Treatment Purchase Fund (NTPF) will administer the application process and provide support and advice to the HSE. Nursing homes whose applications are approved will have their payments processed and released on a quarterly basis by the Health Service Executive (HSE).
All funding through this scheme should be used to fund works in line with the nursing home's compliance plan outlined to HIQA as part of their inspection process.
Further details of scheme rules, eligibility criteria and the application process are available on the HSE website at: www.hse.ie/eng/services/news/newsfeatures/nursing-home-resident-safety-improvement-scheme/, and also on the NTPF website at: www.ntpf.ie/home/rsi.htm#:~:text=About%20the%20scheme,28%20(Fire%20precautions)%20of%20S.I
