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Minister for Mental Health and Older People, Mary Butler TD, has acknowledged the publication of the Value for Money and Policy Review of Nursing Home Care Costs.

The report was produced by an independently-chaired steering committee, comprising representatives of the Department of Health (DoH), the Department of Public Expenditure and Reform (DPER), the National Treatment Purchase Fund (NTPF), the Health Service Executive (HSE), and the Economic and Social Research Institute (ESRI).

The purpose of the Review was to identify and analyse the reasons for any cost differential between the provision of care in private/voluntary and public nursing homes. 

The report found that the cost differential is largely driven by variances in staff-to-resident ratios and the skill mix in public and private nursing homes. However, the review also found that establishing like-for-like comparisons was complex and not always possible, especially when considering differences in dependency levels. 

The report has made 9 recommendations for improving the value for money obtained by the State, covering various aspects of the issues considered. These include for example the roll out of a standard assessment tool for care needs, agreement on a safe staffing and skill mix framework for residential care and supporting people to live in their own communities for longer through the provision of home support. Significant work is underway in each of these areas and all recommendations will be taken forward by the Department of Health and other stakeholders. 

Minister Butler said: “A significant amount of work has gone into producing this report, and the delivery of the recommendations, many of which are already underway, will contribute substantially to addressing the issues identified. I am committed to ensuring that we achieve the best possible quality of care in nursing homes, whilst also ensuring that we achieve value for money in the delivery of our services.”

The Department recognises that the work arising from these recommendations will involve significant research, policy analysis and development work, and an extensive input from clinical, economic, and legal sources. The implementation of the recommendations will also have regard to other recent reports, including the final report published by the COVID-19 Nursing Homes Expert Panel and the NTPF Review of the Pricing System for Private Nursing Homes. 

ENDS//

Notes to editor:

• Whilst the report identified differences in the cost to the state of care provided in public and private nursing homes, these do not lead to differences in the cost to the individual; this is determined by a person’s financial assessment, based on their own assets and income. 
• The Nursing Homes Support Scheme (NHSS) was established by the Nursing Homes Support Scheme Act 2009. The NHSS covers long-term nursing home care only.
• As of October 2021, there were 22,301 people supported by the NHSS. Of these 4,487 resided in a public nursing home, while 18,104 were in a private nursing home. The NHSS budget was €1.04 billion. 
• NTPF negotiations relate to private and voluntary nursing homes. Public (HSE) nursing homes are not subject to the negotiation process. The HSE determines the cost of care for public nursing units. The current NTPF criteria for price negotiations are:
  1. the costs reasonably and prudently incurred by the home and evidence of value for money; 
  2. the price(s) previously charged; 
  3. the local market price; and, 
  4. budgetary constraints and the obligation of the State to use available resources in the most beneficial, effective and efficient manner.