Delayed discharge of patients led to ‘loss’ of 200,000 bed days

HSE says there is ‘practical time lag’ between patient being fit for discharge and leaving

The delayed discharge of patients who no longer require acute hospital care led to the ‘loss’ of more than 200,000 hospital bed days between January and November 2019 new figures from the HSE show.

The Health Service Executive said 218,028 hospital bed days were lost over the 11-month period, with a total of 9,809 patients classified as a delayed discharge nationally.

In November alone, there were 682 delayed discharge patients, with 20,868 hospital bed days lost.

A patient is classified as a delayed discharge when they no longer need acute hospital care but they have no access to step-down care in a nursing homes and or homecare services if they wish to return home.

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The highest delayed discharges were recorded in Dublin’s Beaumont Hospital, with 935 patients, and St James’s Hospital with 677 patients.

The figures emerged in a letter from the HSE to Fianna Fáil spokesperson on Older People TD Mary Butler. Ms Butler said the crisis in the provision of home care was contributing to an increase in the number of patients stuck in hospitals.

“The waiting list for home care has jumped from 6,000 to nearly 8,000 over the course of 2019. It has always been obvious to me that the restrictions on home care for older would put further pressure on acute hospital services.

“However, the Government seems intent on making the problem worse next year with the HSE cutting the numbers of short stay beds in public rentals - from 1,929 to 1,720 - a policy which flies in the face of the HSE capacity review which called for between 5,600 and 6,300 extra beds in this category by 2020.”

In response, the HSE said there is a “practical time lag” between a patient being deemed medically fit for discharge and the patient’s discharge from hospital.

“The time period can be prolonged for a variety of reasons, some of which may include where supports are not immediately available, where the patient or their family are considering an application for the Fair Deal scheme, where housing adjustments or construction must be completed or where the patient is a ward of court,” said a spokesperson for the HSE.

The HSE said a range of measures have been implemented to reduce lost hospital days as part of their Winter Plan 2019.

These including four weeks maximum processing times for Fair Deal applications, increasing availability of home support packages, transnational care and convalescence care in private nursing homes, providing specific care packages for patients with complex needs, and implementing measures to support wards of court.