Where is the Government plan for the crisis in step down care? 500 patients stuck in hospital with nowhere to go

• Over 500 delayed transfers of care in acute hospital for 23 days across March and April, and again for the last eight days
• Huge impact on patients themselves and a knock-on impact on admissions waiting times
• Lack of urgency in Minister’s letter of determination to the HSE and in the HSE service plan

Labour Health Spokesperson Marie Sherlock TD has asked called on the Minister for Health to respond to the DTOC crisis across a number of acute hospitals and has said there is an urgent and vital need to prioritise the delivery of additional step-down care provision.

Deputy Sherlock stated that delayed transfers of care of having a huge impact on patients, particularly elderly patients, and a knock-on impact on admissions into hospitals.

Deputy Sherlock stated it is clear when she raised this matter with the Minister for Health last night in the Dáil that there is no plan to specific national plan to deal with delayed transfers of care.

Deputy Sherlock said:

“It is alarming that delayed transfers of care have exceeded 500 over 23 days in March and April, and over the last eight days. These figures were over 20% higher compared with the same period in 2024.

“This is having a huge impact on patients themselves, exposing to them to the potential of unnecessary infection and whose care would be more appropriately met in the community, and on those awaiting admission to hospital but are left languishing on hospital trolleys in corridors.

“We know that on Sunday night, 120 people were waiting over 24 hours for admission – the highest since the start of the year. Concerningly, 16 of those were over the age of 75. That is simply unacceptable – people deserve better from their health service.

“We need to hear from the Minister and the Health Service as to what is being done with regards to step down facilities. Without addressing this piece of the jigsaw, we will not address our trolley crisis and delayed admissions. It is critical now that we see a comprehensive plan on step-down beds.

“Delayed transfers of care are having a big impact on patient flow through hospitals and over the last two months, there has been a staggering reliance on surge capacity.

“It is clear that a significant cause of delayed transfers of care is the huge shortage of neuro-rehabilitation beds, dementia specific beds, and step-down beds.

“We know from our own parliamentary questions that HSE funded dementia beds are actually down 12% in the last five years despite the projected increase of those with dementia.

“It is crazy that despite the significant issues with delayed transfers of care and their broader impacts on our hospitals, two wards in Cherry Orchard Hospital have been closed since 2024 due to fire remediation works, Killarney Community Nursing Unit was ready more than a year and half ago and is yet to be opened, and that in the South Infirmary, there are beds closed that should be open.

“It is clear when reviewing the Minister’s letter of determination to the HSE and the HSE service plan that there is a lack of urgency or recognition of this issue.

“When we review the service plan, we can see that the majority of community beds being built are actually replacement beds with not enough being done to address major capacity constraints.

“I am calling on the Minister to urgently introduce a comprehensive plan on step-down beds, a community bed expansion plan along the lines of the acute hospital bed expansion plan, and for the Minister to urgently clarify the situation of closed beds across the country. It is simply not fair on patients that they are unable to be moved into more appropriate care or be delayed in their admission and treatment in hospital.”