Winter plan includes daily limit of 236 patients on trolleys

The number of patients on trolleys is to be limited to 236 on any single day under the HSE’s winter initiative to alleviate overcrowding in hospital emergency departments over the coming months.

The plan provides for 55 extra acute beds in nine hospitals and an extra 950 home care packages in the worst affected areas of the country.

An additional 58 transitional care beds and the expansion of community intervention teams for five hospitals are also proposed in the €40 million plan.

Minor injury services in Dublin are being expanded to provide for an additional 100 patients a week, with some patients being seen on Saturdays.

The HSE says it will increase the focus on flu vaccination for the community at large and for healthcare staff. The average uptake for the vaccine last winter was under 25 per cent in hospitals and nursing homes.

Key objective

The HSE said a key objective of this year’s plan is to reduce the number of people waiting to be discharged from hospitals by providing the specific supports and pathways to allow patients to move home or step-down care. Achieving this objective would free up hospital beds which, in turn, would reduce overcrowding in emergency departments.

“These carefully considered targeted measures are designed to achieve specific improvements in patient experience and levels of overcrowding in our hospitals’ emergency departments in the face of sustained increases in emergency department attendances,” said HSE director general Tony O’Brien.

Under the plan, to take effect from late October, the number of delayed discharges must not exceed 500 and patient throughput is to be improved.

The Irish Nurses and Midwives Organisation said the plan left unresolved the issue of how the health service can recruit the additional staff needed to increase bed capacity.

In a number of hospitals, it was likely that existing beds would have to close due to inadequate staffing, the union warned.

In addition, many of the 300 beds opened under last year’s winter initiative are now closed, it said.

Fianna Fáil said the plan would not make a meaningful difference to the number of patients lying on trolleys in hospitals.

"An additional 55 acute hospital beds for the entire country just isn't enough to make a meaningful dent in trolley numbers. While any additional funding to the health system is to be welcomed, €40 million represents just 0.03 per cent of the entire health budget. It's clearly not enough," said health spokesman Billy Kelleher.

The plan was supposed to have been published earlier this week but its release was delayed after Minister for Health Simon Harris expressed dissatisfaction with the level of detail in the original draft.