THE HEALTH SERVICE will be “more challenged” heading into this year’s winter season, but the HSE has said it’s confident it can achieve the targets set under its Winter Plan. 

Announcing the Winter Plan today, the HSE said that €26 million would be allocated by the end of this year in an attempt to ease the pressure on hospitals in what is traditionally the busiest period of the year. 

Flu is set to be a huge problem facing the health service again this year, following over 80 deaths directly from the virus last year. People are being urged to go out and get the flu vaccine as soon as they can this year. 

The €26 million includes €13 million to be provided under the Fair Deal Scheme, €4.2 million to support transitional care for people being discharged from acute hospitals, home support packages of €2 million and €6.8 million for dedicated winter action teams in nine areas across the country. 

HSE chief operations officer Anne O’Connor said that the latest winter plan “builds on the lessons learned from last winter” and was aimed at covering the entire country which wasn’t the case last year.

Reacting to the plan, however, the Green Party said the plan does nothing to address the structural problems in the HSE with health spokesperson Dr Séamus McMenamin describing it “at this point like moving the deckchairs on the Titanic”. 

Winter action teams

At today’s press conference, O’Connor said that the health service was under increased pressure already this year compared to last year.

By October, 1.1 million patients had attended the 29 emergency departments in the country. This was an increase of 3% on last year. 

“We are starting [this winter] in a very different place,” she told reporters. “When we were coming into winter last year, we’d had a very different summer. This year we’re heading into winter having had a different year.

In terms of targets we’re going to be more challenged in terms of activity, but that’s what we’re here to do.

The almost €7 million set aside for the winter action teams is aimed at helping the HSE reach those targets.

The plan says: “The winter action teams are responsible for the coordination of a range of integrated hospital and community actions on a daily basis as well as the application of agreed additional surge actions in response to escalating demand pressures within the local health system.”

This includes seeking to reduce the number of emergency admissions when the patient could be treated in a different setting and ensuring there are appropriate supports available for people when they are discharged.

The teams will have more senior decision makers available, allow for rapid testing in hospitals and have supports from the “frail intervention therapy team” to help patients over 75. 

The Green Party’s McMenamin, however, said staff shortages will mean these winter action teams will not be as effective as hoped.

“The shortage of GPs and hospital consultants means that ‘senior decision makers’ will not be available in many instances and this can not be addressed by December and there does not appear to be any will among the Government to address this in the medium to long-term,” he said. 

Flu

The HSE said that it the take-up of flu vaccinations so far this year is encouraging. Last year, the number of healthcare workers in acute hospitals who had received the vaccine exceeded 50%.

Dr Kevin Kelleher, assistant national director of public and child health, said today that the flu season started earlier in the southern hemisphere this year so the HSE was starting its flu preparations earlier as a result. 

“People often say flu is mild and doesn’t cause problems,” he said. “We repeatedly see every year healthy individuals getting seriously ill and dying.”

After the worst year since the start of the decade in 2017, the number of deaths from flu fell in 2018. 

The HSE will continue to promote uptake of the vaccine and work with GPs and pharmacists over the coming weeks and months, he said. 

Regular updates will be provided on the numbers presenting with flu and the numbers vaccinated. 

Dr Vida Hamilton, HSE national clinical advisor of acute hospitals, said: “A significant number of patients attend our EDs with a flare up / exacerbation of their chronic illness due to incorrect medicine use, or incorrect use of devices such as inhalers and nebulisers.

I would encourage all of these patients living with a chronic condition such as asthma, COPD, diabetes and heart conditions to take some time now to check with their pharmacist and /or GP to ensure they know their medicines and devices and are taking them and using them correctly. Hand-washing is also vitally important to prevent the spread of viruses and infection.

To date 50% of our population with chronic disease have received their winter vaccinations. Whilst this is ahead of where we were last year, I would encourage the remaining half to get their flu vaccine and give themselves the best opportunity to stay well.