Pat Rabbitte (Dublin South West, Labour)
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Question 53: To ask the Minister for Health and Children the progress made in implementing the report by the emergency department task force; her views on the statement by the Irish Association of Emergency Medicine that overcrowding has reached record levels (details supplied); and if she will make a statement on the matter. [22168/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Emergency Department Task Force Report was commissioned by the Health Service Executive and published in June 2007. The Report set out a series of recommendations for action to improve service delivery and included a particular emphasis on the introduction of waiting time targets for patients attending emergency departments. The report also described a range of initiatives which would enable hospitals to comply with these targets.

I do not accept that overcrowding in Emergency Departments has reached record levels. There have been considerable improvements in the delivery of service in accident and emergency departments in the last two years. One indicator of improvement is the reduction in the average daily number of patients awaiting admission from 179 in 2005 to 92 in 2007.

The national daily average number of patients awaiting admission in May (to 30th) was 87, a reduction on the figure of 97 for the same period in May 2007. The average daily number of patients waiting in excess of 24 hours was 3, compared with 7 for the same period in May 2007. The average daily number of patients waiting between 12 and 24 hours for admission was 27 compared with 26 in 2007.

Significant additional resources have been provided to address the problems which manifest in Emergency Departments. Among the developments which have taken place in line with the recommendations of the Task Force Report are:

additional public and private Long Stay Beds,

additional Home Care Packages and Home Help Hours,

major capital developments in emergency departments and the provision of Acute Medical Assessment Units,

Community Intervention Teams in Cork, Limerick and Dublin,

rapid assessment clinics to support the catchment population of the Mater hospital,

expansion of the GP out of hours services in North Dublin.

In terms of waiting times, a revised target of 12 hours waiting from decision to admit was introduced in October 2007. This built on an initial maximum target waiting time of 24 hours. The HSE is also committed to monitoring and reporting on the total length of time patients spend in Emergency Departments, whether they are admitted or not. A number of hospitals have commenced reporting this information and the HSE expects to be in a position to publish data on up to 18 hospitals in the next few months. The majority of hospitals are meeting their admission targets and problems are largely confined to a small number of hospitals. The HSE is working closely with those hospitals with a particular focus on improving and streamlining processes and patient pathways to ensure that care is provided in a more timely, appropriate and efficient manner. Targeted initiatives include:

setting up consultant led Clinical Decision Units and Acute Short Stay Units with a dedicated number of beds,

integrated discharge planning implemented on a 7 day basis, including nurse facilitated discharges,

updating the bed management system and processes with a focus on improved discharge planning,

implementation of a new Code of Practice on Discharge Planning is to commence in June 2008 in a number of Hospitals, including the Mater, Beaumont, St. James's and Tallaght,

reducing inappropriate referrals from GPs to Emergency Departments,

reducing admissions with the duty medical registrar deciding on admissions,

standardising assessment processes,

enhancing diagnostic capacity.

The initiatives which I have described are designed to free up capacity during 2008, to allow for more timely admissions from Emergency Departments and further movement towards a lower target of 6 hours waiting from decision to admit in line with the recommendation of the Task Force report.