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Ireland's Winter Plan: 500 new acute beds and an 'unprecedented' €600m boost on last year

An extra 251 acute beds in Q4 of this year, and 232 acute beds in Q1 next year, are included in the plan.

Image: Shutterstock/Gorodenkoff

Updated Sep 24th 2020, 12:21 PM

THE HSE HAS launched its Winter Plan, which has an “unprecedented” €600 million boost to help tackle the challenges posed by the Covid-19 pandemic.

Ireland currently has 409 acute beds, according to the HSE; as part of the Winter Plan it aims to raise this to 892 beds. It will increase the sub-acute beds from 395 to 484.

Speaking at the launch of the plan today, HSE CEO Paul Reid said ICU capacity started at 225 beds pre-Covid, and was increased to 282 throughout the pandemic. Reid said the plan is to increase capacity by 30% on the February baseline.

The plan aims to increase community capacity and decrease acute hospital demand, which follows the theme of the Sláintecare plan, to mitigate the impact of Covid-19.

Key initiatives within the Winter Plan include:

  • An extra 251 acute beds and 89 sub-acute beds in Q4 2020, with 232 acute beds to be delivered in Q1 2021.
  • A total of 530 repurposed/ new rehabilitation beds, including 631 rehabilitation outreach places will be operational up to April 2021, 868 new Whole-Time Equivalent healthcare workers are needed to staff this initiative.
  • More home-support packages; more HSE-procured private-bed capacity; and more intermediate care beds.
  • Support for GPs. These supports will “ensure” that single-handed and two-doctor practices, of which make up 15% and 24% of GPs respectively, do not experience practice failure and/or GP burnout
  • There are currently 7 Community Assessment Hubs operation within 5 Community Healthcare Organisations with a further 3 on standby to open should demand increase. The plan is to have 20 hubs available from January to April 2021.

Implementing this plan will cost over €200 million this year, and over €403 million next year, totalling €604,172,714.

The majority of the €600 million funding will go towards: home supports (€138 million), acute beds (€81 million), community beds (€87 million), private hospitals (€58 million), and vaccination (€55 million).

Paul Reid said today that this winter is going to be “more difficult than any we’ve ever faced before”.

We are living with Covid-19, we are living differently, however we have planned differently and we have to take confidence in our Winter Plan.

“I am asking the public to follow the public health advice, the worst thing we can do is to get complacent. I am also asking those within the priority groups to ensure they get the flu vaccine and give themselves the best opportunity to stay well this winter.”

Recruitment

Speaking today, Anne O’Connor, HSE Chief Operations Officer said the HSE would focus on the resumption of health services, while preparing for the expected pressures associated with winter, as well as the challenges posed by Covid-19.

“Guidance, new processes, and infrastructure, will be critical to supporting the resumption of service delivery,” she said.

She added that the aim is to recruit 2,760 staff in 2020 as part of the core winter plan and a further 2,200 in testing and tracing.

A proportion of the new staff will be carers and home support staff as part of the health service’s plan to keep vulnerable people out of hospitals as much as possible. The aim, officials said today, is is to provide better supports for treatment and care in the community to prevent hospital admissions and also to get vulnerable people back into their homes more quickly after they have been in hospital.

Following the publication of the plan CEO of Nursing Homes Ireland Tadhg Daly called on the Minister for Health to provide explicit commitment that nursing home staff would not be targeted for recruitment for these new roles.

“We are already concerned in this regard, with some nursing homes reporting approaches being made to staff seeking to recruit them to work within our acute hospitals,” he said.

“We acknowledge the critical requirement to increase capacity within our acute services as we face into an unprecedented Winter period for our health services. However, this must not be at the expense of our wider social care services. It is absolutely imperative the State recognises nursing homes remain under immense pressure and are similarly facing into a Winter that will likely prove the most challenging ever encountered.”

The Irish Medical Organisation has criticised the plans, describing them as “temporary measures or clever ‘workarounds’ to manage what promises to be a herculean challenge”.

The IMO said the funding provided under the plan is equivalent to about 3% of the annual budget for the health services, adding that there is “still no clear long-term plan for how the HSE will manage the very challenging environment of delivering Covid and non Covid Care”.

It also said there is no funding for sustained long-term beds and no clarity on how to guarantee the extra consultants, public health specialists and GPs needed over the coming months and years.

Today IMO President Dr Padraig McGarry said:

“Now is the time to seriously invest in long term sustainable solutions for our health services. We must have a properly resourced service to keep our population well and to enable economic recovery.

“We are now paying the price for repeatedly long-fingering solutions to the crises in respect of beds and recruitment which have been festering for a decade and that is now directly restricting our ability to meet the health service demands of the Covid 19 era.”

The Irish Nurses and Midwives Organisation (INMO) also warned that the winter plan will not work without extra nursing and midwifery staff and clarity is needed on how the health service will recruit and retain staff.

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The INMO said there are some 400 nursing vacancies unfilled in the East region’s 12 hospitals and it has sought a funded workforce plan from the HSE for months.

“We are still awaiting any engagement – something we have referred to the WRC as a dispute,” she said.

“This winter plan brings welcome investment, but absolutely zero clarity on how we will recruit and retain the staff to provide care. The HSE says it will take a zero-tolerance approach to overcrowding, yet trolley figures continue to grow.”

‘Unprecedented times’

Speaking to reporters this afternoon, Taoiseach Micheál Martin said: “It is essential we do what it takes to make sure that we can enable our health service to deal with Covid-19 and also the challenges of non-Covid illnesses that will arise and the need to do everything we can to keep waiting lists down, notwithstanding the impact of Covid in hospitals.”

Health Minister Stephen Donnelly has also welcomed the publican of the plan. 

“We are in unprecedented times and the large amount of funding allocated by the government this year reflects that,” he said. 

Donnelly welcomed the additional supports in the plan for people at greater risk, including older people, those who are homeless, and those with chronic illnesses. 

“The rollout of community specialist teams to support older people and those with chronic disease is hugely positive. These teams will health them to stay at home or, if they need hospital care, to get home more quickly afterwards,” he said. 

“The plan also gives GPs better access to diagnostics, which will have a positive impact by reducing waiting times for patients and reducing demand in our emergency departments.” 

You can read the HSE’s Winter Plan here.

With reporting from Michelle Hennessy and Hayley Halpin

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