The Department has been engaging extensively with the HSE in relation to planning for Winter 2019/2020. In that respect, the HSE have been asked to consider actions/initiatives over and above non-funded actions, and to look at building capacity and options available to them to alleviate the expected overcrowding. The HSE are engaged in a process of consultation with Hospital Groups and Community Healthcare Organisations and the Department expects to receive a draft Winter Plan resulting from this process in the coming weeks.
The HSE provides a variety of different types of social care support which can facilitate the discharge of older persons from the acute hospital and into community care.
Transitional care supports acute hospitals across the country in discharging patients who have completed their acute care and who require long stay residential care under the Nursing Home Support Scheme (NHSS) or who require convalescence up to 4 weeks prior to returning home. This facilitates the patient discharging to a private nursing home to finalise their NHSS application or to take up convalescence.
Respite care is provided in several different ways and settings across the health system. It is provided through designated respite beds in Public Residential centres and also ‘contracted’ by the HSE in private nursing homes – where it is used to increase the availability of such beds to meet demand – within the resources available in the local area. Respite can be provided on an emergency basis for unforeseen circumstances that occur due to bereavement/illness of carers or emergency environmental changes to the residence of the client. Planned Respite can be provided to people, which allows carers a planned break throughout the year. This is planned in conjunction with the person and their carers and is seen as a part of the continuum of care for the person.
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 delayed transfers of care (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 in order to bring the waiting time back to 4 weeks, and to provide additional home support and transitional care beds. This has seen a reduction in the number of DTOCs over the last month.