The Home Support Service is a core service which assists older people to live independently in their own homes for longer and enables large numbers of people to return home following acute hospital admission, who otherwise would remain in hospital or would be admitted to long stay residential care.
In line with Programme for Government commitments, the Government has made improved access to home support services a priority. In 2019 almost €30 million extra was added to the budget, with a target of delivering 18.26 million hours to over 53,000 people. This represented about 800,000 more hours of support than the 2018 target.
Despite this significant level of service provision, the demand for home support continues to grow. The allocation of funding for home supports across the system, though significant, is finite and services must be delivered within the funding available.
To achieve a balanced budget in 2019 the HSE must ensure that the cost of the home support hours being provided does not exceed the available budget. This is in line with normal prudent management of the budget. It is not correct to say that there is an embargo on home support hours. The allocation of new hours continues to be based on clients’ needs and the resources available.
In the context of planning and preparing for the challenges of the winter period, an additional €26m has been made available for the last quarter of 2019 to support the hospital and community system to improve patient egress. The investment is supporting home support and transitional care as well as keeping the waiting time for access to support under the Nursing Homes Support Scheme (NHSS) at 4 weeks to the end of the year.
While the existing home support service is delivering crucial support to many people across the country, it needs to be improved to better meet the changing needs of our citizens.
We have committed to an additional investment of €52 million in Budget 2020 to bring the total funding for home supports to €487 million in 2020. In 2020 the HSE will deliver over 19.2 million hours of home support, a substantial increase of 1 million hours more than this year’s target.
This investment is focused on enabling older people to remain at home and as appropriate, provision of hours will also be targeted at times of peak demand in Winter 2020, at the beginning and end of the year, to ensure more timely egress from hospital for our older citizens.
The core principles of Healthy Ireland, Positive Ageing, prevention and early intervention will underpin this approach.
In relation to recruitment, I am advised by the HSE that while there is no national recruitment embargo or moratorium, there is a priority requirement for all HSE services to maintain, or get to, an affordable staffing level that is sustainable in 2019 and 2020, while also prioritising the delivery of safe services.
In light of this, the HSE have introduced control measures relating to staffing and recruitment to ensure that they live within the available resources provided to them. This does mean that in some Hospital Groups and Community Healthcare Organisations non-critical replacement posts will be paused, however, the HSE report that there is on-going capacity for replacement of critical clinical posts within frontline services throughout this period.