Managers must provide winter plans this month

Hospital Groups and CHOs are required to provide winter plans for 2016/2017, for validation by the end of this month, following publication of the HSE Winter Initiative Plan for the coming winter. Maureen Browne reports.

Maureen Browne
Maureen Browne

The HSE said the winter initiative plan contained a number of key measures aimed at hospital avoidance, timely access, and hospital discharge. It would be implemented through a specific and detailed planning process involving all hospitals and Community Healthcare Organisations (CHOs) across the country.

These plans would be required to detail both management and clinical governance arrangements across each hospital and community for the duration of the winter period including metrics on service provision and supports, and escalation measures.

These plans would be required to detail both management and clinical governance arrangements across each hospital and community.

“The Special Delivery Unit will monitor the implementation of the plans in conjunction with the respective Divisions, and SDU improvement leads will be assigned to Hospital Groups/CHOs to drive the process improvement across the focus sites.”

The HSE Winter Initiative Plans provides for an additional 55 acute beds, an additional 58 transitional care bed approvals weekly for all acute hospitals, an expansion of Community Intervention Teams (CITs) to support five acute hospitals, an additional 950 Home Care Packages and an expansion of minor injuries services in Dublin.

It also provides for increased funding for Aids & Appliances to support discharge of patients from hospitals as well as facilitating hospital avoidance, which it expects to benefit 3,070 people.

The HSE says it will also implement targeted waiting list programmes for orthopaedics, spinal and scoliosis in designated sites by year end and there will also be an increased focus on ‘flu vaccination for the community at large and health care staff.

The HSE says it will also implement targeted waiting list programmes for orthopaedics, spinal and scoliosis

The additional 55 acute beds (which the HSE points out are on top of the additional 300 beds provided in 2015 and which remain open) are being provided in the Midland Regional Hospital in Tullamore, Beaumont Hospital, Naas General Hospital, and University Hospital Waterford and in the Midland Regional Hospital in Mullingar. In addition, 18 step down beds are being provide in the Mercy University Hospital, Cork.

The additional 58 transitional care bed approvals weekly for all acute hospitals are in addition to the funded level of service of 109 per week.

The expanded Community Intervention Team services, which the HSE says will benefit 6,643 additional patients, will be provided across four sites to support five acute hospitals – Beaumont, Mater, Our Lady of Lourdes Hospital, Galway University Hospital, South Tipperary General Hospital. The additional 950 Home Care Packages will target ten specific hospitals – Our Lady of Lourdes, Mullingar, Cork University Hospital, South Tipperary General Hospital, University Hospital, Waterford, University Hospital, Limerick, University Hospital Galway, Tallaght Hospital and St. James’s Hospital.

According to the HSE, the expansion of minor injury services in Dublin will provide for an additional 100 patients each week, with patients being seen in a more timely way, to include a Saturday service.

The HSE said The Winter Initiative Plan would begin to take effect from late October/early November 2016.

One of the key objectives of this year’s plan is to reduce the numbers of people waiting to be discharged from hospitals.

Commenting on the publication of the Plan, Tony O’Brien, Director General of the HSE said, “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 ED attendances.”

The HSE says that following on from the 24 Acute Hospital site visits undertaken by the Special Delivery Unit, over the period January to July 2016, key improvement actions have been issued to individual hospitals, in the following areas:

  • Management of older persons care pathways.
  • Improvement in non-admitted PET (Patient Experience Time) targets.
  • Improvement in the management of patients with chronic diseases.
  • Extension of 7 day discharging – criteria led discharge planning.

An important element of the Winter Plan is the measurement of the impact on scheduled (non-urgent elective) care by measures put in place to deal with the increased demands of unscheduled care. At the recent ED Task Force meeting, the Special Delivery Unit outlined to the group how this impact would be measured. The Director General of the HSE highlighted the importance of the SDU working with hospitals to ensure that all necessary steps are taken to minimise such an impact in as much as is possible.

The HSE said some of the key outcomes to be achieved through the implementation of this plan include:

  • A reduction in Delayed Discharges in acute hospitals to no more than 500.
  • Patient Experience Times: Improve compliance from 63% YTD to 75%.
  • Patient Experience Times: Improve national compliance of 98% from YTD July 96%.
  • Patient Experience Times: Of all ED attendees discharged or admitted within 6 hours of registration (improve compliance from 68% YTD to 75%)
  • TrolleyGAR – All sites to meet 8am TrolleyGAR threshold (max 236).