The Department of Health has this morning communicated measures to be announced by NPHET (the National Public Health Emergency Team) to support disease management in nursing home care.
Read the Department's letter presenting six key measures here.
Measure 1 informs of the establishment of national and regional Covid-19 Infection Prevention and Support Teams with an allocated IPC advisor to liaise with every nursing home. We will immediately engage with the Department and HSE with view to establishing the contacts that will be in place to support every nursing home on the ground.
We are in daily contact with the Department and further representations will be advanced on behalf of nursing homes with regard to the measures just presented to us.
This morning a conference call is being undertaken with HIQA and we will be impressing upon the Authority the requirement to be supportive of the sector during this health emergency.
The proposed financial support scheme to support nursing homes during Covid-19 is separate to the above measures and as per previous communication, the Minister for Health committed to NHI to announce funding support for nursing homes at the end of the week.
Chief Executive Officer
30th March 2020: Nursing Homes Ireland met today with Minister for Health Simon Harris and his officials. In the one-hour-plus meeting, NHI outlined measures it believes necessary to address the Covid-19 emergency in all nursing homes, public, private and voluntary.
Tadhg Daly, NHI CEO said: “We welcome dialogue with the Minister, coming even as it does some way into the crisis. Over 450 private and voluntary nursing homes are providing care to 25,000 people across the country and are on the frontline in the response to Covid-19. We brought to the Minister challenges being presented to us by nursing homes across the country and he also heard from representatives working within nursing homes. We informed the Minister of the considerable challenges for hundreds of nursing homes in meeting the care needs of our most vulnerable during Covid-19. The challenges presented to the Minister centred around timely access to PPE equipment and testing within nursing homes, the necessity for the State to recognise the essential need for nursing homes to be supported around the critical area of staffing, and the need for enhanced staffing and logistical arrangements during this emergency to be recognised in Fair Deal. We thanked him for his engagement and the Minister committed himself and his Department to work constructively with our sector during this public health emergency. He committed to immediately addressing PPE and staffing issues and to bring forward a package of financial supports for nursing homes before the end of the week. No detail was given. It was appreciated by us that the Minister thanked nursing home staff for their dedication and professionalism and recognised the essential role nursing homes fulfil within our communities in meeting care needs.”
Tadhg Daly, NHI CEO, is available for further comment. Media interviews will be facilitated by Michael McGlynn, NHI Communications and Research Executive, who can be contacted at 087 9082970.
Today we provide updates regarding:
HSE communication with NHI re Covid-19 support measures
Within our Covid-19 Friday Members Update we informed of representations to HSE CEO Paul Reid. We received a response from HSE this weekend with regard to matters raised.
The HSE acknowledges the preparedness of nursing homes within a short timeframe for the challenges presented and the risk that the spread of the virus poses to nursing home residents and staff.
The Executive informs it has taken measures to support the sector through:
The HSE informs the management at local level of the Covid-19 measures rests with Area Crisis Management Teams (ACMTs) chaired by the 9 Chief Officers of the CHOs (Community Healthcare Organisations) and including all relevant HSE services including public health, acute hospitals, National Ambulance Service.
It states: "All ACMTs have been asked to prioritise residential care as a focus for testing and management of outbreaks given what we have learned to date about the nature of the spread of the illness related to the virus. ACMTs are asked now to form on an ‘as needs’ basis multi-disciplinary crises teams to include input from public health specialists professionals such as consultant geriatrician and palliative care, senior nursing and management to liaise and work with individual centres who are experiencing an outbreak. These teams will be linked closely to their respective ACMTs to advise on unfolding situations and steps to be taken to support the nursing home to regain a ‘steady state’. It will, of course, be imperative that nursing homes will be taking all the steps necessary to prepare for and contain such outbreaks including ensuring that there is sharing of staff across the sector, supporting contingency arrangements for medical cover etc. Each circumstance may need different solutions and the expertise of the HSE multidisciplinary team linking closely with the registered provider and person in charge to support their plan will help support this through."
With regard to access to PPE, it states the significant delivery anticipated over the weekend will be of assistance in supporting the prioritisation process and ensuring that it can be made available in a timely manner particularly to nursing homes who have outbreaks. It informs engagement will be undertaken with HSE procurement early next week "to ensure that the process through the ACMTs is working well from a logistics perspective, albeit with constraints remaining until we have a steady supply of PPE as we move forward".
Our representations for the HSE to desist from recruiting from our sector will be referred to its head of HR, we are informed.
You will be aware our engagement with the HSE is continuous and we will follow-up further with regard to the effective operation of Area Crisis Management Teams in their support of nursing homes at local level.
HSE helpline for occupational advice for healthcare workers
The HSE has established a helpline specifically to support healthcare workers in relation to occupational health advice during Covid-19. Arising from NHI representations, the helpline is open to nursing staff within our nursing homes and also providers of care. The contact number is 1850 420420 and the helpline is available 8am to 8pm Monday to Friday and 9am to 5pm Saturday and Sunday.
Reminder: Essential workers letter template
Our Update on Wednesday provided you with a template for utilisation by your staff in presenting to emergency services that they are essential workers fulfiling frontline duties. We are providing the letter to you again for utilisation:
Download the letter in PDF format here
Download the letter in Word format here.
Minister for Health meeting tomorrow
A reminder that representatives from our sector are meeting with Minister for Health Simon Harris tomorrow. Critical challenges presenting that will be brought before the Minister will principally be:
We will of course update Members post-meeting and wish you a safe Sunday.
Communications & Research Executive
NHI COVID-19 Guidance - extensive relevant resources are available on their website
Sector disappointed Minister for Health hasn’t met it despite numerous requests over four weeks
25th March 2020: Nursing Homes Ireland has requested an urgent meeting with the Minister for Health re the nursing homes sector and the unprecedented crisis presenting for it by Covid-19. While every measure is being taken by the sector to protect residents and staff during Covid-19 and provide best possible care, it feels it lacks the commitment and support necessary from the Minister. Private and voluntary nursing homes are providing care to 25,000 of Ireland’s most vulnerable people.
The sector is disappointed the Minister for Health and the Government is ignoring it during a health crisis that threatens 25,000 residents in private and voluntary nursing homes and a further 5,000 in HSE homes. Despite numerous representations to the Minister for Health, his party colleagues and senior Department of Health officials for a meeting with Minister to discuss the challenges presenting for private and voluntary nursing homes, no meeting has been forthcoming.
Specific guidance is needed as to what nursing homes should do in the crisis. It is sadly inevitable that nursing homes will experience severe staff shortages at the very time that staff are needed most to care for residents.
We respectfully but urgently ask the HSE to give specific guidance to nursing homes on how they should manage in the crisis and the support necessary from the Government and NPHET. Furthermore we ask that the HSE give immediate consideration to how some of the additional staff currently being recruited by the HSE will be deployed in the nursing home sector as the need arises.
To not issue specific contingency guidance to nursing homes and to not regard all nursing homes as part of the national health infrastructure that needs to be staffed during the crisis would be unconscionable.
Tadhg Daly, NHI CEO states: “It’s astonishing we are now well into a health crisis of a magnitude never presented before and the Minister for Health and his Government have not engaged with a sector providing care to thousands of the most vulnerable people. We view it as a failure by the Minister that we have to keep endlessly pursuing him as this crisis escalates hour-by-hour, day-by-day. Unprecedented challenges present in ensuring we are positioned to meet the care needs of nursing home residents. Yet we are chasing the Minister for Health for weeks.”
Challenges presenting include provision of specialist and necessary equipment, ensuring we are positioned from a workforce perspective to ensure nursing homes can manage during the emergency, how engagement with the wider health services will work and fellow healthcare professionals with regard to Covid-19 contingency measures.
Mr Daly cited access to personal protection equipment by way of example. “Nursing homes cannot access the required personal protective equipment they require to minimise risk to residents and protect staff as the HSE has commandeered it all. Suppliers won’t sell to anyone except the Government. There is a lack of consistency being applied by the HSE at local level in facilitating access to equipment.
“We’re told by An Taoiseach and Government we are in this together but the ignoring of our sector defies such pronouncements. We are on the frontline of healthcare delivery in hundreds of communities across Ireland. The lack of engagement is a major insult to nursing home residents and staff and defies logic given the nature of this public health emergency. We have an absolutely essential role to fulfil in supporting our health services during this unprecedented time. Failure to appropriately engage and support our sector will actually diminish the capacity of our health services and increase pressures upon acute hospitals.”
Tadhg Daly is available for interview. Media interviews will be facilitated by Michael McGlynn, NHI Communications & Research Executive at 087 9082970
This medical directorate has been issued to the National Ambulance Service by the HSE and has been provided to NHI for circulation to nursing homes. It states: "Health care workers may require COVID19 testing to be in a position to return to patient care duties. These important health staff need to be prioritised over other candidates for testing. A negative test will allow them to return to work quickly." Read the directorate here.
This HSE guidance applies for a patient in the last hours of days of life, informing it is helpful if ‘anticipatory medicine' is administered for symptom control at end-of-life. Download the guidance here.
It also advises for more detailed guidance you can visit https://www.palliativecareguidelines.scot.nhs.uk.
It should be noted: "Adherence to guideline recommendations will not ensure a successful outcome in every case. It is the responsibility of all professionals to exercise clinical judgement in the management of individual patients. Palliative care specialists occasionally prescribe or recommend other drugs, doses or drug combinations."
Potential offered by nursing homes to provide rewarding employment
On St Patrick’s Day, Nursing Homes Ireland has appealed to people within our hospitality and retail sectors to look for opportunities that will present in providing care to older people during the Coronavirus emergency.
Staffing needs will arise for nursing homes in meeting the care needs of older people, with the disciplines in nursing homes being wide-ranging. Roles on a temporary basis that may interest people could include those of healthcare professionals including nurses and physios, healthcare assistants, catering, activities, ancillary or administrative support. NHI has informed Minister for Health Simon Harris of the unparalleled challenges COVID-19 presents with regard to healthcare staffing which will similarly present for nursing homes across the country.
Tadhg Daly, NHI CEO said: “We’re in the midst of a national health emergency and are facing up to challenges that have never been presented to us before. A nursing home has to meet all the care needs of people who require specialised and highly dependent services on a round-the-clock basis. Nursing homes are preparing as best they can to meet the unprecedented challenges that will face them in the coming weeks and possibly months. One considerable concern is to ensure a staffing complement is consistently available to meet the day-to-day social care needs of nursing home residents especially at a time of emergency and with visitor restrictions. Irish people have a tremendous ability to support one another during difficult times and this has never been more required. Nursing homes will need that resilience and flexibility from within their communities in the weeks ahead and opportunities will likely present for roles to be filled.”
NHI has urged people who feel they can contribute to care of older people to present such to nursing homes by way of outlining their skillset in a short email and to present their CV with it. A list of email addresses for nursing homes is available at www.nhi.ie and queries or CV’s can also be submitted to firstname.lastname@example.org.
Short, medium and long-term contracts can be offered by nursing homes, as well as flexible working arrangements.
Mr Daly said: “As per all health services, nursing homes are under huge pressure with visitor restrictions at present so we ask people to contact their local nursing by way of email. A listing of Nursing Homes Ireland Members is available from our website. We thank people for their support of our sector during this national health emergency.”
He concluded: “Working with older people can bring satisfaction that cannot be achieved in other jobs. Nursing homes are community settings with very special residents and staff. These highly regulated, healthcare settings provide excellent opportunity to enhance people during these challenging times.”
Tadhg Daly, NHI CEO, is available for further interview. Media interviews will be facilitated by Michael McGlynn, NHI Communications & Research Executive at 01 4699806 or 087 9082970. Please note, recruitment queries should be directed to individual nursing homes and not Michael.