Northern Ireland health chiefs appeal for patients well enough to move from hospital to care homes

Health chiefs have appealed directly to patients who are well enough to leave hospital to move into care homes to address an urgent shortage of beds.

Health and Social Care Board (HSCB) leaders said that there is enough capacity in the care home sector to ease the current pressure on hospitals, but that some patients are reluctant to accept the places that have been offered.

Northern Ireland's health service has been under sustained pressure in recent weeks, with a number of hospitals reporting long waits for patients to be admitted because of a shortage of available beds.

The pandemic, combined with winter pressures, led one HSCB official to say the system is struggling to keep up with demand.

During a media briefing, Brendan Whittle, director of Social Care and Children at the HSCB, said it was "wrong" for patients who are well enough to leave, to stay in a hospital bed when there are other patients waiting to be admitted.

He said: "On Monday this week at noon, there were 205 people in emergency departments waiting on a ward in a hospital and a decision had been taken to admit them.

"At the same time there were 222 people who were fit for discharge but were delayed from moving out of hospital and those delays related to domiciliary care waits or care home delays.

"At exactly the same time there were 589 beds available in our care homes which could be used as a step down option.

"Patients and their families are at times reluctant, or are refusing to avail of the beds that are there."

Mr Whittle added: "We have to support people to step down from our hospitals to our care homes to keep our hospitals flowing.

"We have to step people down to care homes to stop people having to wait too long in emergency departments, to wait for too long outside of emergency departments in ambulances.

"My appeal is simple. I am asking all those who are in this circumstance as a patient or as a family member supporting a loved one, to work with our staff to support and to help people step down to care homes and to make way for people who are currently in our EDs, or outside our EDs in ambulances.

"I know that people can be worried about going into care homes. Our care homes are a safe option. All care homes comply with Covid-19 infection control measures.

"It is wrong for people to stay on a hospital ward when there are people in EDs or in ambulances who need that care and we have other suitable care for them."

Paul Cavanagh, director of planning and commissioning with the HSCB, said it was an ongoing struggle for the health service to keep up with demand.

He said: "I told the health committee in July that we were in the worst winter in the middle of the summer, and that has just endured since then.

"We have had an ongoing challenge in our health service to keep pace with the amount of demand coming our way, to then continue to take on the challenges which have come from the pandemic."

He added: "The particular issue we are facing at the moment is access to beds and we have a number of people who require a bed, who very clearly are unwell enough to need hospital care but they will wait in our emergency departments areas until beds become available.

"We are also seeing ambulances waiting outside our emergency departments to offload patients who will also potentially need to be admitted to beds.

"The challenge of discharging patients has also been significant. We know there is a fair amount of difficulties in accessing domiciliary care packages, using our available care home places.

"We know that some patients will wish to be discharged to a particular care home for example but the reality is we need the patient to be discharged, even on an interim basis to perhaps not their first-choice care home because the pressures in our hospitals are so significant and it is important that we have that flow.

"If we could discharge all of the patients today that we need to discharge to care homes, we would actually have the flow that we require that those patients waiting in our emergency departments would be able to be dealt with."

Meanwhile, Health Minister Robin Swann has announced a support package of up to £23 million for domiciliary care and the social care sector.

Mr Swann said: "I am confident the funding will facilitate increased capacity across the social care sector for the remainder of 2021/22.

"A longer-term solution is self-evidently needed, involving multi-year budgets and a durable financial settlement for all health and social care services."