Improving access to home support is a priority for the Government, and Minister for Mental Health and Older People, Jim Daly TD, acknowledges concerns and queries raised in the past number of days in relation to home support services.
Over the past four years the Government has overseen a considerable increase of nearly €140 million in the Home Supports budget which has grown from €306 million in 2015 to almost €446 million this year. It is however acknowledged that demand continues to grow, not least on foot of the demographic changes being experienced.
The 2019 Health Service Executive National Service Plan provides for more than 18 million home support hours to be delivered this year to over 53,000 people. This includes Intensive Home Care Packages, aimed primarily at supporting people with dementia, for about 235 people who will benefit from 360,000 hours of support in 2019.
Arrangements for home supports have developed over the years with a significant local focus although it is acknowledged that there may be a considerable variation in access to services in different parts of the country. There is also a considerable demand for home support services over and above existing service levels.
The HSE has assured the Department that those people who are on a waiting list are reviewed, as funding becomes available, to ensure that individual cases continue to be dealt with on a priority basis within the available resources and as determined by the local front line staff who know and understand the clients’ needs, and who undertake regular reviews of those care needs to ensure that the services being provided remain appropriate.
Minister Daly said “We are aiming to improve home support services so that people can remain living with confidence, dignity and security in their own homes. While the existing service is delivering crucial support across the country, it is recognised that home support services need to be augmented to better meet the changing needs of our older population. The Department is currently engaged in a detailed process to develop a new stand-alone, statutory scheme for the financing and regulation of home support services. This is a key action under the Sláintecare Implementation Strategy and will improve access to home support services. The Sláintecare Action Plan 2019 also sets out a very significant programme of work aimed at developing and improving health and social care generally, with a significant emphasis on increased community-based supports. As Minister for Older People I will continue to ensure the development of key community supports and services for our older population.”
Notes to the Editor
*Funding provided in 2015 supported home help hours and home care packages. No direct comparison with home support hours.
**Intensive Home Care Packages are managed at National level and targets are not assigned to individual CHOs.
Statutory scheme for the financing and regulation of home support services
The new statutory scheme will introduce clear rules in relation to the services for which individuals are eligible and in relation to how decisions are made on allocating services. For that reason, developing a new statutory scheme will be an important step in ensuring that the system operates in a consistent and fair manner for all those who need home support services. It will also help to improve access to the home support services that people need in an affordable and sustainable way. The system of regulation for home support will help to ensure that the public can be confident that the services provided are of a high standard. The Sláintecare Implementation Strategy commits to the introduction of the new scheme in 2021.
Although a significant amount of work is required before the new scheme can be introduced, the Department and HSE are committed to incrementally improving the existing home support service in the meantime, including in 2018 the introduction of a single funding stream for home support services. This is providing significant benefits including making the services easier to understand; streamlining the application and decision-making processes; and facilitating service users to move to changed levels of service as their assessed needs change, without the need for an additional application process.
In order to progress the new home care scheme and system of regulation it is necessary to identify, understand and map existing structures, policy, processes, shortcomings and good practices as they currently exist. To this end A Programme for a Partnership Government commits to a review of the management, operation and funding of existing services. Work is currently being progressed in relation to this which will provide a baseline for the design of an effective, sustainable service as part of the development of a statutory home care scheme. Approval has been granted for the engagement of consultants to assist with this piece of work and tender documents are currently being prepared by the Department of Health who is taking the lead on this piece of work. The review is expected to be concluded in Quarter 4, 2019.