Dáil Éireann Debate, Tuesday - 20 June 2017
1127. Deputy Micheál Martin asked the Minister for Health his views on whether his Department's staff-patient ratio policy in relation to end-of-life care in a hospice setting is adequate; and if he will make a statement on the matter. [26959/17]
Amharc ar fhreagraGovernment policy on the development and provision of specialist palliative care services is set out in the 2001 Report of the National Advisory Committee on Palliative Care. This document describes the staffing ratios required for specialist inpatient units (hospices) and specialist palliative care services in the community (homecare). In hospices the ratios are determined by the number of beds and in the community by population.
All hospices planned for development include provision for the multi-disciplinary teams described by the Report. The Report recommends one nurse and 0.5 health care attendees per bed and these will be put in place along with additional nursing managers. With regard to Allied Health Professionals, the recommendation is for one of each of the following disciplines for every 10 beds: Physiotherapist, Occupational Therapist, Social Worker, Chaplain. The Report also recommends one session per week for Dietetics and Speech and Language Therapy. In the context of current staffing requirements this ratio is considered to be high for some disciplines while low for others. However, the skill mix is being fully maintained and for example the 15-bedded Kerry Hospice which is due to open in the autumn will have one Senior Occupational Therapist, one Senior Physiotherapist, 1.2 Senior Social Workers, 0.75 Chaplain, 0.6 Senior Pharmacist, 0.5 Dietician and 0.5 Speech and Language Therapist.
In the coming months I understand the HSE will publish a Palliative Care Services Three Year Development Framework (2017 - 2019) which undertook an examination of staffing levels in all existing services. Whereas it found gaps in some health disciplines it also found higher levels of staffing in some areas. One of the recommendations in the Framework is to review these and to work with services to reconfigure where possible and/or to identify the need through the budget process for additional staff to strengthen multi-disciplinary skill mix.
