Mr. Stephen Mulvany:

We are very focused on the over-75 population. First, there is a demographic effect and while overall we have a younger population compared to the rest of Europe, our population is ageing more rapidly. The over-75 cohort is growing at around 4% to 5% per year which is much faster than the general population is growing. Covid-19 has also definitely had an impact. The clinical view coming back is that people may have delayed their health-seeking behaviour during Covid-19 and that elderly patients, and others, are often arriving sicker. They are much more likely to be admitted and their lengths of stay, which are typically longer anyway, are longer since Covid-19. A lot of our efforts are focused on trying to provide early intervention, that is, front door teams in our hospitals so that if older people arrive in hospital, we try to move them through the process as quickly as possible to minimise their waits because we know that is not good for patients. We are also investing in the community side in our integrated care programmes for older people, so that we can again intervene before they go to hospital and give alternatives to hospital admission, and certainly alternatives to hospital admissions via the emergency departments as much as possible. On the discharge side, we are trying to discharge people home for assessment because in hospital they are at their worst and we want to try to assess them at home and keep as many people at home as possible.

A big focus of the overall plan has to be and is on the over-75 vulnerable population. Dr. O'Connor will comment further.