The HSE has said it has not been able to generate savings planned for this year because it has been focussed on dealing with problems such as delayed discharges and patients waiting on trolleys.
The executive’s latest performance report shows in the first five months of the year, it recorded a financial deficit of €164.6 million.
The May performance report says there was an overrun of €95.8million within its core services - primarily acute hospitals and social care.
The report says about €69 million of the deficit relates to the primary care reimbursement service, local health schemes, costs associated with the State Claims Agency, overseas treatments and pensions.
The HSE’s service plan for 2015 stipulated it should delivery of a minimum savings level of €130million in addition to €10 million in increased income generation/collection of charges.
Capacity
“The sustained exceptional level of delayed discharges, the cost pressures these are causing and the level of management time and capacity taken up with dealing with this issue within our acute and social care services is beyond the level anticipated in the service plan,” the report states.
“It has not been possible to deliver the necessary cost reductions up to May 2015 that the plan requires in part because our focus has been on opening/maintaining additional bed and other capacity.
“This capacity is not funded in the national service plan for 2015 and was intended to be closed.” However the performance report states that the announcements by the Government in relation to additional funding to deal with the delayed discharge issue “will impact on the 2015 overall outlook”.
In April, the Government announced the investment of a further €70 million to tackle delays in emergency department and in accessing the Fair Deal nursing home scheme.
Over 3,500 patients spent over 24 hours in a hospital emergency department in May, according to the report. This is despite the fact the departments were slightly less busy than they were at the same time in 2014, and admissions were down 2.7 per cent.
Delayed discharges
The number of delayed discharges has fallen from a peak of 765 in January to 611 at the start of this month. Delays in discharging well patients, often because of a lack of stepdown facilities, has been widely blamed for creating blockages in the system and a surge in trolley numbers.
Due to a €25 million package designed to reduce delayed discharges, 300 extra places have been provided on the Fair Deal nursing home scheme and the waiting list for this scheme has been cut from 11 weeks to four.
The opening of the former Mount Carmel private hospital as a HSE-run convalescent facility has eased pressure on bed capacity in south Dublin and the HSE is looking at acquiring a similar facility to address a deficit in stepdown beds north of the Liffey.
There were 1,603 adults waiting longer than 18 months for inpatient or daycase treatment at the end of May, and 33,496 patients waiting that long for an outpatient appointment, according to the report. The HSE claims to have all but cleared these backlogs by the end of June, the target date set by Minister for Health Leo Varadkar for zero patients waiting for longer than 18 months. This has been achieved through outsourcing about 20,000 appointments to the private sector.
Only 70 per cent of prostate patients are seen within the target time of 20 working days, with low performance reported in Cork, Waterford and Limerick, according to the report.
Absenteeism in April was 4.02 per cent, the lowest figure ever recorded for the month.
