NESC publishes Council Reports 130: Quality and Standards in Human Services in Ireland: Home Care for Older People, and Quality and Standards in Human Services in Ireland: End-of-Life Care in Hospitals
NESC publishes the sixth and seventh of a new series of reports which review quality in our public services.
Achieving quality in public services requires both a commitment to preventing harms and a search for continuous improvement. Over the last decade there has been a ‘silent revolution’ in establishing regulatory infrastructure in the human services in Ireland with, for example, the establishment of the Health Information and Quality Authority (HIQA) and rigorous quality requirements in contracted-out services. Two reports published by NESC today, one on ‘Home Care for Older People’ and one on ‘End-of-Life Care in Hospitals’ demonstrate contrasting but effective approaches adopted to improving standards in two of our public services.
Home Care for Older People
Since July this year, the HSE requires companies providing home care packages on its behalf to meet comprehensive quality standards. This is a positive development, but other types of home care (such as home care provided directly by the HSE, or provided by private companies to individuals) are not required to meet these standards, even though some companies voluntarily apply quality standards.
“This NESC report recommends that national standards and regulations, inspected by HIQA, be applied to all types of home care. This is already a Government commitment, but has not yet been implemented”, said Dr Anne-Marie McGauran, author of the report. “The HSE has already drafted quality standards, and implementing these for all home care services, and backing them up with legislation, would help to improve the quality of home care.”
Guidance for home care providers on how to increase the quality of care they provide is also recommended; as well as collecting standardised data to allow comparison of the quality of care given by different home care providers.
End-of-Life Care in Hospitals
The second NESC report examines end-of-life care standards. With almost 75 per cent of deaths taking place in hospitals and long-term care settings, the Irish Hospice Foundation set up the Hospice Friendly Hospitals programme to develop standards to improve end-of-life care in hospitals.
This programme provides extensive supports to management and frontline staff to help them to implement the standards. These supports include a co-ordinator who works with hospital staff, training courses on end-of-life care, resources such as the relatives’ handover bag (for taking home the deceased person’s belongings), and information leaflets for bereaved relatives.
‘Hospital staff told us how much they liked these supports’, explained Mary , a hospital manager interviewed for the report. ‘They said that it is great to have the little extras like the handover bags and other practical things, that show that there is true compassionate caring, and that there’s been a bit of thought put into it’.
Providing such supports for front-line staff is an innovative way to improve quality in services. However the end-of-life care standards are implemented on a voluntary basis, and funding to employ some of the co-ordinators who have assisted hospital staff to implement them is coming to an end. The report recommends a number of ways in which the HSE, HIQA and the Department of Health could support implementation of these standards into the future, so that the learning from this innovative Hospice Friendly Hospitals programme is not lost.
Further NESC Reports on Quality and Standards in Human Services
NESC is publishing a series of reports on quality and standards in human services. In January 2012 it published an overview of concepts and practices, which examined international and Irish evidence of approaches to regulation and standards-setting in human services, along with the promotion of good practice. This Autumn it has published further reports on quality and standards: in residential care for older people; in policing; and in schools, with an accompanying report on PISA results. In November a report on standards and quality in disability services, and a synthesis report which draws the findings of all the work together, will be published.
To download the reports, visit the publications section of the website.
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Note to Editors
The National Economic and Social Council (NESC) was established in 1973. Its function is to analyse and report to the Taoiseach on strategic issues relating to the efficient development of the economy, the achievement of social justice and the development of a strategic framework for the conduct of relations and the negotiation of agreements between the government and the social partners. The Council is chaired by the Secretary General of the Department of the Taoiseach. It comprises representatives of trade unions, employer bodies, farm organisations, community and voluntary organisations, environmental organisations, key Government departments and has eight independent experts.