An independent review of almost 1,000 Covid-19 deaths in nursing homes, is among 20 recommendations being considered by a cross-party Oireachtas committee.
The special committee tasked with examining the State’s response to the Covid-19 pandemic has drafted its findings on nursing homes having taken evidence from key stakeholders, including the HSE, Health Information and Quality Authority (HIQA), Nursing Homes Ireland and Sage Advocacy, in recent weeks.
The committee also received written submissions from medical experts and organisations and groups advocating for the rights of older people.
The draft committee report, seen by the Irish Examiner, acknowledges that Covid-19 was “most deadly” in nursing homes, with close to 1,000 deaths and accounting for more than half of all Covid-19 fatalities in the country to date.
The report details 20 ‘potential’ recommendations, including seeking an independent review of the circumstances of all nursing home deaths during the pandemic.
During committee hearings, Dr David Nabarro, a special envoy for the World Health Organization, suggested Ireland was at the “upper end of the spectrum” in relation to nursing home deaths. Where more than half of all Covid-19 deaths occurred in nursing homes in Ireland the comparative figure internationally was 25%, although Dr Nabarro also noted there were differences in how deaths were recorded by each country.
The draft committee report found that almost one in five (18%) of 30,000 nursing home residents contracted Covid-19 but also noted that half of all nursing homes remained virus-free.
The committee said it was not able to establish if there was any correlation between nursing homes that had a Covid-19 outbreak and nursing homes that HIQA had identified as being “of concern” from an infection control perspective but that the matter warranted further examination.
As previously reported by the Irish Examiner, HIQA had identified 19 publicly-funded nursing home facilities as “high risk” for the spread of Covid-19 due to multiroom occupancy and shared facilities.
The report notes that HIQA declined to provide the committee with a list of private nursing homes with similar infection control concerns that the authority had sent to the Department and HSE at the end of March.
“The Committee is of the view that HIQA and the HSE need to review the extent of the impact Covid-19 had on both the publicly and privately-run nursing homes on these lists,” the draft report states.
The Oireachtas committee report said greater consideration should have been given to the impact of discharging patients from acute hospitals to nursing homes and found that delays in Covid-19 testing, along with delays in providing results, impacted on the ability of nursing homes to fight the virus.
The “fragmented relationship” between public health authorities and the private nursing home sector, the committee found, had also contributed to the spread of the virus.
The draft report concluded that the overall model of care for older people was “deeply flawed” and recommended integrating private nursing homes into the wider framework of public health and social care.
Other recommendations include an urgent review by the Department of Health of clinical oversight and governance arrangements in private nursing homes, strengthening the role of HIQA, regulating staff ratios in nursing homes, and adopting a “whole care” approach in future pandemic planning.