Delayed discharge patient numbers up

The number of patients inappropriately occupying acute hospital beds is increasing once again, despite several high-profile initiatives…

The number of patients inappropriately occupying acute hospital beds is increasing once again, despite several high-profile initiatives by health service management to deal with the issue over recent years.

Department of Health officials have briefed ministers in recent weeks on the issue, saying that there were an estimated 530 patients across the State in acute hospital beds whose acute phase of treatment had concluded.

And figures produced last week by the Health Service Executive (HSE) reveal the number of delayed discharge patients in hospitals across the State has increased further in the weeks since the material was provided to ministers.

A HSE spokesman said that as of August 20th, there were 568 delayed discharge patients in hospitals. He said 340 of these patients were in Dublin hospitals.

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At the beginning of January the number of patients inappropriately occupying acute hospital beds due to lack of alternative accommodation stood at 479.

Department of Health officials told ministers that while the issue of delayed discharge patients was "a particularly significant problem" in Beaumont Hospital in Dublin, the number of such patients was increasing in all of the main Dublin teaching hospitals and in other centres around the country.

"The Irish Nurses Organisation (INO) work-to-rule (earlier this year) has affected returns of these statistics, but it is estimated that there are currently about 530 delayed discharge patients nationally, about 70 per cent of which are in Dublin hospitals," a Department of Health official told ministers.

High levels of delayed discharge patients in hospitals can have a significant impact on overcrowding in accident and emergency departments.

Over recent years the HSE has devoted significant efforts to developing community services so that patients are not required to be admitted to wards.

The HSE has also sought to secure long-stay beds, frequently from the private sector, for patients who no longer need acute hospital care.

In a statement yesterday the HSE said: "In response to demographic and other pressures the HSE has over the last two years sought to develop additional non-acute capacity to cater for this demand.

"It is estimated that up to 3,700 placements need to be made from the acute hospitals to home care or residential care settings each year."

This year the HSE plans to provide 350 additional long-stay beds by way of contract with the private sector.

It also proposes to expand capacity in the public sector by some 350 beds through the development of community nursing units in Dublin at Cherry Orchard, St Mary's in the Phoenix Park, Clonskeagh and Raheny.

Other initiatives put in place by the HSE to deal with pressures in emergency departments include the establishment of community intervention teams and the hospital-in-the-home programme. Rapid-access clinics and the development of GP out-of-hours services were also put in place by the HSE.

Meanwhile, the Department of Health also told ministers that Beaumont Hospital in Dublin and Our Lady of Lourdes Hospital in Drogheda are the two hospitals where patients in accident and emergency face having to wait more than 24 hours for admission.

"The target of ensuring that patients are admitted within 24 hours is being achieved by the vast majority of hospitals and has been achieved for some months.

"The main exceptions are Beaumont Hospital and Our Lady of Lourdes in Drogheda," Department of Health officials said.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.