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HSE

HSE has 'significant concerns' it will continue to miss emergency department targets

The HSE aimed to have 99% of patients over the age of 75 discharged or admitted within nine hours of having turned up at hospital, but the real figure was 50.9%

THE HSE IS far from the targets it set for emergency departments covering the length of time patients spent in A&E, the numbers on trolleys, delays in treating over-75s, and slow handover of patients from ambulances.

In a board strategic scorecard, unscheduled care was given a rating of just one out of five with “significant concerns” targets were again not going to be met this year.

According to the figures, which were shared with Health Minister Stephen Donnelly in April, a daily target of 236 patients on trolleys in A&Es had been set for 2023 but the actual figure was 352 in January and 326 in February.

Another target of having 97% of patients gone from the emergency department within twenty four hours was also missed, the records showed.

Instead, in January 5.3% of patients were at least a day in A&E while in February, that number had fallen only slightly to 5% of patients.

The HSE had also aimed to have 99% of patients over the age of 75 discharged or admitted within nine hours of having turned up at hospital.

However, the actual figure for January was 50.9% and again in February, there was only a small improvement with the figure rising to 52%.

A further target for over-75s of discharge or admission within 24 hours of registration was also set at 99%.

However, it too was missed with an average of 12% of this vulnerable age group at least a full day in the emergency department in the first two months of the year, many of them on trolleys.

Another performance indictor that was significantly off target was the aim of twenty minutes as the time it took for a “physical and clinical handover” of a patient who had arrived at an ED in an ambulance.

The target set for this was 80%; however, the actual figure for January was just 7.5%.

The score card said the health services remained under “considerable pressure” with high levels of Covid-19 and the norovirus winter vomiting bug causing particular difficulties.

There had also been additional challenges from a fire at Wexford Hospital and a significant rise in demand for services from international protection migration to Ireland, much of it due to the war in Ukraine.

The report said: “At this point, the rating is 1 [out of 5] as key measures are beyond 20% of target in over 50% of KPIs [key performance indicators]. It is anticipated that this rating will improve as the winter surges ease and mitigating actions start to take effect.”

It said key challenges in tackling ED delays and overcrowding were recruitment, infection control, increasing numbers of people needing scheduled care, and difficulties in building new capacity.

Overall, the HSE score card ranked twenty separate areas of service with none scoring five out of five, and seven having a ranking of four out of five.

The majority of areas, twelve in total, scored three out of five meaning there were “some concerns” that this year’s ambition statement “will not be substantially achieved”.

Some of the areas scoring three included the Covid-19 public health programmes, reform of disability services, enhancing bed capacity, and recruitment and retention.

In the area of recruitment, the report said there were challenges around reduced labour supply, as well as the reopening of international borders meaning many Irish staff were taking the opportunity to work abroad.

Asked about the scorecard, a HSE spokeswoman said they were aiming to expand their workforce by 6,000 people this year while making themselves an “employer of choice” for healthcare workers.

She said: “There is a global shortage of particular health professionals. As a result, it is understandable that our own recruitment activity does not always result in qualified candidates for particular roles and/or specialties.”

The spokeswoman added that a new approach to improving A&E performances was underway, as the HSE contended with significant rises in the numbers attending, the numbers being admitted, and the number of over 75s in need of urgent care.

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