The key details in the HSE's €600m winter plan
HSE chief clinical officer Dr Colm Henry addressing the media on the HSE's ambitious winter plan. Picture: Leon Farrell
The HSE is investing €600m in community services and supports to keep more people out of hospital, increasing bed capacity, recruiting 12,500 staff, and also looking to private hospitals to stave off "unprecedented" challenges this winter.
The winter plan hopes to head off additional challenges posed by Covid-19, reduced service capacity, the need for Covid and non-Covid services, and growing waiting lists.
Its success will be contingent on whether 12,500 staff can be recruited on time, as health officials conceded the staffing targets were "ambitious" and came with a "health warning".
Health Minister Stephen Donnelly said Covid-19 had "knocked out" 20%-50% service capacity and accepted that "the number of people waiting on elective care could go up" this winter even with the plan.
- 483 acute hospital beds: €81.5m will provide 251 new acute beds in the fourth quarter of 2020 and 232 in the first three months of 2021. Timely recruitment of staff will be critical to delivery;
- 89 step-down beds: €12m will be spent on step-down beds in regional hospitals to alleviate pressure on acute services. Timely recruitment of staff will be critical to delivery.
- 17 additional intensive care beds: ICU capacity increased from 225 in March to 282 during the pandemic. The increased capacity — close to 300 beds — still falls far short of the 589 beds recommended;
- 1,161 community beds: 631 rehabilitation beds and 530 community beds will be rolled out. This will be contingent on staffing;
- 36 community specialist teams and 11 ‘front door’ teams: 47 specialist teams will provide care in the community, alleviating pressure on the hospital system. These teams will be contingent on staff recruitment;
- 4.7m home-care hours: €138m, 23% of the winter plan budget, will provide 4.7m home-care hours in the community. This will alleviate pressure on hospitals but concerns remain around recruitment;
- 12,500 extra staff: Close to 5,000 staff will be recruited before Christmas — half for Covid-19 testing and tracing and half for core services . An additional 7,500 staff will be recruited in the new year. By its own admission, the HSE says recruitment challenges present a “significant risk” to the plan;
€59m will be spent in the new year to access services and diagnostics from private hospitals. Discussions are ongoing on contingency plans in the event of a Covid-19 surge. The HSE will not want to replicate the three-month takeover of private hospitals at the outset of the pandemic, which came at significant cost.
The HSE hopes to reduce patients on trolleys by 30% under the winter plan, casting doubts over previous commitments to adopt a “zero tolerance” approach to overcrowding.
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