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 their discharge is delayed because they are waiting for some form of ongoing 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 support package, homelessness, ward of court application, and the availability of resources.
When possible, the HSE will use transitional care to accommodate the patient during the period between discharge and the finalisation of new care arrangements, but there can often be a delay, especially in cases where the patient and family are coming to terms with the new circumstances.
This year, services are being stretched more than ever, with demand consistently outstripping supply, and we have seen an increase the number of 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. 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. 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 in September, and provided additional home care and transitional care beds.
In addition, the HSE Winter Plan was launched on Thursday 14 November. The aim of the Winter Plan is to ensure that service providers are prepared for the additional external pressures associated with the winter period, including the prolonged holiday period, severe winter weather, seasonal influenza, and the spread of norovirus and other healthcare associated infections.
Nine Winter Action Teams, each aligned to a Community Healthcare Organisation and associated acute hospitals and Hospital Groups, have prepared Integrated Winter Plans. These plans focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients, and appropriate timely discharge from acute hospitals.
The HSE Winter Plan is supported by an additional €26m in winter funding nationally. This winter funding will support access to the Fair Deal scheme, and will provide additional home support and transitional care to facilitate timely hospital discharge and reduce congestion in EDs over the winter period.
With regard to the Deputy's specific question, I have asked the HSE to respond to the Deputy directly with the requested information.