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The IMO has welcomed today’s publication of the Expert Panel Report on Covid-19 and Nursing Homes, and thanks the expert panel for the opportunity to present the views of the medical profession.
The position of the IMO has long been that a new framework is required for the medical care of patients in nursing homes and supports for older persons in the community.
Dr Denis McCauley, Chairman of the GP Committee of the IMO, said: “We welcome the expert panel’s acknowledgement of the vital need to recruit more GPs, address longstanding capacity issues, and empower GPs to work more effectively in the community and in nursing homes. GPs, along with their colleagues in public health, community geriatricians and nursing home staff, have provided an exceptional service to vulnerable patients despite the challenges posed by the Covid-19 crisis. However, it must be noted that the system for the provision of medical care for nursing home patients was not adequate prior to Covid-19 and was made all the more challenging by the impact of the pandemic.
“These recommendations are a step in the right direction that the Government must acknowledge and address as a matter of urgency, and the IMO is seeking urgent discussions with the Department of Health and HSE to develop a framework for medical services to patients in both public and private nursing homes.
“Too often we have seen reports like these gather dust, and this cannot be allowed to happen now. We need strong and decisive action in order to address these legacy issues.”
Dr McCauley said this report also backed up recommendations from the Scally and Crowe Horwath Reports which include granting consultant status to public health specialists. “We are facing a public health emergency, so we need to properly resource the sector. It is unacceptable that we cannot appoint public health consultants at a time when the country is depending on their expertise.”
Nursing Homes Ireland (NHI) has stated the report should represent a “milestone” for care of the older person. NHI stated its recommendations require immediate prioritisation by Government and the required backing by the State to address substantive policy shortcomings that have deprioritised nursing home care within our health services. There is requirement to implement measures with immediacy where feasible.
Mr Tadhg Daly, NHI CEO stated: “The expert panel finds nursing home care has been an outlier within our health services and there is requirement for enhanced and more formalised integration of it. Coupled with this, it advances long-standing requirement for policies to remove the disjointed nature of financing, provision and regulation of nursing home care.”
NHI has also welcomed the public health measures recommended by the panel.
The report states the very infectious nature of Covid-19 makes it difficult to prevent and control in residential care settings and people within them are disproportionately likely to contract it given they are more medically vulnerable and frail. The recommendations include access to personal protective equipment, timely testing of residents, enhanced infection prevention control measures.
Mr Daly stated: “The measures recommended to protect residents in our nursing homes must be a public health priority and must be in place across the country as we continue to live with COVID19 and do all we can to protect residents in our nursing homes.”
A critical finding in the report is the positive feedback derived from the engagement between nursing homes and HSE CHO teams in managing and responding to the virus, with respondents calling for continuance of the enhanced working relationship. Mr Daly welcomed its recommendation for such engagement to become permanent within our health services.
He said: “Enhancing working relationships between community healthcare specialists and nursing homes and introducing greater integration can ensure residents have their specialised care needs crucially supported through timely access to medical, clinical and community healthcare specialists.
“The recommendation that an identified GP lead be contracted to engage with individual nursing homes was one that was glaringly absent from the heralded GP agreement and now requires urgent prioritisation for nursing home residents. We note the panel “fully recognises the existing significant capacity constraints with regard to GP manpower” but states “the importance of the general practitioner in providing clinical support and services in nursing homes cannot be overstated”.”