Outpatient appointments and elective procedures in the health service are to be fully restored from June, under official plans for a safe return of services that have been curtailed by Covid-19.

Cancer services will not be fully resumed until the end of this year, while 30 per cent of health appointments will be conducted on the phone or by video call, according to the three-phase plan drawn up by the Health Service Executive.

Efforts to clear the massive backlog of appointments and procedures that has built up during the pandemic are unlikely to begin until the autumn, the plan says, and will require private sector input.

Hospital Report

It warns commitments to resume non-Covid services are “conditional on there being no further major surges and full implementation of the vaccination programme”.

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The risk of flu and other respiratory conditions next winter could put plans to return to normal activity under pressure, the document also warns.

The return of services is projected to take place in three phases: March to June; July to September; and October to December.

The plan says adequate staffing is the most critical challenge to restoring services. Absenteeism is expected to decline as Covid-19 cases fall and with widespread vaccination of staff, but carried-over annual leave will impact on staffing.

Cancer services should be restored by the end of 2021, but this is “assuming no significant disruption due to planned delivery, public health restrictions removed or eased, and no adverse winter months impact on acute hospitals”.

Screening for breast, cervical and bowel cancer, along with diabetic retina screening, is projected to increase to 90 per cent capacity in the second phase from June, and to 100 per cent from October.

Covid inpatients

The plan envisages fewer than 50 Covid-19 patients in ICU by April 5th, compared with 81 on Monday. But under a “pessimistic” scenario, this is projected to rise to 100-150.

It also projects 100-270 virus patients in hospital, compared with 359 at present. A higher reproduction number of 1.2 could see this rise to 700-850.

A further 520 cases of the virus were reported by the National Public Health Emergency Team (Nphet) on Monday night, with officials saying case numbers may be starting to rise again. One further death was reported.

There is deep pessimism in Government about an expected rise in case numbers over the coming days, though Ministers believe a rapid acceleration in the administration of vaccines in April and May will change the picture substantially.

Easing restrictions

Taoiseach Micheál Martin on Monday indicated the Government would proceed with easing some restrictions after April 5th, stressing that the congregation of people indoors was a continuing problem in spreading infections.

He suggested some outdoor sports could return and reaffirmed the intention to reopen secondary schools for students who are still at home. However, there is unlikely to be any reopening of churches for worship before Easter, as church leaders had requested.

Minister for Health Stephen Donnelly will brief Cabinet colleagues on the situation at Tuesday morning's meeting of the Government, including the expected opening of quarantine hotels at the end of this week. The website enabling people to book their slot in a quarantine hotel for 10 days – at a cost of €1,875 for 10 nights – was expected to go live on Tuesday, sources said.

It is expected mobile testing centres will be deployed in the coming days for areas of the country with high rates of infection. The HSE is also likely to begin a number of pilot programmes for antigen testing in schools.

Nphet meets again on Thursday to decide on its recommendations to Government on the planned easing of restrictions on April 5th.