Trolley crisis: Record numbers awaiting hospital bed

As the hospital overcrowding crisis reached new record levels on Wednesday, Minister for Health Simon Harris said lessons learned in centres that were performing better than others must be applied across the entire hospital system.

There were 677 patients waiting on trolleys in emergency departments or on wards at hospitals across the State on Wednesday – the highest number ever recorded.

It was 21 more than on Tuesday when another record was set for the number of patients on trolleys.

The highest numbers recorded in individual hospitals were at St Luke’s in Kilkenny (54), which used to be held up as an example of how hospitals should be run, and at University Hospital Limerick (53).

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Mr Harris said he had made it very clear to the HSE that it had his support in taking any enhanced measures necessary to help increase discharges and improve community supports.

“While recognising that there is no one-size-fits-all solution we must continue to ensure the lessons that can be learned from those hospitals performing better are applied across the system.”

The overcrowding crisis has been strongly criticised by nurses, doctors and the Opposition.

The general secretary of the Irish Nurses and Midwives Organisation, Phil Ni Sheaghdha, said the situation now represented a national emergency, and some locations could not cope.

The Irish Medical Organisation (IMO) said the country's hospitals were effectively running an emergency service only on a year-round basis, with elective procedures now down to a trickle.

It said in the UK – where hospitals are also reporting chaotic scenes partly attributed to a rise in flu cases – it was seen as an option of almost last resort to cancel elective procedures, while in Ireland this happened routinely, and about 80 percent of admissions were emergencies.

Under-investment

IMO chief operating officer Susan Clyne said: "We are now seeing the consequences of years of under-investment in capacity and medical staffing, while at the same time the demand on our public health services are increasing.

“We need a range of sustainable solutions to alleviate this shameful situation including increasing the bed capacity in our acute hospitals and in community settings, an increase in consultant numbers, and an investment in general practice which is now operating at full capacity on very limited resources.”

The Irish Association for Emergency Medicine said it was gravely concerned but not surprised at the current situation. “This was always going to be how 2018 started in our EDs [emergency departments]. Everyone, from the Minister for Health to the clinician at the frontline knew it, yet little of substance was done by the Department of Health and the HSE to address it.

“There are now large numbers of patients on trolleys throughout the 12 months of the year. EDs are operating all year round at 100 per cent capacity, with any increase in workload, such as the predictable ‘flu season’ and the surge in respiratory admissions at this time of the year, causing an even worse crisis.”

It said HSE plans to solve the crisis were “unambitious and token, and are either not implemented or are too slow or too feeble to respond. The Acute Bed Capacity Review will tell us what we have already known for years, namely that we need many more beds.”

It said it was “long overdue that the ‘national emergency’ declared in 2006 by the then minister for health, at a time far fewer were on trolleys, finally receives the attention it deserves. How many more have to die needlessly while inertia prevails?”

Recalibration

Labour Party health spokesman Alan Kelly said a recalibration in the health service from acute care to community-based care was needed.

“There is a critical need to look at increasing the volume of home-help hours. We have to ensure that community intervention teams can operate longer and consistently across the country. Our citizens deserve to be treated locally in their community instead of lying on hospital trolleys waiting to be treated.”

The HSE said it was continuing to engage directly with hospitals to provide support in addressing the pressures on emergency departments. It urged the public “to protect both emergency and GP services for those with greatest need”.

Colm Henry, national clinical adviser to the HSE acute hospital division, encouraged those who may be able to defer their appointment or seek the advice and support of other services, including pharmacists, to avail of these options at this time.