Update: Health Service Upsurge in Activity January 2023

SIPTU met with HSE Management this week to further discuss the situation regarding the increase in activity in the country’s acute hospitals. Below is a summary of that meeting.

The HSE provided the following update to the meeting:

• Attendance at ED is considerably higher than the same timeframe in 2022. (10,500 additional presentations)
• Highest ever recorded attendance of 75+ years patients.
• Influenza cases continue to rise
• RSV cases are evidencing a decrease
• COVID cases are steady

• The HSE acknowledged the work being undertaken by staff in all grades of the health service during this difficult period.
• The meeting was advised the National Crisis Management Team is meeting every week and local reviews are ongoing daily.
• The HSE accepted additional capacity is required in the private sector & community care.
• They advised they are engaging on a national agreement with private hospital representatives, but this has not been concluded. They stated funding has been made available.
• The meeting was informed of transfers being undertaken of medical patients to private healthcare.
• Site visits are ongoing across the country.
• They are seeking to increase resourcing over 24hrs and weekend service is being looked at.

In response, SIPTU and fellow health unions outlined the following:

• We stated it was unacceptable that many sites had failed to have any local engagement with union representatives on proposed changes to service provision.
• We advised we could not accept forced outcomes which sought to dismantle existing terms and conditions of employment of our members.
• Any proposal should come from local consultation and agreement with our membership & their representatives.
• We had sought a document from the HSE outlining the challenges and the perceived solutions. This was still awaited.
• We sought clarity what supports would be put in place for healthcare workers during this crisis, both those in work and those who have taken ill due to a workplace sourced infection.
• We asked for clarity on the arrangement with the private sector. What level of additional bed capacity, and where, is expected to come from that agreement? What level of additional support has been sought for the National Ambulance Service and diagnostic services?

The HSE confirmed:

• They are seeking to develop a document which will be shared with the unions.
• A management meeting was happening this evening to respond to the union call for supports for healthcare workers during this crisis. Further clarification would issue on this shortly we were advised.
• There would be no ‘ripping up’ of existing agreements with unions. Any proposal would have to recognise existing agreements. Local dialogue was key and would be supported at national level by the HSE.
• Agreement with private sector is not finalised. Local sites are required to identify what they need.
• Management accepted demands could not be made of staff. While a request may be made, subject to the agreed terms, acceptance would be on a voluntary basis only.
• Management also accepted any proposal for change to provide weekend cover could not simply be achieved by moving existing 5 day staff across a 7 day pattern.
• Management stated they had not received a request internally for additional capacity from the private sector for diagnostics.

The meeting adjourned and management agreed to revert on several key points asap. This includes:

• Provision of a composite document
• Clarity on the supports which will be provided to staff during this phase.

A further meeting was proposed for early next week. The date and time for this meeting is to be confirmed.

SIPTU to meet with HSE to discuss difficulties faced by the acute sector

SIPTU and ICTU Health unions are to meet the HSE later this week to discuss the upsurge in activity faced by the acute sector. It follows a a meeting which took place on December 30th to discuss the situation.

At that meeting, management advised of the following:

• Different issues and pressures are presenting on sites across the country.
• The current challenge is not only prevalent to emergency departments and is being experienced across all areas of the acute system.
• There is significant absence of healthcare workers being recorded due to illness.
• The current level of activity within the acute system has not been experienced since the beginning of the pandemic in early 2020.
• The level of flu symptoms presenting have not spiked and are continuing to climb. This is causing a significant level of concern.
• The meeting was told members of the National Crisis Management Team (NCMT) are visiting all acute sites across the country. This is an ongoing situation.
• NCMT is engaging with all sites and advising them to use whatever means are deemed necessary to address the upsurge.
• Solutions are being identified locally as they will be different depending on the challenges arising.
• Management stated they have been planning for winter 2022/2023 for a considerable period but the current patterns are presenting a sudden surge with no ending in sight.
• Discharges are being prioritised.
• This is an exceptional influenza season. Due to post covid, flu was very low in the last two years. The season normally peaks at week 4. This is now week 7 and is still climbing.
• Cases of RSV (in children of 5 years and younger) appear to be falling.
• No new COVID variant has been identified.

In response, SIPTU requested the following:

1) A composite document from the HSE which outlines all the challenges presenting across the country, the local solutions identified to address them and confirmation they will be supported with necessary funding. The HSE stated they would seek to have a document prepared for the unions and this would be shared at the next meeting.
2) Confirmation from the HSE of what protections and supports they will put in place for healthcare workers themselves who are striving to provide care to their patients in this extremely difficult period. The HSE stated this would be considered and they would seek to respond next week.
3) Clarification regarding the use of additional capacity within private hospitals. We were advised additional capacity within private hospitals has been secured across the country. Th Union understands this includes additional capacity within the private hospitals we organise within. The meeting was advised the specific use of additional capacity within private hospitals will depend on what is available and the local needs arising. The exact arrangements will be agreed at local level.
4) Clarification if additional capacity is being utilised by the National Ambulance Service (NAS). The meeting was advised NAS already has arrangements for the use of private or voluntary ambulance services. SIPTU requested specific information relating to what additional capacity is currently being used by the NAS to address the upsurge in activity. The Union was advised this would be sought from the NAS and presented at a further meeting.
5) Management stated additional capacity within diagnostics is a central element of the plan to address the current challenge arising. SIPTU requested clarification of what specific provisions are being made available for additional diagnostics capacity.

SIPTU will endeavour to keep members updated on the outcome of the next meeting.