IHCA calls for nationwide introduction of Criteria-Led Discharging to improve hospital efficiency

• Consultants highlight the need for structured discharge processes to ease hospital overcrowding and improve patient flow
• IHCA President, Professor Gabrielle Colleran: “While CLD is not a silver bullet, its widespread adoption is a necessary step in addressing emergency care bottlenecks and hospital congestion.”

The Irish Hospital Consultants Association (IHCA) is calling for the widespread implementation of Criteria-Led Discharging (CLD) across Irish hospitals to improve patient flow, reduce delays, and ease hospital overcrowding.

CLD is a structured process that allows pre-approved patients to be discharged from hospital once they meet specific evidence-based clinical criteria, rather than relying solely on the admitting Consultant to make the decision.  Instead, Non-Consultant Hospital Doctors (NCHDs), nurses, or Health and Social Care Professionals (HSCPs) can oversee the discharge once all pre-agreed criteria set by the medical team are met.

Despite increased government investment and staffing improvements, hospitals are facing record levels of demand, with inpatient activity rising by 73,000 admissions last year alone, with 72% of these admissions coming through emergency care. According to the IHCA, smarter, more efficient discharge processes—such as CLD—are essential to ensuring timely access to care.

CLD has been used effectively in other healthcare systems, including the NHS, where studies show it increases weekend discharge rates by 55% and reduces overall hospital length of stay. A structured, predictable discharge process also benefits patients and their families, allowing them to plan for recovery at home.

IHCA President, Professor Gabrielle Colleran, said:

"Despite increased funding and reforms, hospitals continue to face record levels of demand. An ageing population and rising chronic disease levels mean this pressure is unlikely to ease anytime soon.

"While continuous investment and staffing are critical, we must also optimise how our hospital teams work. Criteria-Led Discharging is a proven, safe practice that can help reduce unnecessary delays and improve patient care.

"We have an opportunity to build on recent progress in reducing waiting lists and increasing hospital capacity. Implementing CLD as standard practice across every hospital would be a significant step towards a more efficient, patient-centred hospital system.

"CLD is not a new concept. It dates back to the 1990s and has been recommended in multiple HSE policy documents. It was also part of discussions over the transfer of tasks from doctors to nurses under the Haddington Road Agreement. Yet, a decade later, its implementation remains inconsistent. We have never been in a stronger position to fully implement it.

"While CLD is not a silver bullet, its widespread adoption is a necessary step in addressing emergency care bottlenecks and hospital congestion."

ENDS