Seán Crowe (Dublin South West, Sinn Fein)
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144. To ask the Minister for Health in view of the Prospectus report in 2009, that suggests 579 intensive care unit beds were needed by 2020, if he will confirm that there were 289 ICU beds in 2009; if he will confirm that there are now 233 ICU beds; and his plans to improve this situation that is undermining the health and well-being of critically ill patients. [38710/14]

Leo Varadkar (Dublin West, Fine Gael)
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The HSE commissioned Prospectus management consultancy in 2008 to undertake an independent review of the existing adult critical care provision and an assessment of the future requirements to the year 2020 thus enabling planning for a future model of critical care based on evidence. This review placed significant emphasis on international best practice and the application of these practices to existing service provision in Ireland.

The major deliverable of the review was a detailed report based on three key components: capacity and data, work practices, admission polices & related clinical issues. The report recommended that the number of critical care beds should increase from 289 to 579 over the period 2010 to 2020. It also recommended a model for the delivery of adult critical care that is underpinned by a network approach, whereby ‘hub’, ‘spoke’, and ‘local’ hospitals work together to provide the patient with safe and high quality critical care, in a timely manner. At the time of the 2008 report adult critical care services were provided in 37 hospitals (52 units) across the country, including in a number of the smaller hospitals where beds were described as critical care beds but in practice treated low volumes of critical care patients. The report has informed the work of the HSE critical care clinical programme which was subsequently established.

On behalf of HSE operations, the critical care programme completes an annual census to collate each hospital providers' critical care bed capacity and medical and nursing staffing establishment. Based on the 2014 national census of critical care beds, there are 233 adult critical care beds in public hospitals. The HSE has advised that while there has been a net reduction in the number of critical care beds nationally, the HSE and the Critical Care Programme are working to ensure more appropriate referral of patients requiring higher levels of critical care to major hub hospitals identified by the HSE as meeting a number of criteria in relation to activity volume and strategic importance for the future. The HSE is focused on delivering improvements in the way that critical care is organised and delivered within the hospital group structure to ensure patients receive the same high quality of care no matter where they are treated. There is now a more co-ordinated approach to the planning and delivery of critical care, within and across hospital groups, with a focus on small hospitals managing routine urgent or planned care locally and more complex critical care managed in the larger hub hospitals where the relevant clinical critical care expertise can be provided.

The further development of critical care facilities is being considered in the context of service planning process for 2015.