Tuesday, 15 September 2020

Ceisteanna (84)

Mark Ward


84. Deputy Mark Ward asked the Minister for Health if investment in neurological and neurorehabilitation services will be increased (details supplied); and if he will make a statement on the matter. [23427/20]

Amharc ar fhreagra

Freagraí scríofa (Ceist ar Health)

The Programme for  Government includes a commitment for advancing neuro-rehabilitation services in the community. The Health Service Executive is leading on the implementation framework in respect of the recommendations of the National Policy and Strategy for the provision of Neuro-Rehabilitation Services in Ireland 2011-2015.

The focus of the Neuro-Rehabilitation Strategy is on achieving best outcomes for people, by providing safe, high quality, person-centred care at the lowest appropriate level of complexity. This must be integrated across the care pathway and provided as close to home as possible or in specialist centres, where necessary. The framework will guide the reconfiguration and development of neuro-rehabilitation structures and services at national and local level, through a 10-step Framework. It proposes the formation of Managed Clinical Rehabilitation Networks (MCRNs), with the set-up of one demonstration MCRN suggested as the first step. The ultimate goal of this approach is to put in place a national framework of acute, inpatient and specialist community services.

The Managed Clinical Rehabilitation Network (MCRN) model acknowledges that different service users need different input and different levels of expertise and specialisation at different stages in their rehabilitation journey.

The critical point of this model is that, although service users may need to access different services as they progress, the transition between services should be facilitated by appropriate communication and sharing of information between services so that they progress in a seamless continuum of care through the different stages:

- Acute hospital;

- Complex specialist rehabilitation services;

- Post-acute specialist inpatient rehabilitation services;

- Community based specialist rehabilitation services;

- Primary care; and

- Voluntary organisations.

This National Implementation Framework is evidence-based and informed by population needs. It addresses the continuum of care for those in need of neurological rehabilitation services. It describes the requirement for a whole system approach and provides the blueprint for how we should deliver care and services for those who suffer from neurological conditions who require individualised, goal focused rehabilitation.

The implementation framework covers an initial period from 2019 into 2021. However, it is recognised that continued investment in and development of neuro-rehabilitation services will need to be prioritised beyond the three-year implementation period of this Implementation Framework.

In relation to health needs, HSE Disability Services provide personal and social supports based on the needs of the individual, rather than the provision of services based on a specific diagnosis or condition.

In general services for people with neurological conditions are delivered within the context of Primary Care, with referrals into secondary care for specialist interventions, where appropriate. However, people with neurological conditions may also benefit from Specialist Disability Services such as assisted living services.

The HSE provides a range of assisted living services including Personal Assistant and Home Support Services to support individuals to maximise their capacity to live full and independent lives.

PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.

Services are accessed through an application process or through referrals from public health nurses or other community based staff.  Individual’s needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources.  Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available.  As with every service there is not a limitless resource available for the provision of home support services and while the resources available are substantial they are finite.  In this context, services are discretionary and the number of hours granted is determined by other support services already provided to the person/family.

As the issues raised are service matters, I have asked the Health Service Executive (HSE)  to reply directly to the Deputy.