HSE publishes Winter Plan 2022/23

HSE Press Release

Tuesday, 11 October 2022

HSE publishes Winter Plan 2022/23

The HSE has today, (Tuesday, 11th October 2022) outlined actions that will be taken to support the health service to manage the expected increase in the number of patients requiring health care over the winter period.

Actions to help manage increased demand over the winter period include:

  • Delivering additional capacity in acute and community services: This will include the ongoing delivery of additional acute and community beds and increasing staffing capacity in line with the Safe Staffing and Skill-Mix Framework. The HSE also plans to extend the opening hours of a number of our local injury units during the winter period.
  • Improving pathways of care for patients: Alternative patient pathways will be implemented during the winter period to help reduce the number of presentations and admissions to hospital and improve patient flow and discharge.  This includes Enhanced Community Care (ECC) supports. 
  • Roll out of the vaccination programme for Flu and COVID-19: The influenza and COVID-19 vaccination programmes continue to be rolled out. Targeted communications will be used to increase awareness and uptake for our winter vaccine programmes.
  • Implementation of the Pandemic Preparedness Plan: The Public Health Plan will be implemented as appropriate which includes a surge and emergency response plan, in the event of a significant surge in COVID-19 infections.

Funding of just over €169 million has been assigned to implement these measures over 2022 / 2023, and this will include the recruitment of 608 posts across a range of services.

According to the Chief Clinical Officer of the HSE Dr Colm Henry:  “This coming winter – the third winter we have with COVID-19 – carries much uncertainty. The combination of COVID-19 and seasonal viruses such as influenza has the potential to create much pressure on a healthcare system that has endured almost three years of pandemic pressures. Our response has been to create additional much-needed capacity and to diversify access to healthcare and reduce reliance on hospitals. While these measures are all necessary and helpful, we can all at an individual level reduce the impact of COVID-19 and influenza by getting our winter vaccines as soon as possible. Doing so not only protects us at an individual level, but also helps protect our families and communities. We know that our immunity to COVID 19 infection reduces over time and booster vaccines restore protection for all the groups for whom it is advised.”

There has been significant investment in the HSE over the last number of years, particularly through annual National Service Plans (NSPs) and recent Winter Plans. This investment has facilitated the development of new services and allowed the HSE to improve existing services and respond to the COVID-19 pandemic. That investment continues as part of our annual service planning, and alongside the additional measures we are outlining today, will help us manage the flow of patients and help us deal with the pressure on services.

Mary Day, HSE National Director for Acute Operations said despite the progress made in many areas of the health service due to this investment, substantial challenges remain as a result of both historical and newly emerging risks. A key challenge for the health service is the consistent and sustained increase of emergency attendances and admissions to our acute hospitals.

When we compare the level of unscheduled care provided in 2022 to date to 2019 there is:

  • 5.36% increase overall in ED attendances;
  • 0.74% increase in admissions;
  • 12.92% increase in ED attendances by those >75 years;
  • 8.2% increase in ED admissions by those >75 years.

“No matter what the time of year, HSE services are seeing and treating more patients in hospitals and in the community than ever before. In our acute hospitals this year, over 1.6 million people will have an inpatient or day case procedure or use maternity services. We have also provided 14.2 million home support hours this year to date to enable people to remain at home and to support their families to care for them.

“There has been very significant investment in the health services in the last number of years and this has provided additional beds, staffing and equipment across our hospital and community services. Over the last two years we have opened 907 extra beds across our acute hospitals with a further 300 funded and due to open in the coming months. We know that there are further beds required and we are working on plans to develop those additional beds in the short term. We know that we had a particular shortage of ICU beds in the past and to address that we have opened an extra 68 ICU beds in the last two years and a further 20 ICU beds are funded and due to become available shortly as part of Phase 1 commitments to enhancing critical care capacity”.

Yvonne O Neill, HSE National Director for Community Operations added, “The fact that we are continuously growing the amount of healthcare provided to the population is good news”, she said.  “But the growing demand also results in delays and waiting lists, and the measures being announced today will go some way to easing that in what may be a very busy period.”

Among the measures in the plan are:

  • A further €4.5 million for aids and appliances to enable patients be discharged home or to a community facility as quickly as possible.
  • Expansion of patient flow and discharge teams in hospitals and community to minimise delays in discharge or transfer to other hospitals or step-down facilities.
  • Additional funding for complex care packages which will enable hospitals to discharge patients with complex need by giving them the supports they need to be cared for at home.
  • Extra funding to allow us treat more patients in the private hospital system
  • Funding for additional access to diagnostics for GPs to enable them to refer patients directly for x-rays or scans rather than it being necessary for them to be sent to Emergency Departments in order to access such diagnostic services. Good progress has already been made in some of these areas in 2022. Over 188,516 scans have been completed as part of the GP access to diagnostics initiative so far this year.
  • Additional funding to the GP out of hours service including expansion to provide full coverage in rural areas in CHO West
  • Investment to support expansion of Community Intervention Teams (CIT) across the country with a particular focus on the Mid-West and North-West regions.
  • Funding to enhance palliative care services during the winter which will deliver 1,340 nights of night nursing to 380 patients and families.
  • Funding has been provided for an integrated action team funds which each Hospital Group and CHO can request access for specific initiatives during the winter period.
  • We are reinforcing the key role of Covid-19 and flu vaccines in reducing the level of severe respiratory illness

In addition to these national initiatives, Hospital Groups and CHOs have worked closely together to develop local initiatives for the winter period in line with the needs of their community.

Liam Woods, HSE National Director stated “We have worked closely with our Hospital Group and CHO colleagues around the country, providing funding to Hospital Groups and Community Health teams to allow them recruit additional staff.  This includes additional ED consultants and teams to support them, including Advanced Nurse Practitioners and Health and Social Care Professionals.

“So far this year, almost 1,066,641 people have attended our Emergency Departments.  Of these more than 142,458 were aged 75 or older. Many of these patients are frail and elderly and their health care needs are varied and complex. The increased demand on healthcare is due to a number of factors.  Our overall population has increased significantly in the last 20 years and the prevalence of chronic illnesses such as COPD and diabetes is increasing yearly.  The aging of the population and the constant development of new therapies also increase demand. The ongoing and recurring pressures on the health system will only be resolved by medium and long-term steps.

“The measures being announced today are intended to ensure the health service can provide the best possible support to the population in the coming months. Ultimately, reducing long waiting times in our EDs will require more beds in our acute hospitals and our community units and the teams necessary to staff them safely.  It will also require continued development of community services and the growth in care to people at home or in community-based HSE facilities so they don’t have to be admitted to hospital unless they really need to be”.


Issued by HSE Press Office


Last updated on: 11 / 10 / 2022