Health Service Capacity Review and its Impact

The Health Service capacity review was commissioned in response to the pressures being faced across the health system and the experiences of many patients, service users and families in terms of gaining timely access to healthcare. 

The review extended beyond capacity available in the acute hospital sector and included key components of primary care and services for older people.  In particular, the review was tasked with considering changes that would arise from a shift in the current hospital dominated care model to one more orientated around community based-care.  This is very much at the heart of the Sláinte Healthcare Report, which aims to radically transform Irish healthcare. 

Differing views

The Review highlighted to two differing views on capacity levels in the current system.  One train of thought is that there is a significant under-capacity in most parts of the health system, while the second argument is that the problem is not with the level of capacity, but how capacity is being used.

While there may be a lack of consensus on what is giving rise to the current capacity issues, there is some consensus, that demographic changes, in particular increases in our older population (65+) will create significant additional demand for all our healthcare services, while continuing with the current status quo is unsustainable. 

So what does all this mean for healthcare providers?

The Review recommends the development and promotion of comprehensive strategies to improve the health and wellbeing of the population.  It is acknowledged that many of the illnesses of the 21st century are lifestyle related and can be prevented by promoting changes in life-style and through early intervention. 

The case for the development of a more integrated, proactive and community based care model is broadly accepted.  While this is required for all cohorts of the population, it is acknowledged that it is the older age cohorts who will benefit most from such a reformed healthcare model. 

The scale of the projected demand over the next decade, taking account of the reform measures outlined in the Review, suggests a requirement for a 48% increase in the primary care workforce, 43% increase in residential care beds and a 120% increase in homecare over the period to 2031.  Challenges recruiting and retaining front line healthcare staff poses one of the biggest challenges ahead.  

What is needed?

Even with significant reform, it is forecast that there will be a net requirement for an additional 2,590 acute hospital beds in the public system. 

It is clear that significant public and private sector investment across all areas of our health services will be required, in tandem with a fundamental programme of reform. 

If reforms are not undertaken quickly and demand continues to increase, it is very likely that the system will not be able to cope and health outcomes and patient safety will be put at risk.