Hospital overcrowding: Patients on trolleys hit record high amid ‘inhumane’ conditions

The number of patients waiting for a hospital bed on Tuesday has hit a new record of 931 people, according to figures from the Irish Nurses and Midwives Organisation (INMO).

The number of people on trolleys on Tuesday is significantly higher than the previous record, when 760 people were waiting for a hospital bed on December 19th.

University Hospital Limerick (UHL) has the highest levels of overcrowding with 97 patients waiting on trolleys in its emergency department (ED) or on wards on Tuesday.

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The INMO’s Trolleywatch count said 74 patients were waiting for a bed in Cork University Hospital, 56 in St Vincent’s hospital and 52 in Letterkenny University Hospital and University Hospital Galway.

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An appeal from the Health Service Executive (HSE) for people to avoid hospitals if possible, due to expected pressure on EDs, has been criticised by a medical consultant.

The HSE has appealed to people to “consider all options” before going to a hospital this week in what it predicts will be “one of the busiest ever periods” experienced by the health service.

Hospitals are bracing themselves for exceptional pressures from Tuesday, the first normal working day after the holidays and traditionally the day when attendances in hospital EDs rise sharply.

On Monday both the Mater hospital in Dublin and UHL urged patients to avoid their EDs if possible, due to the pressure they were under.

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Hospitals are under strain from a surge in flu and Covid-19 cases, as well as other winter viruses like RSV (respiratory syncytial virus).

The HSE has said it expects the sharp increase in cases to continue into the coming weeks, putting further strain on hospitals and EDs.

Dr Fergal Hickey, emergency medicine consultant, has said alternatives to hospitals, such as minor injury units or GP clinics, were not practical for many patients.

Dr Hickey said people with respiratory conditions will not be allowed to enter injury units, and many people did not have access to a GP.

The advice to speak to a pharmacist was also problematic as all they could provide was over the counter medication, he told RTÉ Radio 1.

The only people who would pay attention to such appeals were older people who were the ones who likely most needed to be seen, he said.

Dr Hickey said the main problem was the lack of hospital beds in the State which needed to be addressed rather than moving the deck chairs on the Titanic. “This will kill people. Why is this being allowed to happen? Why are old people allowed to die?” he said.

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EDs were “warehousing” patients and were “a big Petri dish” for respiratory conditions, as there were not enough beds or isolation facilities in hospitals, he said.

Speaking on Tuesday, Prof Declan Lyons, consultant geriatrician at UHL said conditions in its ED were “inhumane”. Patients were being “crammed together” on trolleys with little room between them, he said.

The hospital had now been characterised as “the national basket case” due to the serious overcrowding in the ED, he told RTÉ Radio’s Morning Ireland.

Prof Lyons said UHL had been dealing with “chronic and persistent overcrowding in the emergency department” for a number of years, which had only got worse.

The consultant said he was concerned the overcrowding would make it difficult for clinical staff to identify the patients who were most in need of treatment.

Prof Lyons said the pressure in such conditions could lead to mistakes and “adverse clinical results”. The situation was very serious and was compromising patient safety, he said.

Prof Brian Lenehan, chief clinical director of the UL Hospitals Group, said emergency protocols were triggered at UHL because “there were 170 patients in the (emergency) department” on Monday morning.

“That was unsustainable - the department and the waiting room were very overcrowded, and that is why we trigged the major internal incident protocol”.

There were 121 patients in the emergency department Tuesday afternoon, but Prof Lenehan said this figure “isn’t unexpected” during winter time.

While the pressure on the Limerick ED had “started to improve” the present patient surge at the hospital “is going to take number of days to work through”, he said.