The Minister for Health, Stephen Donnelly TD, and the Minister for Mental Health and Older People, Mary Butler TD, have today published the COVID-19 Nursing Home Expert Panel’s report. The Panel, formed in May 2020, was established to examine emerging best practice and recommendations to ensure that all protective COVID-19 public health and other measures to safeguard nursing home residents are planned and in place to respond to the ongoing impact of the COVID-19 pandemic over the next 6-18 months.
Publishing the report, Minister Donnelly said:
“The COVID-19 pandemic has been particularly challenging and impactful on those who live in nursing homes, their families and the staff who provide vital services to residents. The Expert Panel’s report is significant and provides a range of recommendations to build on and continue the existing supports and public health measures required to protect those who live in nursing homes. The report is also informative in identifying areas of older persons service and care delivery requiring consideration for further reform. Many of these themes are reflected in the Programme for Government.
In the immediate term, continued focus is required to support nursing home residents, and I am fully committed to ensuring the relevant measures will evolve in line with identified learnings. We must ensure that older people, especially those at high risk of infection, are at the centre of our continued response to COVID-19.”
The Expert Panel took a comprehensive approach to its work including undertaking an extensive stakeholder engagement process, data analysis, and an international evidence review. Minister Donnelly continued:
“I would like to sincerely thank Professor Kelleher and her colleagues for their substantial work and commitment to this report, and I am particularly pleased to see the level of stakeholder engagement, including with residents and families, undertaken. The Expert Panel has provided a significant contribution to shaping our ongoing response to the challenges posed by COVID-19.”
Minister Butler welcomed the significant report prepared by the Panel and outlined that immediate focus would now turn to moving forward with implementation. Minister Butler said:
“I acknowledge the substantive nature of the range of recommendations made and that the capacity and resource implications are challenging, along with some of the suggested timeframes. However, implementing the Report’s short-term recommendations will ensure the ongoing protection of nursing home residents, the preparedness of the nursing homes sector and the health system in response to COVID-19 and the winter ahead. This will involve building on emerging good practice. We will focus immediately on the establishment of implementation structures with an inter-agency Implementation Oversight Team to be setup and have its a first meeting in the next week.”
Professor Cecily Kelleher, Chair of the COVID-19 Nursing Homes Expert Panel said:
“The Panel’s work has been guided by the principles of in-action and after-action reviews where lessons learned in real time are acted upon. This is not simply to identify those lessons learned but to seek to apply these insights in a tighter timescale in order to improve the outcome of the ongoing response. In Ireland and internationally nursing home residents, families and staff have felt a heavy impact of pandemic. Our report reflects on this and is forward looking to ensure ongoing protection and support for nursing homes residents. Our recommendations also reflect that systematic reform is needed in the way nursing home care and older persons care is delivered.”
ENDS
Note for Editors
At its meeting of 14/05/2020, the NPHET recommended the establishment of an expert panel (COVID-19 Nursing Home Expert Panel – examination of measures to 2021) which, through examination of national and international measures to COVID-19 as well as international measures and emerging best practice, would make recommendations to the Minister for Health, to ensure all protective COVID-19 response measures are planned, for in light of the expected ongoing COVID-19 risk and impact for nursing homes over the next 6-18 months.
The Panel was subsequently established by the Minister for Health.
Terms of Reference
- Provide assurance that the national protective public health and other measures adopted to safeguard residents in nursing homes, in light of COVID-19, are appropriate, comprehensive and in line with international guidelines and any lessons learned from Ireland's response to COVID-19 in nursing homes to date;
- Provide an overview of the international response to COVID-19 in nursing homes utilising a systematic research process;
- Report to the Minister for Health by end June 2020 in order to provide immediate real-time learnings and recommendations in light of the expected ongoing impact of COVID-19 over the next 12-18 months.
Expert Panel Members:
Professor Cecily Kelleher (Chair), DMed MD MPH FRCPI FFPHMI MRIA is Principal of the College of Health and Agricultural Sciences at University College Dublin. She is Full Professor of Public Health Medicine & Epidemiology and a Former Dean of Public Health at UCD. Her research interests are in Cardiovascular and Nutrition Epidemiology and Health Promotion. She has been principal investigator of the Health Research Board Lifeways Cross-Generation Cohort Family study from 2001-present, is Lead Investigator of the Irish component of WHO Childhood Obesity Surveillance Initiative and was also Lead on the All Ireland Traveller Health Study (2007-2011). She is a former Chair of the statutory bodies, the Women’s Health Council and the Medical Bureau of Road Safety. She is currently Chair of the UCD NVRL President’s Advisory Committee and is a member of the Ireland East Hospital Group Board and the Mater Misericordiae University Hospital Board.
Professor Cillian Twomey graduated in medicine from UCC in 1970 and worked for 31 years as geriatrician in Cork University and St. Finbarr’s Hospitals, Cork. The position also involved teaching responsibilities to UCC’s medical students, to doctors in postgraduate training as well to nurses and other healthcare professionals. He retired from clinical practice in November 2010.
He is a member and chairman of the Joint HSE-Irish Hospice Foundation (IHF) Hospital friendly Hospitals (HfH) Oversight Group (2017 to date). He a member of the Board of SAGE Advocacy clg (2017 to date). Prof Twomey has been involved in a range of other activities including: Chair, Steering Group overseeing a three-year Health Research Board (HRB)-funded project on the application of advance care directives in residential care settings and a member to the Board of the Health Information & Quality Authority (HIQA) 2010-2015.
Chief Director of Nursing and Midwifery for the Royal College Surgeons Ireland Hospitals Group. Joining the group in February 2020 at the start of the pandemic provided opportunities to introduce new ways of working and to build strong links with the surrounding community and private healthcare facilities. Petrina previously spent two years, as Director of Nursing for a Private Healthcare Group, having responsibility as person in charge in opening and operationalising a new state of the art Residential Care Home. This role included setting up approved processes and procedures meeting National Regulatory Standards whilst ensuring a safe and homely environment welcomed residents and staff. Prior to this role, Petrina spent 18 years in acute services working in many roles progressing to Executive Nurse Management level. Petrina is an Executive member of the Irish Association Directors of Nursing and Midwifery.
Public Representative Brigid Doherty
Brigid worked as a Patient Advocate from 2010 until her retirement, providing direct advocacy support and guidance to individuals who believed they have had an adverse outcome as a result of an experience within the Irish healthcare system.
Brigid is a qualified general nurse and midwife and has worked in healthcare in Ireland and the UK for over 45 years. Her healthcare experience is across hospital, hospice and community settings with significant management experience at various levels throughout her career.
Brigid currently sits on a number of Department of Health and HSE Advisory Committees, National Screening Service Committees as a public representative and is a member of the Board of NOCA.
Recommendations
In summary, the Panel’s recommendations centre around the thematic areas below. Consideration has been given to recommended timelines, recognising urgent and immediate actions that are needed, as well as identifying requirements for the planning and development of actions over the next 18 months, in light of the expected ongoing impact of COVID-19 over that timeframe. The thematic areas associated with the recommendations are: 1) Public Health measures; 2) Infection prevention and control; 3) Outbreak management; 4) Future admissions to nursing homes; 5) Nursing home management; 6) Data analysis; 7) Community Support Teams; 8) Clinical – general practitioner lead roles on Community Support Teams and in nursing homes; 9) Nursing home staffing & workforce; 10) Education; 11) Palliative care; 12) Visitors to nursing homes; 13) Communication; 14) Regulations; 15) Statutory care supports.