Billy Kelleher (Cork North Central, Fianna Fail)
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To ask the Minister for Health the actions he is taking on the hospitals that have the longest length of stay for patients; and if he will make a statement on the matter. [43529/12]

James Reilly (Dublin North, Fine Gael)
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It is important to note that across the acute hospital sector as a whole, reduction in costs will come from greater efficiencies where possible, including shorter Average Length of Stay (AvLOS) which is key to the delivery of agreed activity levels with fewer beds, and therefore less staffing. This in turn reduces the number of bed days needed. This year, general AvLOS has been reduced from 7.2 days to the HSE Target Plan of 5.8 days. In particular, implementation of the HSE’s Acute Medicine Clinical Care Programme has saved 121,000 bed days to date in 2012. The HSE transitional care initiative is also instrumental in shortening unduly lengthy and inappropriate stays in acute beds for patients, by putting in place 190 transitional care beds and 150 rehabilitation beds this year to which patients can move when appropriate. In terms of surgery, the realignment of services away from in-patient and towards day-case services is in line with international best practice: 2012 has, for the first time, seen agreed targets with all specialties in relation to AvLOS and day case rates for surgical care. The continued implementation of these Programmes and Initiatives is improving access to services, quality of care and the cost-effectiveness of the service provision.

The funding pressures now being experienced in the health services mean that the acute sector must reduce its costs in order to deliver the agreed level of activity within the resources available to it. This means that we must concentrate on maximising efficiency and getting the best possible services for patients from the budgets available to us. However, this on its own is not sufficient. Activity levels in our acute hospitals have been running ahead of the levels set in the approved HSE Service Plan and therefore it is inevitable that activity levels must also be reduced. This will be a significant challenge, and in meeting it we must be flexible and responsive to service needs, in order to ensure that essential services are protected and that patient safety and quality remain paramount.

During 2012, as part of its performance improvement role, the SDU committed limited funds for short periods of time to facilitate the reduction of numbers waiting on trolleys in Emergency Departments, where these numbers were determined to be exceptionally high. Some of the funding provided was directed towards measures for patients whose length of stay had been prolonged due to lack of immediately available assistance and/or accommodation in order to facilitate an appropriate discharge. The types of measures utilised include temporary funding of nursing home beds, purchase of temporary home care or assisted discharge packages, increased access to diagnostic facilities and additional staffing for weekend and holiday periods. The Department of Health continues to work with the HSE to ensure that the contingency plans are operating satisfactorily and that all critical front line services continue to be delivered across all regions. This includes using the provision of the Public Service Agreement to bring about greater flexibilities in work practices and rosters, and maximising redeployment to achieve more efficient delivery of services. Staff resources will continue to be allocated to areas of greatest priority.