Mary Butler (Waterford, Fianna Fail) | Oireachtas source

University Hospital Waterford continues to perform better than the national average for patient experience times in the emergency department, ambulance turnaround times and maintaining a zero-trolley status for admitted patients, and all with a view to supporting a positive patient experience with 452 beds. This has been achieved through close co-operation between University Hospital Waterford, UPMC Whitfield Hospital and three private nursing homes to bring on stream additional capacity of more than 45 beds in the catchment area. This was not just done in the past few weeks; it was done over the past two years and it has made a significant difference. It means patients who no longer need consultant-level care in acute level 4 hospitals can be transitioned safely and securely for local nursing care while they continue their care pathway. A dedicated focus on patient egress through University Hospital Waterford - led by Grace Rothwell, the manager of the hospital, with the co-operation and support of all the staff - has resulted in it not having to rely on trolleys.

The Government recognises a strong healthcare system goes far beyond our hospital doors and we know many older people would much prefer to stay at home. We have the community intervention teams. We have all 22 integrated care programme for older people teams in place. We have home and community nursing units. Without these teams and vital community healthcare networks such as St. Brigid's in Carrick-on-Suir, many patients would have to be seen in hospital. The teams on the ground support people living with long-term illness, pain management and diabetes. In addition, without these teams, many patients fit for discharge would have to remain in hospital. Timely access to home support is critical to supporting older people and people with disabilities to live and age well in their communities. The most up-to-date figures show that 56,500 people were in receipt of home care today. There are 3,240 new applicants with funding approved waiting for a carer and 2,819 people are already receiving some supports but not the maximum hours advised. Home support is important in helping many older people leave hospital safely.

We recognise the workforce challenges affecting access to home supports and I have strongly endorsed all 16 of the recommendations of the strategic workforce advisory group. We are committed to the full implementation as a priority. On 16 December last, in conjunction with the former Minister of State, Deputy English, I announced the authorisation of 1,000 employment permits for non-EU or EEA home support workers, as recommended by the advisory group. I am very hopeful this will significantly reduce the shortage of home support workers in Ireland in the immediate future. A similar measure was successfully provided in nursing homes and the HSE community nursing units, with over 2,500 permits issued up to last year. Rolling recruitment campaigns across the HSE also continue to encourage people to see home care as a viable career opportunity. The payment of the living wage and mileage, which were also dealt with in the report, will be in the new HSE tender at the end of March.

I wish to speak about the enormous ongoing efforts to support the safe discharge of patients from the acute hospitals into the community as soon as possible. The HSE national service plan includes several initiatives to support this and transitional care funding is available to ensure patients can move into a nursing home temporarily while their applications for fair deal funding are being processed. This funding is available all year round, with €16 million being specifically allocated through the winter plan. As a continuation of the winter plan initiatives, the HSE is working to ensure the full utilisation of 654 contracted private nursing home beds that have been brought on stream through the community beds initiative. The initiative has been in place since 2011, when €125 million was first allocated to develop short-stay residential and rehabilitation capacity. These beds are contracted nationally and enable patients to be discharged from our acute hospitals into nursing homes while awaiting transfer either home or into long-term residential care. Under these initiatives, patients transfer into community beds regularly. Last year, 10,000 patients were able to access temporary care funding. In the first week of this month alone 267 patients transferred from acute hospitals to long-term care in residential homes. This is double the number for the same week in January last year. There was also nearly 1,000 approvals for transition into nursing homes through the month of December 2022.

It is recognised that capacity for transitional care will vary across the country. I continue to encourage engagement between nursing home providers and the HSE at a local level to agree suitable measures to meet the needs. Such agreements are already in place and have been effective in reducing delayed transfers of care. The HSE estimates that there are 221 patients awaiting transfer to long-term residential care. I have written to the HSE to ask it to encourage all community healthcare organisations to maximise their use of existing transitional care funding as needed. I have also advised it of my support for extra initiatives regarding home support to free up acute capacity.

I was recently contacted by concerned older people and their families. They expressed the fear that if they attend an acute hospital, they may have difficulty in returning home and that long-term residential support may be a choice offered. I emphasise the importance of at all times hearing, respecting and ensuring that the voice and choice of older people remains central to decisions regarding their care. Many of the supports and capacity I have outlined refer to short-term supports until a person is suitably well to return to their own home. I take this opportunity to thank all the staff of the health service for their work to engage in providing surge capacity in respect of home support.

Every part of the healthcare system, including primary care, social care and community care, is seeing additional investment to build for Ireland's future. When these are put together, they can be used to achieve the reform we all want.

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