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July 26, 2014

Fair Deal scheme delays discharges

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The Government’s Fair Deal scheme is contributing to delayed discharges, which are clogging up hospitals, Cork University Hospital geriatrician Prof Cillian Twomey claimed at the IMO AGM last week.
“There’s now a delay in the moving of people out of hospitals, because of the application of the nursing home support scheme legislation,” Prof Twomey said.


“The Fair Deal scheme is causing major difficulties for elderly patients, who must wait up to three months for long-term care beds, even when beds are available,” Prof Twomey said.
There are over 800 patients in hospital wards who need nursing-home care. Even where patients are capable of making a decision on whether to move to a vacant bed, there is no incentive to go to a long-term bed, Prof Twomey said.
More than 20,000 bed days were lost at Cork hospitals in 2009 due to delayed discharges. The latest figures for January show the problem nationwide is worsening, with 17 per cent of bed days at St James’s Hospital in Dublin lost due to delayed discharges.
One tenth of bed days in Beaumont, St Vincent’s and Loughlinstown hospitals were lost due to delayed discharges in January. “Patients in the acute sector have been waiting between two and three months when there were beds available,” said Prof Twomey.
“I couldn’t move them into the beds because the paperwork hadn’t been done.”
According to HSE South managers, one factor in delayed discharges is patients waiting for the processing of a Nursing Home Subvention Scheme application. Some 60 per cent of those who experienced delayed discharges at Cork University Hospital were over 65.
“There have been empty beds all over the system, in community hospitals, even in our own long-stay wards,” said Prof Twomey. “In the past, we always had more patients needing long-term care than we had long-term beds available. There was no shortage of people to fill a bed, when it became available.”
The HSE has said it planned to tackle the issue as one of its priorities for 2010 and was considering ‘radical options’ to deal with the problem.
“I’ve a problem with [the HSE] pursuing people’s assets,” said Prof Twomey. “Why are we assigning a different funding mechanism for patients who are unfortunate enough to be rendered incapable of looking after themselves due to illness? It’s a small, relatively manageable number.”