Community care services
Public health services provided in the community in Ireland are sometimes referred to as community care services. They are generally provided by the Health Service Executive (HSE). Community care services may also be provided by other organisations in conjunction with, or on behalf of, the HSE. The level of services that are available varies in different parts of the country.
In general, medical card holders are entitled to community care services free of charge. Non-medical card holders may also be able to access services, depending on availability, but medical card holders may be prioritised.
What are community care services?
Community care services can include public health nursing, home help, physiotherapy, occupational therapy, chiropody, day care and respite care.
The rules about which community care services must be provided vary for the different services. In some cases, the HSE is obliged to provide services while, in others, the HSE has discretion about whether to make the service available or not.
Public health nurses
The HSE provides a free nursing service to medical card holders. The service is not necessarily confined to medical card holders but they may get priority access to the service.
Public health nurses work in the community and are usually based in, and work out of, the HSE local health centre. They provide nursing and medical care. The services provided by public health nurses vary from area to area and they act as a point of access for other community care services.
Some Local Health Offices employ care assistants as a back-up to the public health nursing service. The role of the care assistant is to provide personal care rather than domestic services, but there is some overlap between what they do and what home helps do.
Home Support Service
The Home Support Service is available to people aged 65 or over who may need support to continue living at home or to return home following a hospital stay. For example, it can provide support with everyday tasks such as getting in and out of bed, bathing and dressing. The services might be needed due to illness, disability or after a stay in hospital or following rehabilitation in a nursing home.
In some cases, the service may be available to people younger than 65 who need support. For example, people with early onset dementia or a disability.
Physiotherapy services are generally provided in the community and are generally free to medical card holders. Waiting lists operate in many areas. Home services are only available in a small number of cases.
Occupational therapists are employed by most Local Health Offices. Their services are generally available free to medical card holders. Waiting lists operate in most community care areas for these services.
Chiropody services are available free to medical card holders in most community care areas.
Aids and appliances
You may be able to get certain aids and appliances free of charge if you have a medical card or at a reduced cost under the Drugs Payment Scheme. The HSE Primary Care Reimbursement Service provides a list of medicines or aids provided under the medical card or Drugs Payment Scheme.
If you have private health insurance, you may be covered for some or all of the costs.
Respite care or temporary care may be based in the community or in a residential setting. In practice, respite care is provided to a varying degree at a number of locations around the country.
Day centres include centres that provide day activities, such as recreational facilities, and specialised clinic facilities that provide a combination of medical and vocational rehabilitation services. The availability of services varies in different areas. Some day centres are provided directly by the HSE and some are provided by other organisations on behalf of the HSE. Access to day centres is by referral and the eligibility conditions vary from area to area.
Personal Assistant Service
If you have a physical or sensory disability, you may be able to get Personal Assistant (PA) services to increase your independence. The Personal Assistant is employed by you and you decide how and when the support is provided. Contact your Local Health Office to find out about the availability of this service in your area.
Meals services are provided by voluntary and statutory bodies. The ways in which these are provided vary from area to area. Access to meals services is generally by referral. You may be asked to contribute towards the cost of meals services. Eligibility conditions vary from area to area.
Transport services are provided by the HSE on a varying basis throughout the country. These services include access to day hospitals and day centres and access to outpatient departments and other hospital services.
How to apply
Ask your GP about community care services in your area or contact your Local Health Office.