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Emergency Departments Waiting Times

Dáil Éireann Debate, Thursday - 17 May 2018

Thursday, 17 May 2018

Ceisteanna (164)

Fiona O'Loughlin

Ceist:

164. Deputy Fiona O'Loughlin asked the Minister for Health his plans to reduce the time persons over 75 years of age are forced to wait in emergency departments; and if he will make a statement on the matter. [21739/18]

Amharc ar fhreagra

Freagraí scríofa

Against a background of growing demand for unscheduled care and high acute hospital occupancy rates, Government provided €30 million in 2017 and a further €40 million in 2018 for measures to increase acute hospital capacity and alleviate overcrowding in Emergency Departments. Almost 50% of this funding was used to deliver home support packages and transitional care beds to reduce the incidence of delayed discharges. Furthermore, over 200 beds have been opened this winter and more beds are due to come on stream later in the year.

Notwithstanding the increased level of resources provided, this winter has been particularly difficult for our health services with ED attendances up 3.7% and admissions up 3.3% during the first quarter of the year, as compared to the same period in 2017.

The situation was further exacerbated by Storm Emma and the severe weather that followed. In response to this, I approved a further €5m in emergency funding to provide additional home support packages and transitional care beds to assist the safe discharge of patients who required support to return home following the adverse weather.

In the light of the conclusions of the Health Service Capacity Review that the system will need nearly 2,600 additional acute hospital beds by 2031, I have asked my Department to work with the HSE to identify the location and mix of beds across the hospital system which can be opened and staffed this year and into 2019 in order to improve preparedness for Winter 2018/2019.

As outlined in the Capacity Review, the demographic pressures being experienced by the health service are such as to demand not just additional capacity, but continued emphasis on health and wellbeing initiatives, an improved model of care with a stronger role for enhanced community based services and continued improvement in productivity including in acute hospitals. The Government has approved a record level of capital investment in health at €10.9 billion over the next 10 years. This will provide for a major enhancement of the capacity of our health services to meet demand. Importantly, the accelerated introduction of additional capacity for 2018/2019 will be matched by forthcoming reforms including the publication of a detailed Sláintecare Implementation Plan and the overhaul of the current GP contract.

Finally, a review of the Winter Initiative 2017/2018 is being undertaken, which will inform a 3 year plan for unscheduled care, as well as supporting the provision of additional capacity in Winter 2018/19.

With specific regard to the Deputy's question on persons over 75 years of age, there are three main programmes focused on prioritising and improving the experience of patients over 75 in the emergency healthcare system.

The Integrated Care Programme for Older People (ICPOP) and the National Clinical Programme for Older People (NCPOP) are developing integrated primary and secondary care services for older people. This involves establishing integrated multidisciplinary teams (MDTs) in both acute hospitals and CHOs to address the specific needs of older people (especially those who are frail or at risk of frailty); case management within MDTs linked to other services that coordinates and plans care needs across a continuum; and bespoke care pathways with appropriate expertise in older persons’ care.

The Frailty at the Front Door (FFD) programme, which is the assertive case management of frail older patients deployed in acute hospitals (i.e. ED and MAUs) consists of timely identification and screening of older attendees to acute hospitals; comprehensive and early multidisciplinary team assessment; and assertive discharge with a coordinated response to the needs of frail older patients.

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