Ireland is seeing a growing demand for unscheduled care, which is evident from the increased pressures on hospital Emergency Departments (EDs), particularly during peak periods such as winter.
Since the commencement of the Winter Plan 2018/2019 on 1 December, there was a 6.3% increase in ED attendances from the 1 December to the 31 March 2019 compared to the same period last winter, but a 13% reduction in the number of people counted on trolleys.
In addition to the optimisation of existing resources, the HSE invested an additional €30 million specifically in winter initiatives. The HSE Winter Plan sought to ensure that the health system was as prepared as possible for the increase in demand on services over the winter months, within existing capacity and financial parameters.
The HSE are currently undertaking a review of performance across all Hospital Groups and Community Health Organisations (CHO’s) over the winter period. The review will consider planning, implementation and performance at Group and CHO level.
The existing HSE review of winter 2018/2019 will be extended to include an Expert Review and Analysis of ED activity and relative performance of sites. In this context, the HSE’s initial focus will be on the 9 individual focus sites and their relevant CHOs as well as comparative performance with a number of other sites that performed well in 2018/2019.
Nationally, between January and March 2019, the number of patients recorded as waiting on trolleys in acute hospitals nationally at 8am was 28,962, a decrease of 4,050 (12.3%) compared to the same period in 2018 (33,012).
The HSE's provisional figures show 9,708 people were recorded on trolleys in the month of April which was 0.8% lower than March (9,789) of this year.
It is important to put the trolley figures in context. The hospital system is currently operating at close to full capacity. The number of patients attending Emergency Departments continues to increase year on year, with approximately 1.3 million attendances in 2018, up 3.5% on 2017. This reflects increasing demand for unscheduled care, especially by patients in the 75 and over age group.
The Health Service Capacity Review published last year was crystal clear on the need for a major investment in additional capacity in both hospital and community – combined with a wide scale reform of the manner and the location of where health services are provided.
As set out in Sláintecare, moving care options for patients closer to their homes and into their local communities is a key part of the solution.
Increasing capacity is a priority for Government. An additional 241 acute hospital beds opened under the Winter Initiative 2017/2018, and the National Service Plan for 2019 provides for a comprehensive capacity programme. A capacity programme for 2019 has been agreed, which provides for the following increases in capacity:
- 78 additional beds, including a 40-bed modular build in South Tipperary General Hospital, and a 30-bed ward in Our Lady of Lourdes Hospital Drogheda;
- 75 acute beds and 70 community beds as part of the Winter Plan;
- preparation of 202 beds by quarter 4 2019 with a view to bringing this extra capacity into operation in the first quarter of 2020;
- preparation of the proposed opening of a 60-bed modular build in University Hospital Limerick.
The number of available inpatient beds is expected to increase to above 11,000 following the investment planned in the National Service Plan 2019.