The number of patients whose discharge from hospital was delayed was higher in the first 10 months of the year than during the whole of last year, Health Service Executive (HSE) figures show.
The HSE said the Covid-19 pandemic posed “additional challenges”, which has had an impact on the number of transfers of care.
Data released to The Irish Times under Freedom of Information laws show that between January and December 2021, 7,965 patients were unable to be discharged despite no longer needing hospital care. This compared with 8,200 patients up until October 25th.
Delayed discharges are a concern for the health service as they increase the risk of a patient contracting an infection, can contribute to overcrowding due to lost bed days and can result in increased waiting lists as elective procedures can be cancelled when no bed is available.
According to the HSE data, there were 236,907 lost bed days as a result of delayed discharges in 2021.
A HSE report on delayed discharges, dated October 25th, found that Beaumont Hospital had the highest number this year so far, at 846, followed by Cork University Hospital at 757 and the Mater at 505.
Mallow General Hospital has the lowest number of delayed discharges this year to date at three, followed by St Luke’s Oncology, which has had nine.
A total of 120 patients remained in hospital for more than 90 days after they were deemed fit for discharge, while 45 patients had theirs delayed by more than 180 days.
The reasons behind delayed discharges vary, but the most common reason – affecting more than 1,000 patients this year so far – was due to a shortfall in carers available to provide home support to patients.
A spokesman for the HSE said: “Once the needs of a patient are identified, integrated teams of staff work together to establish pathways and supports to enable soonest recovery and discharge of patients from the acute setting.”
Damien McCallion, the HSE’s chief operations officer, said the executive was stepping up its efforts to recruit home care staff, both in Ireland and internationally.
A lack of access to care at home was one of the main reasons patients get delayed in hospital after they are fit for discharge, he acknowledged. The problem varies in size across different parts of the country.
“The number of delayed transfers of care each day is running at about 550-600 at present. We are trying to see if we can get this back down through some investment coming into the winter but it is challenging to recruit people. We’re looking at recruiting internationally and training our own staff.”
A lack of home care staff had been identified in the UK as one of the biggest challenges facing the national health service there, Mr McCallion said.
About half of all delayed discharges involved patients with complex needs for whom the right resources and the right level of resources has to be carefully determined. “It’s not just about paperwork, it’s broader than that,” he said.
HSE enhanced community care teams were also trying to identify vulnerable patients in the community before they require hospital admission, and to provide them with supports that might obviate the need for admission, he added.
A report from the strategic workforce advisory group on home carers and nursing home healthcare assistants, published by the Department of Health in October, noted an “acute shortage of care workers against a background of rising demand”.