Varadkar & Lynch welcome additional funds to tackle Delayed Discharges and ED Overcrowding
Minister for Health Leo Varadkar and Minister for Primary Care, Social Care & Mental Health Kathleen Lynch have welcomed the Government’s approval for further measures to reduce the problem of Delayed Discharges and overcrowded Emergency Departments in our acute hospitals.
This year our hospitals have experienced increased overcrowding in our Emergency Departments, increased numbers of patients classified as “delayed discharges,” and certain non-urgent procedures were postponed. It was clear these problems in hospitals were in large part “knock-on” effects from shortcomings in other parts of the health service. When the capacity of other services became stretched, the only option available to many was the hospital, which inevitably became overloaded in turn.
Based on the Task Force’s Action Plan, and in view of experience to date, it has been decided that additional funds will be provided on a strictly ring-fenced basis, as follows:
- €44 million will be allocated to the Nursing Homes Support Scheme, which will provide an additional 1,600 places and reduce the waiting time for approved applicants from 11 weeks now to the previous norm of 4 weeks for the rest of the year;
- €30 million will cover the cost of additional transitional care beds (temporary contract beds) through to June and additional community, convalescence and district hospital beds on a permanent basis, both of which facilitate more rapid discharge from hospital;
- The temporary transitional beds currently in use to address ED overcrowding will be replaced by sustainable, more cost-effective beds under the Fair Deal scheme. In addition, up to 250 community care beds will be made available around the country. About 60 of these are already open.
Minister Varadkar said: “Overcrowding in our hospitals has eased since January and is trending downwards. But it remains higher than at this point last year. Similarly the number of delayed discharges has fallen from a peak of 850 but remains over 700. For these reasons, it is necessary to take additional action to provide more nursing home placements to free up acute hospital beds and make more community, convalesce and district hospital beds available. The implementation of these measures has now begun but will take about eight weeks to fully implement.
“Taken together, these actions will have a noticeable and measurable impact on trollies, overcrowding and delayed discharges. It will not, however, resolve all problems in all sites. That is not solely a matter of resources and is very much linked to process, management, efficiency and patient flow. This will require further attention. With this extra money we can do the expensive part by creating more capacity across the board. The next part is much less expensive but much harder to achieve as it involves better use of existing resources in the main. Surges will still happen from time to time as they do in all countries.
“Reducing the level of delayed discharges and the wait for Fair Deal places in a meaningful way will improve significantly the situation in many hospitals. I believe however that improvement is not solely, or even mainly, a case of funding. Reform of practices and processes needs to happen on the ground, and I appreciate that in many cases that is already happening.
“I want to thank the members of the ED Task Force: the service providers, union representatives and officials for addressing the problems being experienced in Emergency Departments. I look forward to their continued involvement to drive the implementation of the Taskforce Action Plan to improve services for patients.”
Minister Lynch added: “It is Government policy to facilitate older people to stay in their own homes and communities for as long as possible, and to provide residential care services when they are needed. This additional funding addresses both of these objectives, and in doing so will also very significantly improve the position for our acute hospitals.”
ED Task Force Plan
The Emergency Department Taskforce was convened by Minister Varadkar last December to provide focus and momentum, and to develop sustainable long-term solutions to ED overcrowding. The Taskforce Action Plan published today sets out a range of time defined actions to (i) optimise existing hospital and community capacity; (ii) develop internal capability and process improvement and (iii) improve leadership, governance, planning and oversight.
This includes measures to:
- reduce delayed discharges;
- reduce length of stay in line with agreed HSE National Service Plan targets;
- develop and extend additional and alternative access routes to urgent care, thereby enabling appropriate admission avoidance;
- ensure timely and appropriate assessment, treatment and admission or discharge from ED in line with agreed HSE National Service Plan targets;
- implement targeted initiatives aimed at supporting rapid access to inpatient care and to diagnostics;
- improve access to senior decision makers;
- ensure integrated discharge planning;
- improve chronic disease management;
- ensure effective leadership and oversight in hospitals to implement and maintain sustained improvement and manage periods of surge effectively.
This comes on top of measures already taken in Budget 2015, when the Government provided €25 million to support services that provide alternatives to, and relieve pressure on, acute hospitals:
- €10 million to provide an additional 300 places under the Nursing Homes Support Scheme, reducing the waiting time from a peak of 17 weeks in late 2014 to 11 weeks currently;
- €8 million to provide access to an additional 115 short-stay beds across the Dublin area;
- €5 million to provide 400 additional Home Care Packages which will benefit 600 people in the course of the year;
- €2 million to expand the community intervention team (CIT) services in primary care across Dublin and the surrounding region.
Read a copy of the report – Emergency Department Task Force
You can watch the launch live here