Plan to upgrade nursing homes over budget and behind schedule

The Government's plans to replace and refurbish dozens of State-operated community nursing homes will cost more than the €385 million originally envisaged and the overall timetable for completing the project will be behind schedule, the Department of Health has said.

In early 2016, the then government announced plans to redevelop or replace 90 community nursing units – mainly older buildings across the country – over a number of years to meet new regulatory requirements which will come into effect in January 2022.

However, the department has indicated it has been warned by the Health Service Executive that there are “issues” relating to the timeline and the costs involved in this plan.

The department's secretary general, Jim Breslin, also said in a letter to the HSE last month that the health service regulator, Hiqa, had raised concerns with regard to some of the community nursing units which formed part of the replacement and refurbishment programme.

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Concerns

“While some of these concerns relate to the physical environment, others relation to the operation of the centres in question. While we must acknowledge that the physical environment in these older buildings needs to be addressed, and there is a plan in place to do so, it is important to ensure that the people who currently use these services have access to good-quality services, at a standard that affords them a positive lived experience.”

“In that regard, mitigating the impacts of older infrastructure, particularly where capital works may take longer than expected, and ensuring that regulatory matters not related to the physical environment, should be a central consideration and objective in the HSE’s approach to managing the continued progress of the community nursing unit programme,” he said.

Mr Breslin said the department understood that of the 90 facilities involved in the plan, by the end of this year work would be completed on 31 centres.

He said it was the HSE’s current expectation is that by the end of 2021, 80 per cent of the community nursing units involved in the programme would either have seen work completed or construction under way. He said it was envisaged that by that stage a further 6 per cent would have secured planning permission for development.

“This means that a certain amount of the community nursing units may not be completed and therefore may not be in compliance with the revised regulatory framework that will come into force from 2022,” he said.

“It is understood that the delay in progressing projects has occurred for a variety of reasons, including greater than expected complexities in design requirements, identification and acquisition of suitable land, changes to scope including enhanced design and improvements and changing regulatory standards (fire,energy, etc).”

Overall cost

Mr Breslin also indicated that the department had been notified that the overall cost of the programme was “expected to be greater than originally estimated including as a result of design, scope and regulatory changes along with general cost inflation”.

The department said work was being carried out by the HSE, including a comprehensive assessment of each community nursing home, setting out its current status, timelines for completion of each stage of the project and reasons for any delay or additional costs.

It said this new work would also consider any potential mitigation measures to reduce delays or additional costs as well as a “review of the scheduling of projects to identify community nursing units of particular concern and/or the identification of revised priority projects”.