Plan aims to save money by steering people away from A&E departments to other facilities such as primary care teams
THE HEALTH Service Executive (HSE) has proposed that there should be more than 33,000 fewer emergency admissions to hospitals this year.
The reductions, which are set out in its draft service plan for 2010, would be aimed at those patients who are admitted for very short periods of time.
The HSE also wants to provide alternative access to diagnostics for at least 10,000 patients who are currently admitted to hospital for that purpose.
Details of the service plan proposals are contained in a confidential letter sent by the Minister for Health, Mary Harney, to the chairman of the HSE, Liam Downey, just over a week ago.
The Minister is currently considering the HSE’s proposed service plan – essentially its blueprint for how it will spend its €14 billion budget this year.
The final service plan document was expected to go to Cabinet early this week and be laid before the Oireachtas in the days ahead.
The Minister’s letter appears to clarify proposals revealed last month that the HSE was seeking to reduce significantly the level of admissions to hospitals this year.
Initially, the HSE indicated that it wanted to cut admission levels by up to 54,000 this year. However, The Irish Timesreported last month that it was planning to scale back the extent of these proposed cuts.
It is understood that the HSE is proposing that a campaign should be launched to direct people who would inappropriately attend emergency departments to other facilities such as primary care teams or medical assessment units.
Ms Harney said in her letter that the service plan was based on reducing dependency on inpatient hospital beds and on providing more appropriate care in alternative settings.
“It commits to achieving a substantial reduction in emergency admissions through diversion of patients to more appropriate settings, to the avoidance of admissions for those requiring certain diagnostics, to an increase in day cases and to maintaining 2010 elective activity broadly in line with 2009 elective activity,” she said.
Ms Harney said the plan proposed a reduction of 9 per cent in the level of in-patient care provided over the 2009 out-turn.
The Minister also said the HSE service plan also proposed an increase in the number of day cases in hospitals of 10,569 or 1.6 per cent more than in 2009.
However, she said that she believed there was “considerable scope within existing resources to shift further inpatient activity to day treatment in line with international practice”.
Ms Harney said the HSE plan also proposed that all patients should either be admitted to hospital or discharged from an emergency department within six hours of registration.
“Currently, most emergency department patients not requiring admission [94 per cent] ] )\ ]are discharged within the target maximum waiting time of six hours, but only just over half who need to be admitted meet this target,” she said.
In her letter, Ms Harney said that meeting the targets in the service plan would be “challenging”, and she sought further details on how these would be achieved.
