Increasing use of agency staff by HSE for care of older people 'a healthcare risk', advocates warns

'The agency staffing numbers are like a canary in the coalmine, it’s a warning to us that in this system — which we all think is creaking at the seams — that those fissures are becoming critical now.'

A doubling of agency staff use for older people’s services by the HSE is a healthcare risk and the "canary in the coalmine", warning of serious problems, Age Action has warned.

It follows a report in the Irish Examiner showing money paid to agencies in this sector almost doubled from €64.5m to €118.9m last year. Despite pledges to rein this in, it reached €52.1m spent already by May.

Camille Loftus, head of advocacy and public affairs with Age Action, said she was disturbed but not surprised by the findings.

“A reliance on agency staff in healthcare services is a healthcare risk,” she said.

If you look at instances where there have been errors, failure in care, medical misadventure, you will find very frequently that the use of agency staff was a factor. 

She stressed this was not because temporary workers might not be qualified, but “it does mean they are not familiar with the healthcare setting in which they’re working”. 

She suggested if a nursing home or homecare service was short-staffed enough to need agency help, they were unlikely to have time to offer thorough training on the day.

“If you can see a pattern where a sector in the health service is heavily staffed by people who are not full-time employed, that is an indication of a problem and it is absolutely a risk,” she said.

Low salaries are common in social care for older people, especially in nursing homes, she added.

“We saw the kind of failures that can occur when a provider is consistently understaffed in that RTÉ Investigates programme on nursing homes,” she said.

“At least part of that problem was persistent understaffing. You will remember that horrific scene of that woman standing there with a man desperate to use the bathroom, and she knowing she couldn’t leave over 20 people unattended — that’s an understaffing problem.” 

Undercover footage shot at two homes run by Emeis Ireland was shared by RTÉ in June to widespread outrage.

In general, Ms Loftus said: “When you're dealing with residents where dementia might be an issue, a constant turnover of staff where people don’t know residents’ preferences is worrying.

It’s risky, it makes it more likely something will go wrong for the patient.

The pressures are only likely to continue, with the projected rise in people living longer. She raised concerns about how this is being managed by the HSE and Government.

“The agency staffing numbers are like a canary in the coalmine, it’s a warning to us that in this system — which we all think is creaking at the seams — that those fissures are becoming critical now,” she said.

The HSE said agency staff were used to cover holidays, sick leave or maternity leave, as well as when short-staffed. It acknowledged recruitment as a challenge, saying this was the case for health services worldwide now.

The data was released by the HSE to Sinn Féin health spokesman David Cullinane.

He criticised the HSE’s staff policy — pay and numbers strategy — as ineffective, calling for “an ambitious and realistic workforce plan”.