A special squad of troubleshooters is to travel to hospitals suffering the worst A&E overcrowding, Health Minister Leo Varadkar has revealed.
The next phase of the bid to reduce overcrowding and ease the trolley crisis will involve team visits to hospitals to implement a plan which is tailored to iron out their individual obstacles and blockages.
This may include compelling more senior hospital consultants to stay on site or ensuring hospitals which are still not discharging patients at weekends to start doing so.
He was speaking as some hospitals have more than 30 patients on trolleys every morning despite the start of summer and the injection of €74m to tackle overcrowding last April.
The plight of Rose O'Halloran (102) from Clondalkin in Dublin, who spent 26 hours on a trolley in Tallaght A&E, highlighted the ongoing crisis last week.
The troubleshooting teams will be sent to the hospitals from the HSE's Special Delivery Unit which was set up in 2011 to reduce trolley gridlock.
"If a hospital manager says they are implementing the process changes and extending the hours of radiology, for instance, but still does not have enough beds, we will give them more funding to open the beds," the minister said.
"We have been opening beds but in itself it is not working."
An oversight group, which he will be part of, to implement the changes, was due to be set up last month but will be in place shortly to drive the changes, he added. "We are throwing everything at it. We are expecting more improvements over the summer," said Mr Varadkar.
The hope is the intense overcrowding of last winter will not be repeated from next autumn.
He said the additional €74m in funding has had a significant impact on the numbers of delayed discharges in hospitals, patients who no longer need acute care but are waiting to be discharged to a nursing home or returned home with support.
Their numbers have fallen from 830 in December to 631 at the beginning of June. Of those who remain in hospital, 487 are waiting for nursing home place.
The waiting time under the Fair Deal nursing home scheme is now four weeks, he added.
The initial focus of the emergency department taskforce was on the Fair Deal scheme and getting community beds open at places like Mount Carmel in Dublin. "Now the focus is on getting down to issues in the individual sites," Mr Varadkar insisted.
Lack of staff in some units are continuing to cause hold-ups and the recruitment campaign for Irish nurses in the UK is now being stepped up. The HSE said all 65 beds in Mount Carmel should be open at the end of this month.
An additional €5m is also going towards 400 home care packages for people who are well enough to be discharged.
The aim is to have no more than 530 delayed discharges in hospital and to maintain the waiting time for a nursing home place at four weeks for the rest of this year, said a spokeswoman.
Of the €74m, some €44m went on more nursing home places.