Niamh Heneghan, NHI HR Advisor, tells SCP the workforce challenges facing the private and voluntary nursing home sector are complex and therefore require a versatile approach.

Challenges recruiting and retaining staff within our health services, including our nursing homes, must be prioritised in the planning for our healthcare needs. These challenges must not be allowed to compromise care delivery within our health services and there is need for the state to lead in attracting people to pursue careers within our health and social care sectors, with older person care an essential deliberation in this regard.

Whilst the recruitment and retention challenges are not unique to any specific role, presently there is a particular difficulty arising in recruiting Healthcare Assistants (HCAs). This is mirrored across health and social care settings. 


The reasons for these difficulties are complex and multifaceted. An inherently inequitable Fair Deal funding model – a system which effectively enables a significant discrepancy between the funding allocated to publicly fund nursing home resident care in comparison with their private and voluntary counterparts – compromises the ability of the latter to fairly compete with the terms and conditions offered by state care providers.

Whilst it is unquestionable that an urgent reform of the Fair Deal funding model is required to bring parity in supporting the care needs of residents and to facilitate the provision of equivalent terms and conditions for roles, we cannot ignore the reality that additional measures must also be taken to ensure a sustainable future for the staffing of nursing home care in Ireland.

The COVID-19 pandemic highlighted the vital role fulfilled by nursing home staff within society and there is a requirement for recognition of roles in gerontological care to be enhanced in their standing within society. In particular, there is a requirement for greater recognition and enhancement of the role of the HCA in the wider community. This needs to be supported by career development pathways for professionals in the discipline. 

The recent development of the Advanced Healthcare Practitioner Apprenticeship by Griffith College in partnership with NHI and a consortium of other bodies is an initiative is an important milestone in the development of the HCA profession and older person care. This QQI Level 6 programme aims to advance the professionalism and the skillset of the HCA role, and enhance its standing as a profession.

Such a focus on skills development will lead to more people considering becoming an HCA. It will also make the role a more attractive career prospect and support the professional and personal development of those already in the profession. Of course, the reality of the matter is that such progression must also be linked to better terms and conditions and so this must also concurrently relate to the review and reform of Fair Deal funding support.

For the past decade, NHI has called upon the state to engage with regard to the critical requirement to plan for the workforce challenges that present in meeting the growing health and social care needs that come in tandem with a rapidly increasing older population. This necessitates the need to ensure roles in gerontological care are promoted amongst undergraduates and within the education discipline, in tandem with the necessity to ensure they are valued within society. 

Three key pillars should be under consideration for navigation of the challenges presenting for the nursing home sector: 1) A review and reform of the Fair Deal funding model to support the private and voluntary nursing home sector in applying equivalent terms and conditions for employees, bringing parity in the conditions applied for workers in older person care; 2) A promotional campaign to showcase the rewarding nature of careers within the sector, focussing initially on the role of the healthcare assistant and 3) The development of clear career pathways to signpost development opportunities within the sector, encompassing engagement with education institutions.  

The workforce challenges facing the private and voluntary nursing home sector are complex and therefore require a versatile approach. State actors such as the Department of Health and Department of Higher Education must ensure their workforce planning encompasses the voice of the nursing home sector. 


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