While Irish society emerged in 2021 from the unprecedented restrictions imposed by the Covid-19 pandemic, people with disabilities continued to face challenging and often life changing situations. These have included delayed court hearings, delayed transfers from residential settings and problems accessing home support.
This is a key finding of the 2021 Annual Report of the National Advocacy Service for People with Disabilities (NAS) which highlights the key activities, statistics and achievements of the Service in 2021. NAS is funded and supported by the Citizens Information Board and provides free, independent and confidential representative advocacy to people with disabilities across Ireland.
In 2021, NAS provided advocacy support in 3,833 instances, continuing the trend which has seen the Service’s casework increase by over 50% since 2015.
Due to the growing demand on the service, NAS holds a waiting list of people who have been assessed as needing support, which has remained consistently high year after year. By the end of 2021, there were 158 people on this waiting list, demonstrating the value of the advocacy work carried out by NAS and the need for continued investment in the service.
During the year, NAS advocates worked on a range of multi-issue cases, showing the complexity and importance of advocacy and the crossover into many sectors, from housing to healthcare, personal finance, justice and family issues. As a result of the ongoing Covid-19 public health restrictions, many of the unique issues that emerged in 2020 continued to present themselves in 2021.
Capacity building, which made up 18% of NAS cases, was the biggest issue the Service’s advocates worked on when providing support for people with disabilities in 2021. This included determining how a person with a disability communicates and supporting them to express their will and preference. This involved demonstrating that the person does communicate when others may have said that they cannot contribute opinions or a decision. It also meant working with a person to inform them of their rights to contribute to decisions that are being made that affect them.
Access to appropriate housing and accommodation accounted for 13% of NAS advocacy cases. This included providing advocacy for people who were inappropriately accommodated in residential settings and faced delayed transfers to more appropriate accommodation, people stuck in acute hospitals because of a lack of appropriate housing upon discharge, difficulties faced by people with disabilities navigating the social housing list, and issues finding appropriate accommodation for people with disabilities facing homelessness.
Issues around residential and healthcare settings also made up 13% of NAS casework, including visiting restrictions and communications difficulties between health professionals and family members.
Issues involving decision making accounted for 12% of NAS cases. This involved supporting people with disabilities in relation to Next of Kin issues, or situations where family members had prevented them from accessing the Covid-19 vaccination, contrary to their will and preference.
In general, difficulties with mental health and well-being continued to impact on the lives of many people receiving the Services’ support. Issues included ongoing visiting restrictions in residential services and day services. People who spoke to NAS Advocates faced prolonged periods without direct contact with their family and loved ones, and they spoke of feeling anxious and alone. When combined with continued reductions in other public services, including transport, education, housing supports and limited access to technology, this led to ongoing mental health concerns for people with disabilities.
Other issues that emerged in 2021 included:
- Ward of Court hearings in the High Court were delayed and subsequently took place online
- Delayed court hearings in parenting with a disability
- Suspended access to children in care for disabled parents
- Delays in assessment and provision of new home support and personal assistance services
- Lack of access to home support and personal assistant services due to staffing issues in service providers
There were many advocacy successes, reflected in the positive outcomes achieved for the people supported by NAS. The 2021 Annual Report includes case studies (attached) which highlight the impact the support of NAS advocates has made.
Commenting on the work of NAS in 2021, Louise Loughlin, National Manager of the National Advocacy Service, said: “While life improved for many people in Irish society in 2021, people with disabilities continued to deal with many traumatising and life changing experiences. It appears that many of the Covid-19 related issues that impacted on the lives of people with disabilities in 2020 still had not been improved by health and social care services in 2021.”
“If we want to adapt to any future challenges that arise from Covid-19 or other potential emergencies, we must ensure that the voice, will and preference, and human rights of people with disabilities are recognised. They must be at the centre of decision-making processes, leading decisions about their own lives and providing input into the development of key policies and legislation.”
Patient Advocacy Service
The 2021 Annual Report also presents the work of the Patient Advocacy Service, provided by NAS and commissioned by the Department of Health. The Patient Advocacy Service provides empowerment support to people who wish to make a complaint to the HSE about care they have received in a public acute hospital or HSE-operated nursing home.
In 2021, the second full year of operation for the Service, it received 1,205 new complaint enquiries, of which 3,382 separate complaint issues were identified. This was an increase of 125% on 2020 complaint enquiries of 535.
Key moments in 2021 for the Patient Advocacy Service included the extension of the service to October 2022, the implementation of a Memorandum of Understanding (MoU) with the HSE outlining their joint commitment to further improve support services for people who wish to make a complaint about the care they have received in public acute hospitals and an expansion of the remit of the Patient Advocacy Service to include support for people in HSE-operated nursing homes.
The Covid-19 pandemic and public health guidelines continued to have an impact on hospital patients, with visiting restrictions, difficulties communicating with loved ones and delays in medical procedures having a profound effect on people.
The Full Annual Report 2021 is available HERE