Delayed transfers of care (previously referred to as delayed discharges) occur when patients have been deemed clinically fit for discharge from an acute bed but whose discharge is delayed because they are waiting for some form of on-going support or care following their discharge. There are many reasons for this, such as a patient undertaking the application process for NHSS, awaiting assessment for a home care package, homelessness, ward of court application, and the availability of resources.
In many cases, the HSE will use transitional care to accommodate the patient during the period between discharge, and the finalisation of the new care arrangements, but can often be a delay, especially in cases where the patient and family are coming to terms with the new circumstances.
The HSE seeks to balance patient experience with the need to keep DTOCs as low as possible.
This year, services are being stretched more than ever, with demand consistently outstripping supply and we have seen increases in delayed transfers of care. While the HSE maximises the use of resources, prioritising those requiring discharge from acute hospitals, there is a growing demand for egress support and in response, and in the context of planning and preparing for the challenges of the winter period, the Department and the HSE have been considering a comprehensive approach to the current the high-level of DTOCs. However, recognising the urgency of the situation, approval was provided to the HSE to begin actions immediately to the value of €5m in 2019. As part of these measures the HSE released a significant number of funding approvals within NHSS this month, bringing the waiting time for the release of funding back to 4 weeks, and provided additional home care and transitional care beds.
Separately, following the 2019 publication of the Independent Expert Review of Delayed Discharges, an implementation group has been established to progress the recommendations. Minister Daly has also established a Cross Divisional Oversight Group within the Department of Health to oversee the HSE’s implementation of the recommendations.
As regards those persons discharged and awaiting new care arrangements for over 6 months, the Department does not have specific details on these individuals, but generally these cases are complex, and include issues such as homelessness, legal issues (such as ward of court) and the requirement for modifications to be undertaken at the patients home before they can leave hospital.
The Department will seek further information and provide a further response directly to the Deputy.