HSE chief tells hospitals to focus on Covid care amid concern over potentially ‘unthinkable’ consequences for ICU

HSE chief Paul Reid has told hospitals nationwide to prioritise Covid-19 care amid fears of ‘unthinkable consequences’ for ICU.

n a letter to senior executives in hospital groups and other top officials HSE chief Paul Reid said that “across all services, there needs to be a 14-day period of prioritisation of unscheduled Covid care and urgent time-sensitive work” particularly in the biggest hospitals.

They have been told to maximise the use of private hospitals to support the transfer of urgent and scheduled care patients including maximum use of intensive care beds.

They should also maximise all available capacity in an integrated way through community, step-down beds and level 2 hospitals – with an enhanced focus on delayed transfers of care through integrated work at local leve.

There should be an enhanced focus on hospital avoidance measures including prioritisation of home support, therapies and community-based beds.

Each hospital will be required via their Hospital Group to outline the number of additional surge intensive care beds which can be created within the next 7 to 10 days.

“This may necessitate curtailing all other activity to facilitate redeployment of staff to critical care areas.

“In parallel, funding will need to be prioritised to support the resourcing of these additional beds.

“Staff to support critical and priority services will need to be identified in the first instance through redeployment.

” We will also continue to focus on support for training, development and continuous and accelerated recruitment of staff.”

He said that “over the course of last week in particular, the concerns about the potential impacts for our acute hospitals due to yet another resurgence in Covid-19 have unfortunately come to pass.

“It is clear that the entire health system, both hospitals and community healthcare, are now under very serious pressure. Based on discussions with many of you about your lived experience in our hospitals and in the community, I attended the Cabinet Committee on Monday and I conveyed the seriousness of the situation just as you conveyed it to me.

“The Government responded with a number of public health measures in order to try and mitigate some of the impacts on the health system.

“Numbers of people requiring hospitalisation due to COVID-19 infections continues to increase and the modelling suggests that this will not abate, at least in the short term. Case numbers have now reached a 7-day average of 4,317 with hospitalised cases increasing from 461 to 643 in the period 4 to 18 November (a 40pc increase).

“We have also seen a corresponding increase in ICU Cases from 86 to 119 in the same period (a 38pc increase).”

Mr Reid said that given the current level of activity it is clear that the pressure on general practice, hospitals and supporting community services will increase in the coming weeks.

“Within our community services we have seen a substantial and sustained increase in demand for testing and in recent times an increase in demand for vaccinations based on recent National Immunisation Advisory Committee advice.

“The current level of demand for home support is for the first time in a long time exceeding the available resource to meet that demand.

“Fortunately, the current surge is different to our previous experience of the disease, in that it is characterised by a lower conversion of Covid-19 infections into hospitalisations, and in turn a lower rate of admissions to ICU.

“Nevertheless, the rate of transmission is increasing, and it is inevitable that the pressure on our hospitals will continue to grow, and in turn the situation in ICU will continue to deteriorate.”

He said clinicians in ICU inform us that the system is already facing increasing difficulties in meeting the needs of patients who require specialist high-dependency care.

“The consequences of such an occurrence although unthinkable, are also well understood by each of you. It is clear to me that we need to take steps now to protect and to make the best possible use of our remaining hospital and in particular our ICU capacity.

He said :” I want to express my heartfelt thanks to those people working in the HSE, our partners in the voluntary sector, and indeed our colleagues in the private sector. I know that people have made great personal sacrifices to support the national pandemic response. I am also very aware that our staff and indeed the public are exhausted, frustrated and close to their wits end as we endure yet another setback, just when we had begun to experience some optimism.”

Visit our Covid-19 vaccine dashboard for updates on the roll out of the vaccination program and the rate of Coronavirus cases Ireland

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