HSE plan for non-acute patients

The Health Service Executive (HSE) has been examining the possibility of placing public patients who no longer require acute hospital care in private hospitals.

The move forms part of a plan by the HSE to secure 1,100 extended care beds, mainly in private nursing homes or in community nursing units in the public sector.

The provision of extended care beds is considered critical to the success of HSE plans to transfer out of public hospitals patients who no longer require acute care. This move is central to the strategy for dealing with over-crowding in A&E departments.

HSE management told its board in October that it was estimated that around 850 extended care beds could be provided by next March.

"In addition, other opportunities continue to be examined including, for example, the scope for using potentially spare capacity in private hospitals, where this arises during the winter period, for high dependency and intermediate care.

"It is too early to predict the likely outcomes of such examinations," the report stated.

The HSE estimated in the report that it could secure up to 400 beds in the private nursing home sector by next March.

"Currently some 82 out of 290 patients who have their discharge delayed in the Dublin hospitals are listed as requiring public long-term care due to medical needs. This figure may be overstated as there is a tendency for patients and their families to actively seek care in public facilities due to care preferences and perceptions regarding financial arrangements.

"Nevertheless there is evidence of substantial need for high-dependency care, and the HSE would intend working actively through the service agreement process to put in place arrangements with established providers identified as having the potential to provide this care," it stated.

The report also stated that the HSE is looking at the provision of 187 beds through projects to expand existing public facilities. "A further 100 beds are to be brought onstream through the existing capital programme or where additional capital is not required.

"In line with the previous estimate given to the board, it is expected that 50 of these beds can be introduced by March 2007, with the remainder delivered in the subsequent three to six months," the report stated.

HSE management told the board that the Department of Health had also given approval for the construction of seven 50-bed community nursing units and that the competition for the selection of developers to design and build these facilities was under way.

"Use of an existing State contract for the construction of up to four of these units is also being explored, subject to outstanding issues being addressed," the report added.