Bernard Durkan (Kildare North, Fine Gael)
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20. To ask the Minister for Health the extent to which he will provide or avail of step-down bed accommodation as a means of alleviating overcrowding in public hospitals in general; if he has examined the potential use of decommissioned beds or wards in or adjacent to the public hospitals, thereby providing an available solution; and if he will make a statement on the matter. [36262/15]

Kathleen Lynch (Cork North Central, Labour)
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Delayed discharges arise when a patient has been judged clinically to no longer have a requirement for acute hospital care but remains in an acute hospital bed, thus rendering that bed unavailable for patients who need admission. As of 14 October (latest figures available) there are 561 delayed discharges nationally, of which 284 are in the Dublin Academic Teaching Hospitals (DATHs). Delayed discharges can arise for a number of reasons in addition to difficulties in finding a suitable nursing home place. For example, some patients have yet to apply for the Nursing Homes Support Scheme, and others are in the course of having their applications assessed and validated. Applicants are entitled to choose their own nursing home and while a facility may be available, the applicant may decide to wait for an option closer to home or to their family.

The Government committed an additional €25m in Budget 2015 to address delayed discharges. Of this:

- €10m was allocated to the Nursing Homes Support Scheme (NHSS) to provide additional 300 places;

- €8m was allocated for the provision of 50 additional short-stay beds, in addition to the establishment of Mount Carmel as a short-stay facility for the Dublin area;

- €5m was allocated for an additional 400 Home Care Packages;

- €2m was allocated to strengthen community care teams.

In a further initiative earlier this year, the Government approved additional funding of €74m, of which €44m was allocated to the NHSS to provide an additional 1,600 places. €30m was used to cover the cost of a range of additional measures including transitional care beds (temporary contract beds) and additional community, convalescence and district hospital beds on a permanent basis.

The waiting time for approved applicants for the Nursing Homes Support Scheme has been reduced from a previous high of 17 weeks to 2-4 weeks. It is intended to maintain this at a maximum of 4 weeks.

At 30 September 2015, there were a total of 1,936Short Stay Community Public Beds nationally. These are a combination of 'step up/step down' care,intermediate care, rehab and respite care. These beds are interchangeable in their use depending on demand in the units. The opening of further additional short stay beds in the majority of our public residential facilities has now been exhausted, particularly in areas of high demand including Dublin, Cork, Galway and Limerick. HIQA regulations set out strict guidelines around the numbers of beds that can be operated in any one unit.

In addition to Community Short Stay Beds described above, a number of Acute Hospitals also operate direct managed step down beds both on their hospital campus and in off-site locations.

The provision of Short Stay Support Beds will be a fundamental component of the integrated model of care being planned for the delivery of services to Older People.