A major part of the Government's Action Plan in response to Covid-19 was to substantially increase the capacity of public healthcare facilities to cope with the anticipated additional demand. In order to urgently ramp up capacity for acute care facilities, an arrangement was agreed with the private hospitals to use their facilities as part of the public system on a temporary basis, to provide essential services. A Heads of Terms of an Agreement between the HSE and the Private Hospitals was agreed at the end of March 2020 and all 18 of the acute private hospitals signed up to it. Under the arrangement, all patients in the private hospitals are treated as public patients and their treatment is prioritised based on clinical need. Provision was made under the agreement to allow for continuity of care for patients who were in a private hospital or attending for treatment at the time the Heads of Terms of the Agreement were agreed, on the grounds that these patients would be treated as public patients.
The agreement was reviewed at the end of May and the Government decided that the existing arrangement should not be extended beyond the end of June. It has however mandated the HSE to negotiate a new arrangement with private hospitals which would provide the HSE with full access to private hospital capacity in the event of a surge of Covid-19 and separately with ongoing agreed access, to enable the HSE to meet essential and elective care needs.
Guidance on patient pathways to mitigate the risks associated with the delivery of non-covid care, for patients and healthcare workers, and support safe delivery of care has been developed under the auspices of the Expert Advisory Subgroup of NPHET (EAG) and approved in principle by NPHET. It is recommended that in-patient occupancy levels are maintained at 80% to facilitate the requirement to address surge safely. Utilisation rates show a growing increase in the rate of use of inpatient beds in private hospitals. As of 28th May 2020, 54% of private inpatient beds were in use, up from 43% at the start of May.
The HSE is currently working to develop a continuity of services plan to examine how healthcare activity suspended because of Covid-19 can be resumed while maintaining acute occupancy at 80% to provide for surge capacity in the event of a further wave of Covid-19. This work should enable non-urgent elective care to resume within the necessary constraints. The latest information available with regard to the level of activity in the Bons Secours in Limerick is that it is utilising 63% of its in-patient capacity as of 28 May 2020.