The Health Service Executive (HSE) is to undertake a fresh investigation of seven-day working in the health service as figures show the number of patients discharged from hospitals plummets at weekends.
Hospitals discharge about three times as many patients during the week as they do at weekends, the analysis shows.
In response, a new team comprising former HSE manager Gerry O’Dwyer and other officials has been tasked with investigating the scope for greater seven-day working.
The group will look at the current performance of hospitals in discharging patients and seek to establish how activity levels can be raised at weekends.
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However, health unions attending the recent meeting of the HSE emergency department taskforce gave the proposal a cool reception and demanded representation on the group.
The biggest model 4 hospitals discharge an average of 606 patients during the week compared with 202 over the weekend, according to HSE data.
Smaller model 3 hospitals discharge an average of 518 patients during the week compared with 181 over the weekend. Discharges during the week tend to be lowest on Mondays and highest on Fridays.
The figures, which were presented at last week’s meeting of the HSE emergency department taskforce, are the first to shed detailed light on the variable rates of patient discharge in hospitals across different periods in the week.
HSE chief executive Bernard Gloster has been stressing the need for more seven-day working in the health service since he started in the post last March.
Weekend discharges fall to less than half the normal weekday rate in all hospitals and to less than one-quarter in Limerick, St Vincent’s and Mayo, an analysis of the data by the Irish Patients’ Association shows.
Weekend discharges at Portlaoise, the best-performing hospital, are 46 per cent of the weekday rate, according to analysis. But weekend discharges at Portiuncula hospital in Ballinasloe are just 22 per cent of the weekday figure.
“Delaying discharges impacts on the safety of the patients’ journeys throughout the hospital system,” said Stephen McMahon, co-founder and director of the Irish Patients’ Association. “At last there is official recognition that we need a seven-day operation to utilise the resources we have and provide what may be missing to enable this to happen.
“If we can get to a seven-day operation, it will be one of the most important operational achievements in the healthcare system, but it cannot be at any cost.”
The HSE report looked at hospital discharges from the start of February to the end of April for weekdays, weekends and bank holidays, for different types of hospitals.
The national average discharge during the week was 43 patients per hospital, compared with 13.7 patients at weekends and 27.9 patients on public holidays.
Beaumont Hospital and St James’s Hospital had the highest average number of discharges on weekdays and at weekends, while Wexford (which suffered a fire in its emergency department in March) and Navan had the lowest over the three-month period.
On bank holidays, Beaumont and the Mater hospital had the highest number of discharges, and Wexford and Mayo had the lowest.
Among model 4 hospitals, Beaumont and the Mater had the highest average discharge, and University Hospital Galway and University Hospital Waterford had the lowest.
Letterkenny University Hospital and St Luke’s hospital in Kilkenny had the best discharge record for model 3 hospitals, while Wexford and Navan had the lowest figures.
Model 4 hospitals are the biggest facilities, caring for the most acutely ill patients. Model 3 hospitals provide 24/7 acute surgery and medicine and critical care.
