HSE chief says he will be 'shocked' if trolley numbers exceed 900 again this winter

Bernard Gloster said he will focus on ensuring the experience in emergency departments is the best it can be.

The head of the HSE said he will be "shocked" if daily trolley figures exceed 900 this winter, as happened on one day last January, as reforms in health services take effect.

Bernard Gloster told the Irish Examiner that while there is still some uncertainty around potential flu and RSV numbers, if trolley figures were to reach that level again, "serious reflection" would be needed.

“What I’m saying though is, based on everything that is known and available to me, I would be shocked if we were to hit that type of number anytime this winter,” he said.

“I think it is important, as the leader of the health service, of 150,000 people, that I’m prepared to at least commit to saying: ‘I can’t see what else we can do’.

“And if we arrive at those kind of numbers I think we would have to seriously reflect on what is happening.” 

Mr Gloster said closer integration between hospitals, community services, and private nursing homes is part of the reforms, as is a seven-day week for staff.

Bernard Gloster said closer integration between hospitals, community services, and private nursing homes is part of reforms, as is a seven-day week for staff. Picture: Sasko Lazarov/Photocall Ireland

“We normally work Monday to Friday; we are normally quite siloed; we don’t normally go into private nursing homes. We now have to change that narrative if we are going to do the avoidance [of hospital] and do the timely discharge,” he said.

“I have to focus internally on the hospital managers and leaders, on making sure that the experience of people in the emergency department is the best they can be — it won’t be perfect — and that the operation of the hospital is moving consistently over the seven days.

“That is the best chance we have of reducing what happened last winter. It’s not about money right now.” 

He hit back at criticism of targets around trolley waits in the HSE’s Urgent and Emergency Care Plan 2023.

We don’t have an ambition to have 320 people on trolleys at 8 o’clock in the morning, but we have to start with an ambition to not have more.

Improvements must be seen in the context of extremely high trolley numbers last winter, he said.

"We have to accept the reality of where we are today, and where we can get to," he said.

Mr Gloster was speaking during the HSE National Conference on Enhanced Community Care in Dublin, which heard that reforms in care outside hospitals are linked to reductions in hospital numbers.

A scheme allowing GPs to directly refer people for scans provided 196,988 radiology scans between January and July 2023.

“This is extremely important, as timely access to diagnostics meant an 89% reduction in the number of patients requiring referral to emergency departments or acute medical units,” the HSE said.

The conference heard that 48,230 older people were seen this year through integrated care programmes for older people (ICPOPs) which are community based. 

“The Enhanced Community Care Programme represents our unwavering dedication to providing exceptional healthcare to our communities,” said Health Minister Stephen Donnelly, opening the conference.
“This crucial part of the Sláintecare Programme is a valuable resource, providing both short-term and long-term benefits to the reform of healthcare delivery.” 

He said full implementation of the €240m programme means “providing care closer to home, while simultaneously alleviating pressure on our hospitals".