The challenges facing the health service this winter have been well signalled. There are fears of major overcrowding due to surges of Covid-19 and flu infections and record demand for emergency department services. However, less is heard of the system’s preparedness for all this.
It is therefore concerning to learn that the number of recovered patients whose discharge from hospital is delayed is also on the rise. So far this year 8,200 patients could not be discharged as planned due to a wide variety of factors. Last year, more than 236,000 bed days were lost as a result of such so-called delayed transfers of care .
Many of these delays are the result of failures to organise services in the community. More than 1,000 patients have remained in a hospital bed so far this year due to a shortfall in carers available to provide home support. A similar number of discharges were delayed due to issues with the Fair Deal scheme.
Hospitals save lives, but they can be bad for patients too. Unnecessarily long stays put patients at risk of deconditioning, making it harder for them to readjust to life in the community. There is also the risk of infection, which has worsened since the Covid-19 pandemic.
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The figures on delayed discharges indicate that society does not accord enough importance to the caring function. Home carers are lowly paid, often transient workers. Many have other care commitments in the home, but the social welfare system makes it hard for them to work part-time. And yet the work they do is vital and will only become more important as the population ages.
The HSE says it is trying harder to recruit carers, both at home and overseas. The fact that delayed discharge figures vary across different parts of the country suggests that some hospitals are better than others at ensuring beds are freed up once patients are well.
So far this year, 165 patients have had their discharge delayed by at least three months, suggesting many hospitals could be managing their patient flow more efficiently.