Mary Butler (Waterford, Fianna Fail)
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In March 2022, the Minister for Mental Health and Older People, Mary Butler, T.D., established a cross-departmental Strategic Workforce Advisory Group and this Group was charged with examining, and formulating recommendations to address challenges in front-line carer roles in home support and long-term residential care sectors. The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022 and made 16 recommendations spanning the areas of recruitment; pay and conditions of employment; barriers to employment; training and professional development; sectoral reform; and monitoring and implementation.

The implementation of the 16 recommendations is underway by a cross-departmental group, chaired by the Department of Health. The implementation group meets quarterly and publishes progress reports thereafter. The implementation group met for the fourth time in May 2024 and a progress update will be published shortly.

A new HSE home support tender has been in place since August 2023. This delivers on commitments for sectoral reform such as payment for travel time for home support providers, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding. Additionally, recommendation number 9 is fully implemented. The statutory instrument authorising the issuance of 1,000 employment permits for homecare workers was signed on 16 December 2022. 917 permits have been issued as of June 2024.

The Home Support Service is funded by Government to deliver a volume of service each year as approved in the HSE National Service Plan. It aims to enable older people to continue living in their own homes with confidence, security and dignity, and the Government has stated its aim to improve community-based services to make this possible. Home support is a non-statutory service and access to the current service is based on assessment of the person’s needs by the HSE, having regard to the available resources and competing demands for the service. Home Support Services for Older People are provided either by directly employed staff or by voluntary and private providers who have formal tender arrangements with the HSE to deliver the services.

Recommendation 1 of the Strategic Workforce Advisory Group calls for a national campaign to raise the profile and promote the training opportunities available for a career as a healthcare assistant and home support worker.

Recommendation 3 calls on the HSE to build its capacity for timely, targeted, and locally focused recruitment of healthcare assistants and home support workers, to include enhanced advertising of vacant roles. It is also recommended that a rolling recruitment campaign should continue in each CHO for as long as positions remain unfilled.

Recommendation 11 proposes that there should be a significant increase in the proportion of home support hours and packages provided directly by the HSE.

Regarding the recruitment of direct Home Support staff, the HSE conducts local rolling recruitment campaigns across the CHOs. A process is in place across the HSE whereby service areas may seek approval for the recruitment of certain grades of staff including Home Care Assistants (Home Support) to assist with patient flow. Additionally, the HSE has encouraged its Chief Officers, where appropriate, to consider increasing the hours of current home support staff who may have additional capacity.

In June 2023, the HSE launched an action orientated Resourcing Strategy to help address the future workforce needs of the HSE. This programme of work has been developed with and by the services. It is driven by 5 professional led service groups, one of which is focused on Patient Client Care and Support Grades to include home support workers. The Strategy is available at the following web-link:

The HSE and Department of Health continue to monitor the proportion of directly provided service through the performance management framework. The Department of Health is currently developing a regulatory framework for home support providers. This will consist of primary legislation for the licensing of providers, secondary legislation in the form of regulations, and HIQA national standards. The introduction of this framework will ensure consistent high quality service across public and private providers of home support. This will offer quality assurance to service users that their service meets the same minimum standards wherever and however it is provided.