Martin Ferris (Kerry North, Sinn Fein)
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Question 110: To ask the Minister for Health and Children the action she will take to address the situation whereby there were 611 delayed discharges of patients from hospitals in 2007 and 733 in 2009; and if she will make a statement on the matter. [10454/10]

Mary Harney (Dublin Mid West, Independent)
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I wish to advise the Deputy that, due to public service industrial action involving members of IMPACT, the Department has not been in a position to obtain current information from the HSE in relation to delayed discharge numbers in the acute hospital system.

The HSE has taken a series of steps across the health system to shift the balance of care from acute hospitals to community based alternatives and to improve the way in which hospitals operate. These steps include the development of more enhanced community based services, Primary Care Teams, Community Intervention Teams, Rapid Access Clinics, Home Helps and Home Care Packages. The actions are designed to provide care for patients outside the acute setting where appropriate.

The National Code of Practice for Integrated Discharge Planning was introduced last year to target difficulties in the discharge of patients from an acute setting. It will be accompanied by significant changes to internal hospitals processes, work practices and behaviours. Those changes will involve developing the role of nursing in supporting more efficient processes at ward and overall bed management level and improving patient flow in, through and out of the hospital system. The Code also requires changes in clinical practice in terms of scheduling ward rounds to facilitate appropriate and timely clinical review of all patients, seven-day discharging, improving access to senior clinicians, improved tracking and follow up of tests and procedures and improving communication between teams and with patients.

Since the introduction last year of Fair Deal, the Nursing Home Support Scheme, there is no longer an incentive for patients in hospital following completion of the acute phase of their treatment to seek a publicly funded long-term care bed as opposed to a bed in the private sector. A person will make the same contribution towards their care costs, based on an ability to pay, regardless of whether they enter a public or private long-term care facility. At my request, the HSE has streamlined the administrative process for dealing with applications under the Fair Deal so that patients' discharge to a suitable long-stay facility is not delayed unnecessarily.

The HSE Directorate of Quality and Clinical Care will be establishing Clinical care programmes in key health service areas with national clinical leadership. These programmes will have a significant focus on increasing the efficiency of hospital bed use by moving care out into the community, same day admission and increasing day case care.