Wednesday 21 August 2019

Eilish O'Regan: 'Hospitals will stay clogged up unless waiting lists are tackled'


(Stock photo)
(Stock photo)
Eilish O'Regan

Eilish O'Regan

The life expectancy timebomb - which is putting more pressure on pensions, health and social services - is heaping more strain on the Fair Deal nursing home support scheme.

There were 23,143 nursing home residents supported by the scheme in public and private facilities in March 2019 - 348 more than a year previously. At the same time, the waiting list of people who were approved for the scheme, but were waiting for placement in a nursing home, grew.

In March, the number of people on a waiting list for placement in a home climbed to 800, compared to 243 in 2018.

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The target of the scheme is to have people who are passed as eligible for Fair Deal to be offered a nursing home place in four weeks.

There is evidence that is now being pushed out to five weeks in some cases.

When this is coupled with the rising demands for home support, to allow older people to live independently in their own homes, it has a knock-on effect on hospitals.

The target is to not have more than 550 patients occupying hospital beds who are fit for discharge.

But delays in transferring patients to a nursing home or securing home help can mean a significant number of these patients must stay longer than they should in an expensive hospital bed.

At the end of March, there were 626 patients in hospital who were medically fit to leave but were delayed.

The main concern must be for those patients who have to stay in hospital when they should be discharged.

Staying in hospital means they are more open to risk of infection and they are subject to the confines of a hospital ward.

But as has been well documented, the delay in discharge also contributes to a clogging up of the system.

The bed they occupy is not available to the patient on a trolley in A&E, which in turns adds to emergency department gridlock.

It means fewer beds are available to patients on public waiting lists who need to be admitted to hospital for surgery or a procedure.

This is an endless cycle which remains at the heart of many of the problems of hospital overcrowding.

Despite various plans and pledges, it has never been properly tackled.

The number of patients occupying hospital beds who are medically fit and ready for discharge is something of a barometer of how key areas of the wider health service are performing.

The fast-rising demand for care is outpacing budget increases. Once one section of the chain is in difficulty, it means other parts of the health service are thrown off course. If the trolley crisis in June 2019 is on par with the winter of 2014, it is a stark reminder of how much has yet to be reformed.

Otherwise, we're into more stalemate, and an eternal rerun of 'Groundhog Day'.

Irish Independent

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