Coronavirus surge: HSE chief directs hospitals to take urgent action

Letter details escalation measures as system struggles to deal with fourth wave of infection

Chief executive of the HSE Paul Reid has instructed hospitals to take urgent action in the face of the current coronavirus wave.

Mr Reid warned of the “unthinkable” consequences of hospital capacity being “insufficient to meet anticipated demand”. A letter from Mr Reid sent to hospitals today details serious escalation measures as the system struggles to deal with the fourth wave of infection.

Hospital managers have been told they must outline what additional “surge” intensive care unit (ICU) beds can be created in the next seven to 10 days. And if necessary curtail “all other activity to facilitate redeployment of staff to critical care areas”.

Mr Reid has also instructed the hospitals to prioritise unscheduled coronavirus care and urgent time-sensitive work for two weeks in the larger “model 4 ” hospitals, among a range of other measures.


In a letter sent on Thursday to the chief executives of hospital groups, hospitals and other senior managers, Mr Reid said: “It is clear to me that we need to take steps now to protect and to make the best possible use of our remaining hospital and in particular our ICU capacity.”

The letter outlines nine actions to be taken, including the “maximisation” of the Safetynet contract with the private hospitals and “hospital avoidance” strategies in order to reduce the flow of people coming in.

These include prioritising home support, therapies and community-based beds.

“If the disease continues to spread as it has in the past two weeks, we face the prospect of any remaining capacity being insufficient to meet anticipated demand,” he wrote.

“Clinicians in ICU inform us that the system is already facing increasing difficulties in meeting the needs of patients who require specialist high-dependency care. The consequences of such an occurrence although unthinkable, are also well understood by each of you.”

Priority services

The hospital managers have also been told to focus on the “maximisation of all available capacity in an integrated way”, with a focus on clearing hospitals of delayed transfers of care – a term for a patient whose clinical treatment is complete but has not yet left the hospital system.

Funding will be provided to support the additional beds, Mr Reid told the managers. He added that staff to support critical and priority services will be identified for redeployment.

Mr Reid also outlined how “the entire health system, both hospitals and community healthcare, are now under very serious pressure”, while the number of people being hospitalised due to coronavirus infection continues to increase.

“The modelling suggests this will not abate, at least in the short term,” he told staff. While there is now a lower rate of people being hospitalised thanks to vaccination, Mr Reid wrote that “nevertheless, the rate of transmission is increasing and it is inevitable that the pressure on our hospitals will continue to grow, and in turn the situation in ICU will continue to deteriorate”.

He told the hospital managers of his gratitude to the people working in the HSE and wider healthcare system.

“Any organisation that has been through even one wave of a global pandemic would be challenged . . . Yet, in the very best traditions of public service our healthcare staff have continued, time and again, to deliver. I am also very aware that our staff and indeed the public are exhausted, frustrated and close to their wits’ end as we endure yet another setback.”

Meanwhile, the Department of Health has reported 4,650 additional infections on Thursday. The number of patients being treated in hospital was 643 as of 8am, it said, with 118 in ICU.

Jack Horgan-Jones

Jack Horgan-Jones

Jack Horgan-Jones is a political reporter with The Irish Times