How will seven-day a week healthcare work in reality?
What changes will patients and health staff see now that the HSE and unions have agreed on working over seven days instead of mainly Monday-Friday?
The big change will be more staff at weekends to help address spikes in overcrowding and target waiting lists. However, do not get excited just yet, as staff were told of a lead-in time of at least 63 days in a circular issued on Monday.
Thousands who now work Monday to Friday, 9am to 5pm, will move to working five days across a seven-day roster. Hours will extend from 8am to 8pm.
It could also see more patients discharged home at weekends.
However as many elderly people know it is very hard to get homecare at weekends already, so how will sudden hospital discharges be supported?
We asked about this, and services such as Child and Adolescent Mental Health Services (Camhs) and the Integrated Care Programme for Older Persons, however the HSE said only they are working on: 'plans to introduce extended working arrangements in the areas with most need and these requirements will vary from site to site'.
CEO Bernard Gloster was in Cork on Tuesday to discuss having some weekend clinics up and running by August. Expanding clinic hours and reducing patient delays are his priorities, the HSE said.
It is voluntary. However, managers were advised to assign people to new rosters if necessary by HSE chief people officer Anne Marie Hoey in the circular seen by the Irish Examiner.
This all follows Forsa, just last month, finding that 68% of members describe staff morale as either 'low' or 'terrible'.
The long hangover from the pandemic years, coupled with recruitment challenges and a growing number of patients, have left many exhausted.
Despite this, the pressures to make savings and slash waiting times are only growing, including from the productivity and savings taskforce, amidst a record budget of €26.9m which is seen as not reducing delays quickly enough.
Forsa expects local managers' proposals for each site will make the practicalities clearer.
'It remains our position that while these proposals can work in some areas, the resource challenges in other areas may inhibit efforts to extend services,' a spokesman said on Tuesday.
A similar fear was expressed by the Irish Medical Organisation (IMO).
'The IMO is not ideologically opposed to extended services, but their introduction cannot be based on robbing Peter to pay Paul where there may be a reduction in services on other days,' said consultants committee chair Dr Matthew Sadlier.
All unions, including Siptu, have called for urgent investment in staffing.
Health minister Jennifer Carroll MacNeill said the plans are 'a major, major reform' which she expects to reduce waiting lists. She expects to see evening outpatient clinics and more scans at weekends.
'We want to get to the point where we are using our theatres on Saturdays, spreading into Sundays,' she told RTÉ.
The minister said the move will include community services without specifying which ones.
She also brought the Patient Safety (Licensing) Bill before Cabinet on Tuesday. This could address problems such as use of unapproved springs in children's spinal surgery at Temple Street hospital, she expects.
The Irish Nurses and Midwives Organisation called for this legislation to include a legal requirement for safe nursing and midwifery staffing levels.
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HSE reaches deal with unions to extend hospital hours and tackle overcrowding
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