The single most important factor for admission to hospital is bed availability. A report called Acute Hospital Bed Capacity – A National Review, carried out by my Department, identified a requirement for an additional 3,000 acute beds in acute hospitals by 2011 and this requirement is reflected in the Government's health strategy, Quality and Fairness – A Health System for You. Some 568 of these beds have been commissioned to date.
In order to address the current increase in demand for acute beds, I have provided additional funding of €5.5 million in 2003 to the Eastern Regional Health Authority, €3.8 million, and to the Southern Health Board, €1.7 million, to facilitate the discharge of patients from acute hospitals to a more appropriate setting thus freeing up acute beds.
The Deputy will appreciate that due to the nature and complexity of the acute hospital system the number of beds in use at any one time may fluctuate. It is a feature of all acute hospital systems that some beds are out of use for short periods of time. Bed closures result from ward refurbishment, essential ward maintenance, staff leave, seasonal closures and infection control measures. In 2003 some hospitals, particularly in the Dublin region, have temporarily closed some beds for financial reasons in order to stay within budget.
My Department routinely collects information on beds not in use in acute hospitals from health agencies on a quarterly basis. The most recent complete figures available to my Department relate to the first six months of 2003. This data shows that 50,584 bed days were lost in the period, which is equivalent to a daily average of 278 beds out of use representing just over 2% of the available acute bed stock.
Following the accident and emergency nurses strike in March 2002 the Labour Relations Commission put forward a number of proposals in the area of accident and emergency management. It was agreed that the bed management function was fundamental to the consistent application of admission and discharge policy. In May 2002, CAPITA Consulting was commissioned by the Health Service Employers Agency, HSEA, to carry out a national review of the bed management function. This review made specific recommendations that will assist hospitals to structure more effective and integrated bed management departments. The implementation of the recommendations contained in the CAPITA report are now being progressed by a combined management and nursing union steering group under the chairmanship of the HSEA.
The HSEA also commissioned a detailed two stage staffing review of nurse staffing levels required in 36 dedicated emergency departments around the country. The staffing review examined existing structures and staffing levels in emergency medicine departments and included an assessment of the appropriate support, professional nursing role, skills and structures required. The second stage of the review has just been completed and the draft final report has been presented. As part of the process of considering the final report it is expected that the consultants will make a presentation on their findings to management and nursing unions in the near future.
