Many people using health and social care services in Ireland have dealt with traumatising experiences due to the restrictions and disruptions caused by the impact of the Covid-19 pandemic.

That is according to the National Advocacy Service for People with Disabilities (NAS) and the Patient Advocacy Service.

Two reports developed by the groups have been published under the title 'Advocacy Matters: Advocating for People during the Covid-19 Pandemic'.

The first report highlights issues faced by people in relation to health and social care during the Covid-19 pandemic.

It focuses on the services' advocacy for people attending acute public hospitals and for people with disabilities using social care services.

The second report outlines the issues people experienced in relation to restrictions in nursing homes during the pandemic.

It explains the services' support for residents dealing with issues such as communication and visiting, infection control and isolation.

Several people contacted the Patient Advocacy Service who felt that their own discharge, or that of family members, from hospital was rushed, unsafe and carried out without discussion.

It was also contacted by people with Covid-19 who were being discharged home into the care of at-risk family members without any community or primary care support packages in place.

Some people who did not have Covid-19 have found themselves placed in wards where there had been confirmed Covid cases, or where other people were awaiting Covid test results.

The lack of communication with families whose loved ones contracted Covid-19 while in hospital was a repeated concern according to the report.

Almost 40% of people who contacted the Patient Advocacy Service during the pandemic had difficulty communicating with healthcare units.

They said they were unable to get a response to their phone calls, or their phone calls were not being returned. Some families were unaware of a Covid-19 diagnosis.

Both the NAS and the Patient Advocacy Service say they supported people in acute hospital settings who were awaiting discharge home or to more appropriate supports.

At the beginning of the pandemic, people were moved quickly from hospitals to ensure acute hospital capacity for Covid-19 affected patients.

This, according to the organisations, resulted in people moving to placements that they did not want to live in as they had no alternative options.

In the early months of the pandemic, home care packages for disabled people to live independently were reduced, curtailed or at times stopped.

Many people were reassessed to determine whether they required the same number of hours provided before Covid-19.

When it came to personal care, the National Advocacy Service received several calls from people whose personal assistant service providers decided to pause services or reduce the hours provided during the Covid-19 pandemic.

There were also issues around primary care supports such as home support service, which provides personal care support for people, for example to get out of bed, dressing and undressing and taking a shower.

For some people with disabilities the organisations found there was difficulty accessing GP appointments, as many GPs moved to remote consultations and some people found that virtual appointments did not meet their needs.

The reports say people living in nursing homes faced the most extreme restrictions.

Some people had to stay in their rooms 24 hours a day during certain periods of lockdown, with no access to friends or family.

Due to staffing issues, many people were not able to receive the care, information and reassurance they needed from nursing home staff.

This resulted in people feeling isolated, fearful and unsure of what was happening in their nursing home and the outside world.

At the beginning of the pandemic, a lack of information, technology and safe spaces impeded communication between the Services' Advocates and people living in nursing homes.

The organisations say that this was particularly concerning at a time when people had already been "exposed to challenging circumstances and events beyond their control".

Some families said they had no way of communicating with their loved ones and no way of knowing if they were safe from the virus or not.

They found it very difficult to get updates from nursing homes and were often unaware how serious the outbreak was within the nursing home.

The NAS and the Patient Advocacy Service worked with families who did not get to see their loved ones before they passed away and were left with the worry that they died alone and scared.

Many of the families have expressed their feelings of guilt for not being able to do more and not knowing how seriously ill their loved ones were.

The organisations say nursing homes did not have a clear protocol for managing the virus, while family members also expressed fears that care plans were not being followed.

During the pandemic, people under 65 reported that social workers or discharge coordinators from hospitals helped them to sign up to the Fair Deal scheme for nursing homes without alternative options being discussed or knowing the long-term consequences.

Key recommendations from the reports include the suggestion that health and social care services review and continue to improve on their service delivery, adapting to the evolving situations arising from the ongoing pandemic.

In line with the HSE's 'Your Service Your Say' complaints process and the 'Incident Management Framework' for patient safety incidents, they say learning should be drawn from the experiences and feedback of the people using health services and their recommendations implemented to improve service delivery.

"It is crucial that people are supported to have their voice, will and preference heard and are included in decisions that impact on their lives".

The reports call for improvements in acute hospitals to make sure their environment, processes and systems work effectively to ensure patient safety and build on the safe and effective care already being provided.

Home care provider services are advised to have plans in place to ensure continuity of services during times of crisis, while home support services should be regulated under a set of national standards that will improve the supports provided to people living in the community.

People inappropriately placed in acute hospitals on a long-term basis should be supported to move to more appropriate settings in line with their will and preference.

There is also a recommendation for increased government funding for alternatives to nursing homes such as rehabilitation, supported accommodation and home care hours.

They organisations say less emphasis should be placed on the Fair Deal Scheme, especially in cases following a stay in an acute setting.

It concludes by saying it is "crucial" that the Nursing Home Expert Panel (NHEP) report recommendations are implemented regarding the integration of private nursing homes into the wider framework of public health and social care.