More than 350 planned hospital beds yet to be delivered

HSE winter plan proposes additional home-support hours to alleviate pressure

More than 350 hospital beds promised in the Health Service Executive’s service plan for this year have yet to be delivered.

Some 795 of the promised 1,152 acute beds are open, according to the HSE’s winter plan.

However, a further 143 beds will be provided by the end of this year and 62 more by the end of March 2022, the plan states.

Of 551 community beds that were promised in the service plan, 276 are open, the remainder will be provided over the winter and an additional 100 private beds are to be accessed.

The plan also envisages the provision of 2.7 million additional home-support hours this winter, in addition to the 2.3 million already provided this year.

About 1,100 private bed days are to be used each week as part of the €77 million short-term plan to alleviate winter pressures. GPs will be able to access about 4,000 diagnostic tests a week.

In line with Sláintecare, the plan aims to enable patients to be seen in the community wherever possible by providing alternative care pathways outside hospitals.

Winter challenges

Minister for Health Stephen Donnelly acknowledged the health service was expecting to face significant challenges in providing emergency care while also dealing with Covid-19 and other winter challenges.

Publishing the plan, Mr Donnelly said he particularly welcomed the “enhanced focus” on restoring services in disability, mental health, services for older people and social-inclusion care groups.

People will be supported to remain in their own homes by providing GP-liaison nurses to manage referrals to emergency departments, the use of frailty intervention and community response teams providing nursing and other therapies and geriatric community support.

The plan warns that a “key underlying risk” is not being able to attract and retain the appropriate number and calibre of staff, especially for home care and in nursing homes.

In relation to hospitals, it says an enhanced focus will be maintained on a group of sites "in a prolonged state of escalation", whose challenges are not amenable to a "quick fix". Hospitals in Cork, Galway and Limerick are listed as having the highest numbers of patients waiting for admission.

Vaccination campaign

About 80 per cent of the infrastructural capacity of the original vaccination campaign will be maintained until the end of December, the plan states.

In addition, the minimum space of 1m between beds, trolleys and treatment chairs will be required “indefinitely”.

“Where bed numbers were reduced in hospital rooms to achieve this minimum during the pandemic, this should be considered as a non-reversible measure.” However, this will impact on bed costs as bed numbers will have to be reduced by 5-10 per cent without any reduction in staffing.

The Irish Medical Organisation said the plan was “inadequate” to meet the challenges ahead.

Its president, Dr Ina Kelly, said: “Covid has exposed the long-term cost of failing to invest in our health services. Our only response now seems to be to try to force more work out of our exhausted doctors.

“We have 700 vacant consultant posts meaning huge extra pressure on those consultants we do have.”

The Irish Nurses and Midwives Organisation said it welcomed “the belated publication” of the plan.

Its deputy general secretary designate, Edward Mathews, said: “We need urgent action to use all available bed capacity in private hospitals to divert appropriate care from our acute hospitals. Our acute hospitals are not just full, they are overcrowded, so surge capacity from the private sector to alleviate the pressure in hospitals across the country is imperative.

“The INMO will be seeking an urgent meeting with the chief executive of the HSE and his senior officials with regard to implementing this plan.”

He was speaking on the same day that INMO members at Mayo University Hospital held a protest to highlight excessive workloads and staffing pressures.

The union said staff in the hospital were unable to take adequate breaks or use their annual leave due to their excessive workloads, and that despite raising the issues with management, no improvements had been made to working conditions.

The Saolta group, which is responsible for the hospital, said it was “keenly aware of the ongoing pressure on all healthcare” workers and was taking steps to address this including a “significant” overseas nursing recruitment campaign.

It said it hoped conciliation talks due to take place this week would be productive.