NURSING HOME EXPERT PANEL - STRONGER CONNECTIONS IN LONG-TERM CARE A look at service improvements being designed and implemented by HSE teams, responding to the work of the 2020 Nursing Homes Expert Panel
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or those living in long-term care, and those who care for them and live alongside them day-to-day, and for their loved ones and families, COVID brought severe hardship, isolation and loss. The Expert Panel report gave everyone connected to long-term care – residents, families, healthcare teams, providers and advocates - a clear review and analysis of how Ireland’s long-term care system responded to COVID-19. As well as representing the experiences of those involved, the expert panel report also aimed to be future-focused, giving guidance on what can be improved in our services. This is so that we are better placed to respond to any future risk and to improve people’s day to day experience of long-term care. HSE teams all over the country are involved in implementing over 60 of the report’s recommendations. COVID-19 Teams (CRTs) actively support prevention, preparedness and management of outbreaks, in public, private or voluntary provider facilities. CRTs facilitate access for nursing homes to a range of HSE supports, including Public Health and Infection and Prevention Control advice and guidance, support and training, PPE and temporary staff accommodation. As acknowledged by the Expert Panel, these interventions played a central role in supporting the welfare of nursing home residents throughout the pandemic. While significant progress has been made with regard to the number and severity of COVID-19 outbreaks, supported by high vaccine uptake among residents and staff, there is a need for continued vigilance. The focus for the CRTs is increasingly to proactively engage with facilities, including those who have previously experienced significant outbreaks or where concerns have previously arisen. Work is also underway to establish Community Support Teams, who building
on the work of the CRTs, will support nursing home providers to self-manage prevention, preparedness planning and outbreak management in the event of further Covid-19 surges or other infectious outbreaks. Training and professional development is another area of focus, and funding has been secured to support gerontological nursing training, as well as engagement with our existing staff on training needs.
"While significant progress has been made with regard to the number and severity of COVID-19 outbreaks, supported by high vaccine uptake among residents and staff, there is a need for continued vigilance." Work is also well underway to strengthen the public health workforce, who support nursing homes as part of their work, and also in delivering enhanced multidisciplinary teams. Recruitment campaigns have progressed at pace to deliver 250 WTE additional permanent multidisciplinary resources, 210 of these posts have been accepted, and recruitment is now 83% complete. Structured and attractive career pathways have been developed for Health Protection Nurses and Public Health Surveillance and Epidemiology. The HSE has also progressed recruitment campaigns for the first 34 WTE Consultant in Public Health Medicine posts in Ireland. One of the significant challenges experienced during the COVID response was the lack of connected IT systems across this sector. This hampered services’ ability to share information with central teams, and increased pressure on staff on the ground, on facility management, and on central
co-ordinators, public health teams and more. The eHealth ICT Capital Plan includes provision to implement an IT platform within our Community Services, including in Older Persons Services. Responding to recommendations enhanced approaches to end-of-life care, at all times, but also in the context of a pandemic, the HSE and Irish Hospice Foundation are collaborating on a national programme on palliative, end-of-life, and bereavement care for the nursing home sector. Part of the HSE response has been to agree a community strategy for infection prevention and control. This sets out priority actions to 2023 for the establishment of community based teams to ensure Infection Prevention and Control and Antimicrobial Stewardship expertise is available in CHOs and Community Health Networks. The HPSC continues to offer ongoing guidance to support safe visiting with residents of Nursing Homes during COVID, which is continuously updated to reflect current public health advice, and to ensure that the personal needs, dignity and wellbeing of residents is at the heart of the guidance. COVID-19 is still very much with us, though we have turned an important corner by efficiently and swiftly vaccinating a large majority of our population. The work done to respond to COVID, to support and care for our residents and clients in unimaginably difficult circumstances, is hard to encompass, and each member of staff should feel extremely proud of their efforts. As we work through the Expert Panel recommendations and implement them as a service, we want to thank each member of our teams for all they do to improve the experience of each person and resident we have the privilege to care for. For updates and progress reports go to: https://www.gov.ie/en/publication/3af5acovid-19-nursing-homes-expert-panel-finalreport/
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