To ask the Minister of Health how the use of domiciliary care agencies in the provision of home care packages represents value for money for the Health Service.

Within N. Ireland domiciliary care is provided by both statutory and independent sector agencies. This ranges regionally from an approximate 20 % statutory and 80% independent sector spilt to a 40/60% spilt (respectively) across the region.

The five HSCT’s receive baseline funding for domiciliary care from Strategic Planning and Performance Group (SPPG). This money is devolved down to SPPG from DOH. SPPG have a role to performance manage the HSCT’s against activity delivered in domiciliary care.

The current problem is around the recruitment and retention of domiciliary care staff. The role of a domiciliary care worker is very different now compared to the past. The staff are working with people who have more complex needs, who are living longer and are choosing to remain living at home rather than opting for institutional care. Post covid, family and carers are returning to the work place and therefore have less time to provide care to loved ones which is increasing the demand for domiciliary care.

In NI, the current base rate for independent sector domiciliary care is £18.54 per hour, which is at the lower end of the average across the UK. (It should be noted that some Domiciliary Care agencies may cost more than the base rate of £18.54, depending on the service or locality.)

This largely allows for a pay rate of £10.82 to £11.33 to domiciliary care staff. (Employer’s costs such as NIC and travelling expenses for the direct care and support and corporate overheads subsuming the balance).

This hourly rate supports those who need the services to remain in their own home rather than require more costly support such as a residential care home placement, which in NI currently starts from £694 per week (c£36k per annum) for an Independent Sector residential care home. Or the alternative of a delayed discharge within a hospital setting which costs an average of c£440 per day.

I would direct you to the recent report HOW MUCH DOES IN HOME CARE COST in February 2024 - A Definitive Guide (ukcareguide.co.uk) which indicates:

On average, for the cost of overnight care at home in the UK, or day care, you can expect your home help costs to be anywhere between £15 and £30 per hour;

The average cost for a live-in carer in the UK is between £800-£1500 per week

The research shows that average care home fees range from £27k to £39k per annum for a residential care home.

Strategic Planning and Performance Group are currently working with the 5 HSCT’s on a pilot that is designed to bring some of the previously allocated domiciliary care hours back into the system by ensuring timely reassessment of need post hospital discharge, thereby ensuring efficiency of the baseline resource.

It is very clear that domiciliary care provides value for money over other options available within the health care system.