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Full capacity protocols ‘now the norm’

05 Jan 2017

Full capacity protocols have their place in extreme cases but they are now becoming the norm, which will mean more problems down the line for patients as their long-awaited procedures are postponed, the IMO has warned.

The hospital crowding crisis will continue until “cuts to bed numbers in public hospitals are reversed and policies are changed to make Ireland an attractive location for Irish-trained doctors to want to work,” the Chair of the IMO Consultant Committee Chairman said yesterday (January 4).

Dr Peadar Gilligan stated that the root cause of the problem was a lack of beds, a lack of doctors and other staff, as well as a poorly resourced GP infrastructure. According to the Beaumont Hospital consultant in emergency medicine: “We’ve reduced the size of the container but we’re still trying to get more and more into it every day. It just won’t work.”

Dr Gilligan called on the Government to commit the funds required to run our health services to meet “the real demand, not some notional level of activity”.

At the end of last month (December 29) and before the latest record levels of patients waiting on trolleys, the Minister for Health had welcomed the fact that the Winter Initiative target for delayed discharges had been exceeded. Extra home help funding and community supports brought delayed discharges to a new low of 436, the Minister said last week. The figure for delayed discharges hit a high of 832 in 2014, and a total of 659 was recorded in early 2016.

However, this “major achievement” came just days before INMO Trolley/Ward Watch showed a record number of 612 patients, admitted for care, on trolleys in hospitals on Tuesday (January 3). The figure eased slightly by Thursday January 5, to 578, but was expected to rise again after the weekend.

The union’s Trolley/Ward Watch analysis for 2016 confirmed there were a record 93,621 admitted patients on trolleys. “Our genuine fear is, based upon a number of factors including the incidence of influenza and closed beds due to staff shortages, that, in the coming days, the situation may deteriorate still further,” INMO General Secretary Liam Doran had said.

There has been an intense focus on delayed discharges in the Winter Initiative. In June, an additional €41.4 million was provided for home care on top of the original €330 million provided for 2016, and a further €23.2 million (€13.2 million from the Winter Initiative, and €10 million in new development funding) will be provided for home care in 2017. This will provide for an increase in the number of home help hours from to 10,570 million in 2017.

The number of people in receipt of a home care package will also increase from 15,450 to 16,750 in 2017, while intensive home care packages are being maintained at 190. The 2016 Winter Initiative provided 650 additional home care packages in 2016, and 300 extra are included in the 2017 Service Plan. Paediatric home care packages are also increasing, from 474 to 514.

The 2016/17 Winter Initiative includes increased funding for aids and appliances to support discharge of patients from hospitals as well as facilitating hospital avoidance, benefiting more than 3,000 people.

An additional 55 acute beds and 18 additional step-down beds are being made available, while minor injury services in Dublin are to be expanded to provide for an additional 100 patients each week.

“Allowing patients to move home or to an alternative suitable community setting which meets their needs is a key priority,” said Minister Harris, before the latest surge in numbers this week. “This has been achieved not only by detailed planning but by providing significant additional funding for home help and for aids and appliances, as well as an additional 58 transitional care bed approvals every week and the expansion of community intervention team services — helping more than 6,500 patients.”

More than 34,000 more people in at-risk groups who hold a medical or GP visit card received the flu vaccine so far this flu season compared to the previous flu season, the HSE has indicated. A total of 486,249 people in at-risk groups have received the flu vaccine compared with 451,790 for the same period last year — an increase of 34,459.

There has also been an increase in healthcare workers receiving the flu vaccine, as the latest mid-season data for vaccine uptake show almost a 6 per cent increase for this year’s flu season compared to last year. Overall uptake among healthcare workers has risen to 28.3 per cent, compared with 22.5 per cent during the previous season. However, rates overall remain disappointingly low among healthcare workers, the HSE added.

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