The HSE Winter Plan 2021/2022 states the inability to attract and retain an appropriate number and caliber of staff as a “key underlying risk”.
“This is particularly the case in relation to the home care and nursing home sector,” according to the document, which was published on Monday 15 November.
The document notes how Covid outbreaks and staffing challenges in community facilities have significantly delayed the opening of additional community bed capacity this year.
The new Winter Plan outlines the coming months will be difficult due to the challenges in managing potential Covid-19 surges, the co-circulation of seasonal influenza, service restoration, workforce availability, cyber attack recovery and addressing the backlog of care.
“There are also new risks emerging including the impact of delayed care as a result of the postponement of care and long Covid on service users and associated service demand,” it states.
The full year cost of the Winter Plan is €77.051 million. In terms of cost breakdown, €29.345 million will go to acute services; €41.654 to community services; €5.7 million to ambulance services; and €350,000 to communications.
The plan contains “an enhanced focus” on patient experience times (PET) and performance against these targets will be monitored, by integrated oversight teams.
“The greatest challenge to addressing high trolley queues and poor patient experience times are the delays encountered in accessing acute in-patient beds especially for older people,” according to the document.
“In order to alleviate ED [emergency department] congestion this plan sets out the requirement to reduce ED attendances and admissions by the delivery of care in the most appropriate clinical level, maximise patient flow from community to hospital and appropriate discharge while maintaining optimal inpatient length of stay and strengthening the existing integrated approach to patient flow.”
A specific focus will be on improving 24-hour PET and PET for patients over-75-years-of-age.
The Winter Plan aims to support people to remain in their own homes by providing the following patient pathways: GP liaison nurses to manage direct referrals from GPs to ED; geriatric community support; enhancing and expanding frailty intervention therapy team models; community response teams (nursing and therapies); community respiratory admission avoidance teams; expansion of the National Ambulance Service pathfinder initiative and COPD outreach teams.
There will also be a public advice/communication campaign for winter regarding alternative pathways for winter and managing winter viruses.