HSE needs 'more than €100m' to tackle trolley crisis

More than €100 million is needed to resolve the overcrowding crisis in hospital emergency departments, according to internal HSE estimates.

The money is needed to open more acute hospital beds, pay for more nursing home places and provide more resources for community services such as home help.

It is understood that while the HSE has not specifically requested additional State funding, it has identified the scale of resources required to deal with the problem.

Informed sources suggested this would be more than 100 million, and possibly as much as €130 million.

Internal Department of Health records show a number of short-term measures are being considered to try to ease pressure on hospitals.

They include placing hospitals “off call” for limited periods and diverting ambulances to less crowded hospitals.

There are also proposals to encourage the public and GPs to consider alternatives to emergency departments and to trigger “escalation status” at crowded hospitals, obliging all staff to respond and identify patients ready for discharge.

Taskforce report

In a statement, a spokesman for Minister for Health

Leo Varadkar

said the upcoming report of an emergency department taskforce will “specify the actions required to address these matters and provide a clearer picture of any adjustments or re-focusing of resources to deal with the problems concerned”.

The Irish Times reported in January that the HSE had sought €106.5 million in funding as part of the estimates process leading up to the budget. This was needed to free up hospital beds and tackle emergency department overcrowding.

This bid was ultimately rejected and €25 million was allocated by the Government late last year to go towards extra nursing home beds under the Fair Deal scheme and other measures.

However, internal Department of Health records indicate this funding will have a limited impact in easing the pressure. This is because some of the extra nursing home beds announced include those already occupied by former hospital patients.

“The net gain from additional Fair Deal allocations is reduced by the fact that some patients are already in nursing home beds which are being subsidised by hospitals,” according to a briefing note, drawn up for the Minister in late December.

Bed capacity

“Therefore, the impact on bed capacity is not of the same magnitude as the actual number (announced).”

Since December, the number of patients on trolleys in emergency departments waiting for a hospital bed has increased significantly compared with recent years.

This is due partly to hundreds of patients who have completed their acute treatment and are waiting for nursing home beds or supports to allow them to be discharged.

Many of these “delayed discharge” patients are older people who have been approved for funding for private nursing home beds but who are waiting to draw down the funds under the Fair Deal scheme.

More than 1,200 people have been waiting 11 weeks for this funding.

A spokesman for Mr Varadkar said actions taken to date were working – with delayed discharges down from a peak of 850 to just under 700 – but they needed to be intensified.

Mr Varadkar told the Dáil last week that while the figure for delayed discharge patients was down since the start of the year, it remains a problem.

He said additional resources were needed for the Fair Deal scheme, home care packages and home help provision.