Out-Law Analysis 4 min. read

Home care could revolutionise the way healthcare is delivered in Ireland

Bringing healthcare services into the home can prevent hospitalisation or the need to visit a GP, saving the national healthcare system as well as providing a better outcome for patients.

While we cannot predict when another pandemic such as Covid-19 may hit, we can predict that Ireland is headed towards ageing populations. People are living longer, and birth rates are slowing, with an ageing population significantly driving the demand for home care services.

To put it into perspective, the number of people aged 60 or over is expected to double by 2050. This will no doubt have a lasting impact on the healthcare sector. Hospitals in Ireland were overcrowded before the pandemic hit, but the full impact of the pandemic really pushed the healthcare system to the limit, causing all healthcare services to be interrupted.

Backlogs and disruption continue to be an issue with long hospital waitlists and delays across both the public and private healthcare sectors. There is a considerable backlog of patients awaiting home care packages upon discharge from hospitals. Consequently, individuals awaiting assistance from home care agencies experience prolonged stays in hospital. This is not ideal when hospitals are already lacking beds for their patients.

Since the pandemic, there has been a noticeable growth in appreciation that many services can be provided at home. This shift can help lessen the burden in traditional healthcare settings, with companies now beginning to recognise the long-term benefits of bringing support to patients within their homes. These non-traditional healthcare settings are being embraced in these post-pandemic years as people are generally more concerned about their health since Covid-19.

Home healthcare provides investment and innovation opportunities

The need to adapt brings with it investment opportunities. The healthcare sector is one which is less affected by the current economic downturn in comparison to other sectors, with geopolitical risks less likely to impact the industry.

Looking at the UK, the home care sector has been growing by 2.4% consistently for the past five years. A recent report from PWC highlighted that private equity has become the dominant source of deals but nevertheless, private equity houses are being careful with their investments and focusing on sectors such as pharma and healthcare.

Many healthcare companies in Ireland and the UK have seized the opportunity to innovate, with the pandemic reassuring people that receiving care at home was both efficient and convenient. HealthNet, a trusted partner of the NHS, has already innovated how clinical home care is delivered across the UK. The service provider has embraced the use of technology and digital tools, demonstrating what can be achieved when the boundaries of traditional models of healthcare in the home are challenged. This provides evidence of the continuing growth and investment opportunities provided by home care firms. TCP Homecare is just one Irish company which is offering a “unique turnkey solution for delivery of hospital care in patient’s home.” Some of the healthcare services being brought directly to a patient’s front door include home nursing, pharmaceutical products, and sharps waste management.

Looking ahead, the option of care at home is likely to expand even more, with artificial intelligence (AI) developing rapidly. AI tools may be able to assist in delivering more of these essential services at home, helping alleviate pressure on traditional environments.

Legislative framework and regulatory consideration look to support home healthcare

For a long time, there have been calls for a national statutory scheme in Ireland to regulate private and public home care and home support sectors.

During 2024, the Irish Department of Health is focused on developing the regulatory framework for home care service providers. The aim is to ensure that all service users are provided with regulated care. In 2011, the Irish Law Reform Commission (LRC) published a report setting out clear recommendations on how this could be achieved.

The Health (Amendment) (Professional Home Care) Bill 2020 (20 pages / 591 KB) is another example of regulatory support, allowing new legislation to amend the Health Act 2007 and implement the recommendations of the LRC.

The definition of designated centres under the act will be amended to include undertakings, both unincorporated and incorporated, and whether established for gain or not established for gain, that are involved in the provision of professional home care services. This definition appears to be in line with Deputy Colm Burke’s comments that “in drafting legislation, we need to make sure we cover all the angles, whether the service is provided by the Health Service Executive or other state agencies, or by private companies.”

The legislation will also require professional home care to be defined as services that ensure an adult person can continue to live independently in their home. This may include the services of nurses, home care attendants and home helps as well as various therapies and personal care. The change provides that palliative care is considered within the definition of professional home care. The broad definition means that a vast range of health care services can be provided within the home under the new legislation.

The bill will also allow the minister for health to put regulations in place for minimum training requirements, additionally providing for the extension of the function of the Health Information and Quality Authority to include standards of service.

However, the bill is currently at the second stage in the Dáil and therefore still a journey away from being signed into law. It means, despite progress being made to deliver the sought-after statutory scheme, there is uncertainty as to when the regulatory changes will come into force. This leaves companies in a position where they can only anticipate how they may be impacted.

Regardless of this, companies need to ensure that safeguarding of patient safety and quality of services exists when transitioning to providing healthcare services in the home. Looking ahead, by leveraging legislative reforms, regulatory frameworks and industry collaboration, healthcare in the home has the potential to revolutionise the way healthcare is delivered.

The strain on healthcare systems, exacerbated by a global ageing population, requires innovation to ease the systemic and financial pressures. It is encouraging that many cutting-edge businesses are looking at new ways to bring healthcare closer to the people, be that for routine treatment or delivery of medicines, in an effort to reduce waiting lists and, ultimately, save taxpayers’ money. A robust regulatory framework is required to facilitate such change with patient safety and quality of services at the forefront, and it is pleasing to see Ireland leading the way with the Health (Amendment) (Professional Home Care) Bill 2020.

Pinsent Masons is hosting an event aimed at Irish healthcare businesses seeking to grow within Ireland and in the US. Further details and a registration link are available online.

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