Over 850 hospital bed days lost this year amid renewed pressure on emergency departments

More than 850 hospital bed days have been lost to the HSE this year after closures, amid the ongoing pressure on the health service due to a surge in hospital attendances.*

The data from the HSE comes as hospitals are bracing themselves for renewed pressure on their emergency departments on Tuesday, amid fears the number of patients on trolleys will rise again.

The HSE has said that 858 bed days have been lost across the hospital network due to closures and other reasons.

The biggest number of unavailable bed days is 554 which were lost due to the need for infection prevention and control.

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A total of 120 were lost due to staffing issues and further 113 due to Covid-19.

Another 63 bed days were lost due to refurbishment while eight have been unavailable due to weekend closures. It comes as the Government has urged the HSE to escalate the use of funding for transferring patients from hospitals to private nursing homes and ambulance drivers have reported long waits to hand over patients to emergency departments in recent weeks.

Thanks to an increased rate of patient discharges, overcrowding dipped over the weekend and Monday, but Tuesday is traditionally the busiest day of the week for many EDs.

Due to what HSE chief clinical officer Dr Colm Henry termed the “whole system response” of the health service in recent days, the number of patients waiting to be admitted on Tuesday is thought to be unlikely to climb as high as last Tuesday’s record figure of 923.

However, hospitals remain under significant pressure due to waves of flu, Covid-19 and other respiratory infections.

There were 489 patients waiting to be admitted to hospital on Monday, according to the Irish Nurses and Midwives Organisation, down from 535 on Friday, which is normally a quieter day.

The HSE says staff at all levels responded to its call to work over the weekend in order to ease pressure on the health service. As a result, the number of patients discharged at the weekend was higher than usual, and so more beds were available for new patients admitted through the emergency department.

The hospital with the highest trolley numbers on Monday was University Hospital Limerick, with 48.

[ Hospital overcrowding should be treated as a ‘national crisis’, says INMO ]

From Monday, ambulance personnel started diverting patients with stable medical conditions from UHL to Ennis Hospital, under a new protocol at the Co Clare hospital. Three non-critical patients were brought to Ennis on the first day of the pilot scheme.

There were 635 patients with Covid in hospital on Monday, up from 619 on Friday.

This included 35 patients in intensive care, compared to 36 on Friday.

The first cases of a new Covid-19 subvariant which is causing concern internationally have been detected in Ireland.

The Health Protection Surveillance Centre says “less than five” cases of the XBB. 1.5 subvariant were detected by genomic sequencing in the four weeks before Christmas.

Separately, private nursing-home owners have provided the HSE with a list of available beds in the facilities following a meeting between the Executive and Nursing Home Ireland on Monday.

Some 760 beds are said to be available in 147 nursing homes, though it’s believed more beds are available among 230 facilities that did not respond to a Nursing Homes Ireland survey. While more than 500 patients remain in hospitals despite being declared fit for discharge, health sources said only 40 per cent of these patients are waiting for standard long-term residential care.

[ Hospital overcrowding: Is adding more beds really the solution? ]

Minister of State for Health Mary Butler wrote to the HSE on Friday urging increased uptake of a €16 million Transitional Care Fund (TCF) for transferring patients to private nursing homes.

She wrote that data from December “shows variable usage” of the TCF across the HSE’s Community Healthcare Organisations (CHOs).

Ms Butler added: “All CHOs should be encouraged to escalate the use of this fund where possible”.

A spokeswoman for Ms Butler said there were nearly 1,000 approvals for transitional care in nursing homes throughout December and CHO’s have been encouraged to “maximise” their use of the TCF.

A HSE statement said hospitals and CHOs are talking to nursing homes on a daily basis to discharge patients.

The HSE said that in the first week of January 2023 alone 267 patients transferred from acute hospitals to long term care in residential nursing homes, enabled by this the TCF funding, double the number of funding applications managed for the same week in January 2022.

Elsewhere, Greg Lyons, Siptu ambulance sector president, said that in some instances paramedic crews are having to wait several hours to hand over their patients for admission to emergency departments.

“It’s more common than not,” he said adding: “In the lead-up to Christmas there was a crew in the West of Ireland that spent their entire 12-hour shift with a patient in the emergency department.”

Mr Lyons said this was “killing morale” among staff and longer shifts were impacting the retention of staff. He said calls had become more manageable since the weekend, but this would likely be “short-lived and could shoot up again”.

*This article was updated on January 10th, 2023 to reflect updated information from the HSE which revealed that bed-days, rather than individual beds, were referred to in the data.