Report shows bed closures escalating

New figures show that the HSE is closing beds to save money in a response to a greater than anticipated demand on hospital services this year.

Meanwhile, it has been revealed that nearly 1,900 beds in the hospital system are currently not available due largely to cutbacks and delayed discharges, and figures show than increasing number of beds are being closed to make savings in the HSE's budget.

The HSE has also admitted that it is using the National Treatment Purchase Fund (NTPF) to have the additional patients creating extra demand on the public system treated privately at taxpayers' expense.

In its newly-published performance management report for July, the HSE says combining inpatient and day case activity, over 20,000 more patients have been treated in 2009 compared to planned activity levels.

The report shows that hospital spending up to July this year were €48 million ahead of budget.

The report states: "A number of measures are being implemented in an attempt to control this growth (in hospital service demand), eg. hospitals have reduced bed capacity by approximately 519 beds from January to July, with further planned reductions for the remainder of the year, where required."

The HSE says that where capacity is reduced and/or there is an increase in service demand, hospitals "are working closely with the NTPF to ensure appropriate and timely referral for treatment."

The report shows that the number of beds available in the system is steadily diminishing.

It says there were 959 acute beds unavailable for discharges in July and on top of this 899 beds were taken up by delayed discharges (patients whose acute treatment has ended but for whom alternative accommodation cannot be found).

A breakdown of the missing beds (other than the delayed discharge beds) shows that 599 of them were planned closures, 130 were missing due to refurbishment or maintenance, 79 were seasonal closures, 19 were closed for infection control purposes and 83 were classified as "other".

On a specialty basis, the largest number of beds closed was in the medical area, with 386 closed, followed by 318 surgical beds closed. And at a time when concern has been expressed about the effects of a swine flu upsurge on hospital serivces, the report shows that 13 critical care beds are not available.

The report shows that the number of unavailable beds, apart from delayed discharge beds, increased from 389 in January to 959 in July. However, only 79 of the July figure for unavailable beds was due to normal seasonal closures

The HSE, in the report, says the large number of delayed discharge patients occupying hospital beds remains a concern.

It also says hospital bed capacity management and shifting the emphasis to community care continues to be a key objective.

The report also shows that three hospitals in the country- Beaumont, the Mercy and St James's, have average waits of over 12 hours for admission through emergency departments, after a decision has been made to admit.

The average ED trolley wait in Beaumont for July was 28.1 hours, according to the report.

In addition, a further three hospitals - Limerick Regional, Cork University, Tallaght and St Vincent's in Dublin  reported average A&E trolley waits of between six and 12 hours in July.

The HSE says it is continuing to work to ensure reductions in target ED waiting times.

[Posted: Fri 11/09/2009]