Minister for Mental Health and Older People Mary Butler launches the first meeting of the Cross-Departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants

Published on: 04 March 2022

Minister for Mental Health and Older People, Mary Butler T.D., opened the inaugural meeting of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. Minister Butler highlighted the urgent need for the Group to dig deep into the issues and identify solutions to address the current workforce challenges.

Highlighting the unprecedented funding that is available for the provision of services in the home support and nursing home sector Minister Butler said “Government is providing the funding, but we don’t have enough workers to deliver the services to people in need. There are some worrying challenges in the older persons workforce sector which are affecting recruitment and retention of home support workers and healthcare assistants but despite this it is important to note that the total number of people waiting for home support has reduced from over 9,000 at the start of 2020 to approx. 5,800 at the end of 2021 ”.

Minister Butler continued: “Recruitment and retention of workers is the most pressing issue right now, but this is interdependent on broader strategic workforce challenges being experienced in the sector. Increasing pay could increase the attractiveness of the carer role however this alone will not fix the current crisis, every aspect of making the carer role more attractive must be looked at. All organisations and the HSE, are sourcing staff from the same declining pool of candidates, with significantly less new entrants to the carer profession.”

“As we know, the number of older people requiring care is increasing, and we need to address the challenges urgently before the situation deteriorates even further. The work of this Group will centre on engagement with the relevant stakeholders in the sector who have direct experience of the challenges.”

The Department of Health is leading the work of the Group and is joined on the Group by representatives from various Departments (Enterprise, Trade & Employment, Justice, Further & Higher Education, Research, Innovation and Science, Social Protection, Children, Equality, Disability, Integration and Youth, Public Expenditure and Reform,) and HSE, HIQA and SOLAS.

At yesterday’s meeting the Group agreed to adopt the Terms of Reference proposed by the Department of Health, in addition to agreeing the Membership for the Group, the Model of Engagement and the Timeline Plan.

Further engagement by the Group with key relevant stakeholders in the sector will be undertaken in the next 2 to 3 months, in the form of one on one meetings with Stakeholders during March and facilitated workshops with Stakeholders during April.

The Strategic Workforce Advisory Group is working to a tight timeline and is committed to providing a set of recommendations to Minister Butler by September 2022.



Last year additional funding of €150 million was secured for home support to progress the development of a reformed model of service delivery to underpin the statutory scheme for the financing and regulation of home-support services and to provide 5 million additional hours of home support.

The HSE National Service Plan sets a target to provide 23.67 million hours of home support this year and it is estimated that at the end of December 2021 some 20.46 million hours had been provided to over 55,00 people.

This is about 2.9 million more hours compared to the same period last year - an increase of 17%.

The funding secured in Budget 2021 to provide these additional 5 million hours has been maintained for 2022.

Significant inroads have been achieved in reducing waiting lists for funding approval for new or additional service from over 9,000 at the start of 2020 to approx. 5,796 at the end of 2021.

This has been achieved through a combination of validation of the waiting list and availability of funding to address those waiting.

Of those waiting for a carer to become available, at the end of December 2021, 5,322 people had been assessed and are waiting for a carer to become available. In January 2020 there was about 1,300 people in this category.

Certain areas that are experiencing increased pressures, due to workforce availability, are particularly affected.

Despite the increase, it is important to note that the total number of people waiting for home support across both categories has reduced from over 9,000 at the start of 2020 to approx. 5,796 at the end of 2021.

The HSE is aware that there are increasing capacity issues across both direct and indirect provision, and it continues to advertise on an ongoing basis for Health Care Assistants and recruits as many suitable candidates, where possible. The HSE conducts its recruitment through a variety of channels both locally and nationally.

Due to the nature of Healthcare Support Assistants posts, this recruitment is normally conducted at a very local level and is on-going continually across the HSE. Approved Home Support Providers also continue to recruit home support workers.


Strategic Workforce Advisory Group Terms of Reference

1.    Introduction

The Minister for Mental Health and Older People has committed to establishing a Cross Departmental Strategic Workforce Advisory Group. 

Areas to be considered by the Group include the recruitment, retention, education and training, and career development of front-line carers in home support and nursing homes.

2.    Role and Functions

The role of the Group will be to examine strategic workforce challenges in publicly and privately provided front-line carer roles in home support and nursing homes, and to engage with relevant stakeholders to facilitate their views during the process.  The objective of the Group will be to identify the issues concerned, and to make recommendations to the Minister for Mental Health and Older People, where appropriate, to respond to the identified issues and to develop a draft action plan for implementation for the Minister’s consideration.

The Group will:

•    Agree and adopt Terms of Reference.

•    Advise on the further identification of key members who will have responsibility for designated deliverables.

•    Engage with cross sectoral stakeholders, professional bodies and civil service experts.

•    Make recommendations for consideration by the relevant Minister or Ministers. 

•    Review relevant national and international literature to identify best practice.

Terms of Reference 

1)    Agree and progress a structured programme of ongoing consultative engagements with key sectoral stakeholders for the lifetime of the Group to:

a.    further explore and define the issues, listen to stakeholder views and identify approaches to respond to the strategic workforce challenges.

b.    gather information, evidence and data as required from stakeholders to inform the work of the Group.

c.    consult on any proposed recommendations and/or actions arising.

2)    Identify and examine key issues in recruitment, retention, education and training and career development of front-line carers in home support and nursing homes.

3)    Direct the collection and analysis of required data and information, including from the Group’s members or bodies under their aegis, as needed.

4)    Oversee and provide direction, guidance and support in examining these issues. 

5)    Engage with sectoral stakeholders in line with an agreed programme of engagement. 

6)    Provide a forum for agreement on strategic approaches to address the workforce challenges in the sector.

7)    Develop a report for the consideration of the Minister for Mental Health and Older People, providing:

a.    An outline of the Group’s key findings on a thematic basis.

b.    Recommendations to respond to the identified findings, as appropriate.

c.    A draft Action Plan to support implementation of any recommendations.

d.     Consideration, as required, of key enablers and impact assessment (including costs) of actions and recommendations.

e.    Consideration of the need and design of a mechanism for periodic monitoring of implementation of the Action Plan.  

Approval and/or adoption of any proposed Action Plan will be a matter for the Minister, and as required, Government. 


3.    Membership

Members of the Strategic Workforce Advisory Group are responsible for the implementation of agreed relevant actions in their respective organisations. 

The Group will comprise of Cross-Departmental/Agency membership with representatives from:

•    Department of Health (Chair)

•    Department of Enterprise, Trade & Employment

•    Department of Justice

•    Department of Further & Higher Education, Research, Innovation and Science

•    Department of Social Protection

•    Department of Children, Equality, Disability, Integration and Youth

•    Department of Public Expenditure and Reform

•    HIQA

•    HSE Older Persons

•    HSE National HR

•    SOLAS

4.    Terms of Engagement

4.1.    The Chair shall:

4.1.1.     Set and manage the agenda for each meeting. 

4.1.2.    Encourage broad and effective participation from members.

4.1.3.     Conclude each meeting with a summary of decisions and/or actions.

4.1.4.     Sign off meeting minutes in consultation with Team members.

4.2.    It is anticipated that Group will meet every two weeks for the first 6 to 8 weeks and the frequency of meetings thereafter will be determined by the Chair in consultation with the Group. 

4.3.    Attendance is required by members at all meetings, and where this is not possible an alternate will attend in their place, agreed in advance with the Chair. Papers, contributions, and decisions provided by those representing agencies are on behalf of those agencies.

4.4.    A Secretariat will be provided by the Department of Health to assist the work of the Group. It will arrange for circulation of relevant documentation, records of meetings, and communications with regard to the convening of meetings.

4.5.    Meetings will be documented by the Secretary, including actions to be taken, main points discussed, etc.

4.6.    Draft minutes will be circulated to Group members following each meeting and approved subject to any appropriate amendments at each subsequent meeting [approved minutes will be published on the Department of Health’s website subject to limited redaction if required e.g., to protect the integrity of the deliberative process and/or other matters falling under the Freedom of Information Act (FOI)].

4.7.    The Chair may invite third parties to participate in meetings to provide expert input and advice. The Chair may ask such persons to prepare discussion documents as appropriate.

4.8.    Each Group member will be required to provide relevant material, papers, and updates in advance of meetings.