The latest figures from the HSE show that there were delays in discharging 5,500 people from acute hospital care so far this year, leading to more than 85,500 lost “bed days” in the system. In turn, this is contributing to delays in people getting through the A&E system and in particular more time spent on trolleys. And we know that, as well as causing discomfort, this also exposes the patients to higher clinical risk.
What is formally called a delayed transfer of care occurs when a person is ready to leave the acute care system but remains occupying a bed. This is a perennial problem in the Irish hospital system and is part of a wider story of a growing and ageing population putting pressure on social services. This can happen for a number of reasons but generally involves older people who are waiting for an appropriate care programme at home, a bed in a step-down facility or space in a nursing home. Homelessness can be another issue.
There has been some limited progress in recent years, with the 5,548 delayed patient transfers so far this year down from 6,6610 in 2023. But despite a range of action plans from successive ministers going back more than a decade, the issue remains a serious one. As well as contributing to the ongoing unacceptably high number of people on trolleys, an unnecessarily long stay in an acute ward also opens up the patient to greater risk of infection and means they are delayed getting on with their lives in a more appropriate setting.
More funding for step-down facilities and home support packages will remain needed as the population ages. The lack of joined up technology in the Irish health system remains an issue. And delays in the administration of the support schemes for nursing homes - the Fair Deal scheme- and in the provision of home care packages are also factors.
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Tackling delayed discharge remains a key issue for the hospital system . And it is also vital for the support and dignity of the largely older population and their families, who are seeking the best way forward after a period of hospital care.
