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Currently, home care packages can only be tracked through Community Healthcare Organisations (CHO).
As part of the Winter Initiative 2016/2017, funding for dedicated home care packages was provided for a specific number of acute hospitals on a weekly basis, through the relevant CHO, which was in addition to the general provision of home care for the CHO catchment area.
These dedicated HCPs were reported on weekly as part of the Winter Initiative meetings, which were attended by Minister for Health Simon Harris, along with other stakeholders in the Department and HSE.
While the Department wanted this level of reporting to be made throughout the year, the HSE said this was not possible, stating that the current allocation of home care was for the CHO catchment area and not specifically for acute hospitals within that area.
“This is of concern to the Department, who noted that we should aim to have an IT system that would facilitate HCPs (and the related budget of €350 million) being tracked by both supply and demand and giving details of referral pathway,” according to the minutes of the Winter Initiative meeting on 25 October 2016, released to MI through Freedom of Information legislation.
A HSE spokesperson told MI that the vast majority of HCPs are provided to people who live in the community, though “every effort is made to prioritise home care for those ready for discharge home from acute care”.
“The HSE reporting systems are manual, and while it was possible to track these limited number of HCPs for the 17-week Winter Initiative period, it is not possible to provide this level of reporting for every acute hospital on an ongoing basis,” according to the spokesperson.
“The home care activity is recorded monthly at CHO level and reported on as part of the overall performance against the National Service Plan agreed targets. The current IT system does not allow for collating the information in the format suggested by the Department of Health.”
A Department spokesperson told MI that it was seeking to understand the origin of the referral for a HCP (ie, the level of demand from individual hospitals, primary care, etc).
“As part of the Winter Initiative process, it was clarified that HSE information systems currently record home care packages by CHO area and performance is monitored monthly against the National Service Plan agreed targets,” according to the spokesperson. “The current IT system does not allow for collating the information in the format suggested.”
The Department has commenced an examination of options to bring greater national consistency to the regulation and financing of home care.