In March 2020, the National Public Health Emergency Team, as part of a package of public health measures recommended that staff movement across long-term residential care settings should be minimised to support COVID-19 transmission risk mitigation
The Nursing Homes Expert Panel report, published in August 2020, made 86 recommendations on a range of issues, including in relation to ensuring that safe staffing is available in nursing homes, that staff should not work across multiple sites, that infection prevention and control measures are in place and that PPE is readily available and utilised appropriately. The Department continues to engage, including through the Implementation Oversight Team and the Reference Group with the HSE as a nursing home provider and with the representative body for private and voluntary nursing homes on the implementation of the recommendations of the Nursing Homes Expert Panel report.
As you are aware, the epidemiological situation in relation to COVID-19 has deteriorated, including in relation to nursing homes. Preliminary data from the Health Protection Surveillance Centre (HPSC) indicates that there are over 165 open outbreaks, which is over 5 times the amount of nursing home outbreaks open in mid-December. As noted by the Expert Panel and the European Centre for Disease Control (ECDC), where there are high rates of community transmission, the risk to nursing homes is high. The HSE indicates that the recent changes in the incidence of COVID-19 nationally and, in particular, in nursing homes have presented significant staffing challenges across healthcare settings. The HSE is indicating that over 1,000 nursing home staff are presently absent as a result of COVID-19. As you will appreciate this is placing significant challenges on nursing homes. The HSE and HIQA are activating all of the available and established supports; however, staffing, particularly nursing staff, remains a particular challenge. Having regard to the current challenges, it is necessary to prioritise adequate levels of staffing in nursing homes, which may require the temporary redeployment of staff to other facilities to support safe care for residents. Where possible, the HSE is redeploying its own staff to other public and private nursing homes to support the safe delivery of care.
The established serial testing programme for nursing home staff remains a key support mechanism and is now in its seventh cycle. The testing programme is a critical part of the ongoing response to COVID-19 in nursing homes and allows for the early detection of cases and targeting of the early intervention of COVID-19 Response and Outbreak Control Teams. Over the coming weeks, where appropriate, the frequency of testing will be temporarily increased to a weekly basis under the guidance and advice of the relevant local HSE teams in agreement with nursing homes.
Additionally, the comprehensive range of public health and infection prevention and control advice remains to be of critical importance, including the appropriate use of PPE. The HSE and HIQA has developed and delivered comprehensive training resources and webinars for staff in relation to these matters.
