It is recognised that waiting times for acute hospital appointments and procedures have been impacted as a direct result of the COVID-19 pandemic, and as a result of the deferral of elective scheduled care activity in March, April and May of 2020, and since 2nd January 2021. Patient safety remains at the forefront of the HSE decision to defer elective scheduled care activity.
While Inpatient/Daycase waiting lists reached a peak in May 2020 as a result of the deferral of non urgent elective care, steps taken by the HSE to improve patient pathways in the context of the pandemic, and secure new routes to treatment had a positive impact on the overall waiting list. The number waiting for a hospital appointment/procedure dropped by 17% from May to December 2020.
However it should be noted in this context that the COVID-19 pandemic has led to unprecedented interruption to normal healthcare activity in the community sector as it has in the acute sector. Community services are facing equivalent challenges in relation to business and staffing capacity and, in this sense, the ability of the community sector to act as a substitute for the acute sector is limited. It should also be noted that many inpatients may require specialised care that cannot simply be transferred into a community setting.
At the same time, there is a commitment to progressing a strategic agenda that responds to the needs of our population and to demographic trends in line with the vision set out in Sláintecare. Community healthcare spans primary care services, social inclusion services, older persons’ and palliative care services, disability services and mental health services. These services will be significantly strengthened in 2021, facilitated by over €900m in increased funding across a range of reform and investment programmes. This will in turn ease pressure on our hospitals and allow more care to be delivered at home or as close to the patient’s home as possible.
More broadly, the Strategic Framework for Delivery of Service Continuity in a COVID Environment (HSE, June 2020), focusses on restoring our services in a prioritised manner with investments targeted at rebuilding services guided by the principles and priorities of Sláintecare. A Community First approach to the delivery of care will be central to delivering safe, efficient and effective services through winter and beyond. Service delivery will be re-oriented towards general practice, primary care and community-based services. By ‘shifting services left’ and prioritising Primary Care and Community Services, the goals of Sláintecare will be advanced and may mitigate the impact of COVID-19. The enhancement of community services will also allow people to remain at home, prioritising older people and those with chronic conditions.