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HSE Mid West Community Healthcare and UL Hospitals Outline Initiatives For Winter 2022/23

HSE Press Release

November 28th, 2022

HSE Mid West Community Healthcare and UL Hospitals Outline Initiatives For Winter 2022/23

HSE Mid West Community Healthcare and UL Hospitals Group are together outlining actions that will be taken to support local health services this winter, as part of their joint Winter Plan 2022/23. Each winter, hospitals and Emergency Departments face significant pressure due to increased public demand. This joint Winter Plan covering acute and community services in the Mid West region seeks to support patients, and reduce pressure on services by facilitating hospital discharges and delivering more care in the Community.

The HSE Winter Plan 2022/23 includes a number of actions to help manage increased demand over the winter period, including:

  • Delivering additional capacity in acute and community services: This will include the ongoing delivery of additional acute and community beds and increasing staffing capacity in line with the Safe Staffing and Skill-Mix Framework.
  • Improving pathways of care for patients: Alternative patient pathways will be implemented during the winter period to help reduce the number of presentations and admissions to hospital and improve patient flow and discharge. This includes Enhanced Community Care (ECC) supports.
  • Roll out of the vaccination programme for Flu and COVID-19: The influenza and COVID-19 vaccination programmes continue to be rolled out. Targeted communications will be used to increase awareness and uptake for our winter vaccine programmes.
  • Implementation of the Pandemic Preparedness Plan: The Public Health Plan will be implemented as appropriate which includes a surge and emergency response plan, in the event of a significant surge in COVID-19 infections.

Nationally, funding of just over €169 million has been assigned to implement these measures over Winter 2022 / 2023, and this will include the recruitment of 608 posts across a range of services.

A key focus for HSE Mid West Community Healthcare this winter will be to help reduce demand on acute services through a series of targeted measures designed to support older people.

The Integrated Care Programme for Older Persons (ICPOP) is a service that provides rapid access to a multidisciplinary delivered Comprehensive Geriatric Assessment (CGA) for older adults who have frailty or are developing frailty. Appointments are offered within one week of the referral being received. There is no active waiting list.

Services offered include a CGA, rapid access to a Falls Assessment, a comprehensive medication review, and outpatient rehabilitation.

Under ICPOP, an average of 740 Assessments and Interventions have been completed each month in 2022, while 240 monthly Diagnostics, including MRI, CT, X-Ray and Dexa scans have also been conducted.

This year’s Winter Plan also prioritises investment to support the expansion of Community Intervention Teams (CIT) across the country, with a particular focus on the Mid West and North West regions. These teams focus on hospital avoidance and early supported discharge to the person’s home. Community Intervention Teams in Clare, Limerick and North Tipperary are currently supporting an average of approximately 760 people each month.

Increased funding is being provided for additional GP access to diagnostics in primary care, allowing for patients to be referred directly for x-rays or scans. Good progress has already been made in this initiative in 2022, and currently, in the Mid West region, over 1,400 of these scans are being completed each month.

Margaret Costello, Head of Service, Primary Care, HSE Mid West Community Healthcare says “By prioritising investment in primary care services that will enable people to remain well in their own homes, and also facilitating early discharge from hospital, we are easing pressure on our colleagues in acute services. By doing this, we are also enhancing the quality of life of people throughout the Mid West region, whom we serve. We are already seeing the benefits of Enhanced Community Care, ICPOP and other strategies outlined in Sláintecare, and HSE Mid West Community Healthcare looks forward to driving on these initiatives this winter and into the future.”

UL Hospitals Group is pursuing the following initiatives this winter:

Expansion of ED admission-avoidance for over-75s - Winter 2022/23 funding and investment secured through the HSE Winter Plan has enabled us to open the new Geriatric Emergency Medicine (GEM) unit at UHL and expand the hospital’s OPTIMEND assessment and intervention service for over-75s, through the recruitment of an additional 25 WTE staff.

Additional staff to focus on discharges - UL Hospitals is also focused on post-admission patient flow in UHL through the recruitment of additional four discharge coordinators, along with one WTE Clinical Nurse Manager (CNM2) who will specifically target discharges at weekends. Efforts to increase numbers of hospital discharges at the weekends will be supported with the recruitment of an additional four radiographers.

More doctors for ED - An additional two WTE Emergency Medicine consultants and eleven WTE NCHDs will be recruited, with a particular focus on patient flow at pre-admission stage

Such staffing initiatives are complemented by the recently introduced Pathfinder programme. A collaborative service staffed by UL Hospitals allied health staff and the HSE National Ambulance Service (NAS), Pathfinder provides safe alternative care at home to people over-65 . Pathfinder is provided Monday to Friday from 8am-8pm in the Limerick region.

Shirley Real, Group Lead, Allied Health and Pathfinder Limerick said: “The aim of this new service, a collaboration between the National Ambulance Service and Occupational Therapists and Physios in UHL, is to keep vulnerable older people who call 999, in their own homes, rather than transferring to ED. The Pathfinder team responds to lower complexity 999 calls. A comprehensive assessment is completed in patients’ homes, alternative pathways of care are discussed with patients and their families, and a suitable and a safe treatment plan is initiated, with input from GPs, community and acute services. Another advantage of the Pathfinder team is their ability to provide follow up support. This may include home-based rehab, providing equipment and managing alternate pathways of care.”

Colette Cowan, CEO of UL Hospitals Group, said: “Winter is the most challenging season for acute, community and primary healthcare providers, with intense levels of demand for services. The year to date has been one of our busiest ever, with record numbers of attendances at our ED and high numbers of elderly people with very complex conditions. We hope the Winter Plan’s focus on patient flow and recruitment will help provide safe and effective healthcare alternatives to the busy ED pathway. The plan, jointly devised by UL Hospitals Group and HSE Mid West Community Healthcare, is an integrated strategy to help people of all ages to get the care they need, whether that’s in our hospitals or closer to home. All the acute hospital initiatives dovetail with the strategies of our Community Healthcare colleagues in a way that will enhance patient flow throughout our hospitals and the health system across the region.”

Maria Bridgeman, Chief Officer, HSE Mid West Community Healthcare says: “This winter plan continues the integrated approach to healthcare in the Mid West that has been adopted by HSE Mid West Community Healthcare and UL Hospitals Group for many years now. It represents a further investment in local services, following on from significant improvements already implemented by the HSE over the last number of years, particularly through annual National Service Plans (NSPs) and recent Winter Plans. This has facilitated the development of new services throughout the Mid West region.”

“This plan is good news, as it shows we are growing the amount of healthcare provided to the population. But the growing demand for services also results in delays and waiting lists, and the measures announced to support Community Services in the Mid West will allow us to ease those pressures this winter.”

Other measures contained in the HSE Winter Plan include:

  • Extra funding to allow for more patients to be treated in the private hospital system
  • Additional funding for aids and appliances to enable patients be discharged home or to a community facility as quickly as possible.
  • Expansion of patient flow and discharge teams in hospitals and community settings to minimise delays in discharge or transfer to other hospitals or step-down facilities.
  • Additional funding to the GP out of hours services in the Mid West.
  • Funding to enhance palliative care services during the winter which will deliver 1,340 nights of night nursing to 380 patients and families across Ireland.
  • Funding has been provided for integrated action team funds which each Hospital Group and CHO can request access for specific initiatives during the winter period.
  • The HSE is reinforcing the key role of Covid-19 and flu vaccines in reducing the level of severe respiratory illness.
  • A comprehensive communications programme will support patients, families and GPs to identify the most appropriate care based on need. The HSE will provide tailored messaging on how to keep well this winter in addition to updates about COVID-19, the flu and other respiratory illnesses.
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