In Budget 2015, additional funding of €25m was provided to support services that provide alternatives to, and relieve pressures on, acute hospitals. Of this €25m: €10m was used to provide an additional 300 places under the Nursing Homes Support Scheme. This reduced the waiting time for approved applicants from 17 weeks to 11 weeks; €8m was used to provide access to an additional 115 short stay beds across the Dublin area; €5m was used to provide 400 additional Home Care Packages to benefit 600 people over the course of a year: and €2m was used to expand the Community Intervention Team services in primary care across Dublin and the surrounding region.
In April 2015 the Government provided a further €74m to address issues that impact on delayed discharges. This amount built on the €25m provided earlier and was allocated as follows: €44m was allocated to the Nursing Homes Support Scheme to provide an additional 1,600 places and to further reduce waiting times for approved applicants from 11 to 4 weeks; the remaining €30m was principally applied to provide additional transitional care beds, some of which were on a temporary basis to address the particular pressures then being experienced by acute hospitals.
The Nursing Homes Support Scheme (NHSS) budget in 2015 is €993 million, which includes the additional €54 million referred to above. It is expected that a waiting period of 4 weeks will be maintained for approved applicants for the rest of the year.
The latest information available to me is that there are about 22,600 people now receiving financial support under the NHSS. The Scheme is continuing to take on new clients and it is estimated that we will be supporting in excess of 23,900 people by the end of this year.
The position regarding the availability of nursing home beds is that there are some areas where supply is tight, and individuals sometimes have to wait for a place in the facility of their choice, but in overall terms there are enough nursing home beds to meet demand. However, between now and 2024 the population over 65 years is projected to increase by about 200,000 people. Based upon current trends those requiring long-term care will increase by about 9,000 over the same period. In that context, it is important to both consolidate our existing stock, particularly of public beds, and to ensure that sufficient additional capacity is provided across the public and private sectors to meet future demand. My Department is examining how this can best be achieved, and is committed to ensuring that support continues to be available through the Nursing Homes Support Scheme, that there are adequate beds available for those who need them and that any public funds committed are used efficiently and deliver value for money.
In this context my Department has engaged DKM Economic Consultants to identify the policy options that are available to address future requirements for nursing home capacity, and to undertake a Cost Benefit Analysis of these options. I will take careful account of the conclusions of this exercise in planning for the coming years.
Whilst ED trolley numbers have continued to present significant challenges for acute hospital services the plans of the ED taskforce which are being implemented by the ED Taskforce Implementation Oversight Group are expected to have an impact by helping to reduce ED trolley numbers in the next few weeks and months.
The implementation plan produced by the HSE includes a performance focus on the worst performing hospitals and envisages Hospital Groups and Community Health Organisations working more closely together to provide better integrated care and implementing the process changes needed to address my priorities. These changes are being supported through joint visits of Social Care, Acute Hospital Divisions and SDU to specific hospitals to identify any on-going process issues, in particular any issues which affect the effective linking of hospital and community services.
Actions to support the implementation of the ED taskforce plan include: the issuing of targets in relation to associated hospital discharge reduction for each Community Healthcare Organisation, particularly in relation to supporting discharge through home care prioritisation; the Irish Hospital Redesign Programme, which is reaching project implementation phase in Tallaght and is now commencing preliminary work with University Hospital Limerick, in advance of full project initiation in September; extension of the Community Intervention Team (CIT) service, which deals with an average of 360 new patients per week, and has provided services at home for over 8,500 patients in the first 6 months of 2015; improved liaison between hospital and primary care services with the appointment of CIT link nursing staff in each hospital served by CITs; expansion of electronic referrals from GPs to hospitals, supported by the roll-out of health-mail nationally, which has improved the safe transfer of clinical information in a timely manner; referrals to hospital EDs from GP Co-ops are being monitored on a weekly basis and negative variances followed up for explanation and further action.
