COVID-19 Nursing Home Expert Panel: Final Progress Report sees Government commit to ‘reform for older persons' care’

Posted 14 July, 2022

How Ireland cares for its older generations could undergo widespread reform as the Government commits to delivering the broad and comprehensive recommendations of the COVID-19 Nursing Home Expert Panel.

Following the Fourth and Final Progress Report based on the work of the expert panel, originally chaired by Professor Cecily Kelleher, College Principal for the UCD College of Health and Agricultural Sciences, Minister for Mental Health and Older People Mary Butler, TD said the pandemic had “shone a light on older persons’ care and highlighted many fragilities within” the system.

“The Expert Panel recommendations have provided a guiding framework not only for the pandemic response in nursing homes over the last two years but also more broadly for a wide-ranging programme of improvement and reform for older persons’ care.

“[This work] resulted in the garnering of significant commitment to and momentum for wide-scale improvement across all stakeholders.”

Adding: “I am committed to continuing to work with the department, HSE, HIQA and stakeholders in further delivering on this crucially important and extensive programme of work."

Established in early 2020 following a recommendation from the National Public Health Emergency Team (NPHET), the COVID-19 Nursing Home Expert Panel examined national and international measures in response to COVID-19, as well as emerging best practice.

In August of that year, it published a report containing 86 recommendations in line with the lessons learned to date aimed at safeguarding nursing home residents over the next 12-18 months and into the longer term.

An oversight group was swiftly established to action the recommendations contained in the 2020 report and included an Implementation Oversight Team (IOT) and a stakeholder Reference Group.

“Much has been done, but we must roll out the rest,” said Professor Kelleher, who described the Government's reaction to the 2020 report as “a very positive response”.

“It was taken seriously, and in such detail that the root and branch of every recommendation was examined.

“Two years on, and we've produced this final very sustainable report which tells us exactly where we are with each of the recommendations. I would say it was very positive that the actions were taken, and that the Government has published a report that outlines what has been achieved and what else is to be done.”

Adding: “A key highlight is that the prevention and control mechanisms for first incidents of COVID-19 are still in place, as are the resources that were put into them. And the commitment is there to support transitioning the COVID-19 response teams to long-term Community Support teams.”

The Fourth Progress Report highlights that many of the short and medium term recommendations aimed at safeguarding people living in nursing homes against COVID-19 have already been mainstreamed into normal day to day activities.

This includes actions taken by nursing home providers and the provision of a range of State supports to nursing homes which are ongoing, including:

  • Free PPE.
  • Access to expert advice and support via COVID-19 Response Teams.
  • Serial testing programme.
  • IPC training and guidance.
  • And financial supports under the Temporary Assistance Payment Scheme

The report also outlines the progress in relation to those medium to longer term strategic reforms recommended by the Expert Panel. Highlights, including

  • The provision of over €22m in Budget 2022 for the main streaming of a range of Expert Panel recommendations, including the establishment of permanent Community Support Teams, piloting of clinical governance oversight committees and the development of a Safe Staffing Framework for the sector.
  • The development of legislative proposals to enhance governance and oversight of nursing homes.
  • The roll-out of a National Nursing Home Experience Survey this year, and the development of a National End of Life Survey for 2023.
  • The extension of Patient Advocacy Service to all nursing homes before the end of 2022.
  • The development of a multi-annual End of Life Care Education, Training and Support Programme for nursing homes.
  • And, a report by the cross-Department Strategic Workforce Advisory Group examining workforce challenges in front-line carer roles in home support and nursing homes

“We would greatly have preferred that we'd never had had the pandemic and so much of the suffering, ill-health and difficulties for older people in nursing homes,” said Professor Kelleher.

“It posed unprecedented challenges for residential care settings, and we still have to understand the impact it had on the well-being of those who had to cocoon.

“[But] a key takeaway is that this experience has shown we need a long term and sustained community wide approach to caring for older people. Anything that will help keep people in their homes and communities.

“We need to ensure the well-being of older people is at the centre of health policy into the future. There has been much progress, but the impetus must be kept up to deliver on the recommendations in full," she added.

Professor Kelleher was joined on the COVID-19 Nursing Home Expert Panel by Professor Cillian Twomey (Retired Geriatrician), Petrina Donnelly, Group Director of Nursing, RCSI Hospital Group, and Bridget Doherty, acting as a patient advocate.

The work for the Expert Panel and the establishment of the IOT and the Reference Group to action the recommendations of the 2020 report were presented at year's Universitas 21 Health Group summer school by Professor Kelleher earlier this month.

By: David Kearns, Digital Journalist / Media Officer, UCD University Relations