50 new consultants to be appointed to emergency departments to tackle trolley crisis

Up to 50 new hospital consultants are to be appointed to emergency departments (EDs) around the country in the coming months in a fresh effort to relieve blockages and cut trolley numbers.

With another difficult winter looming in hospitals, Minister for Health Stephen Donnelly plans a 40 per cent increase in the number of ED consultants within months, and at least a doubling of numbers in the following years.

Mr Donnelly has told the HSE to fast-track the appointments because of what he describes as the “multiple layers and delays” in the traditional process for appointing consultants.

Numerous reports have highlighted the need for increased numbers of senior decision-makers in EDs to ensure safe services are delivered to patients. A lack of ED consultants capable of making key clinical decisions is linked to higher admission rates and longer stays in hospital.

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[ Analysis: Major changes are needed, particularly at the worst-affected hospitals ]

Mr Donnelly told the HSE last April to come up with “immediate actions” to alleviate hospital ED overcrowding. In June he wrote again to HSE chief executive Paul Reid seeking information on the actions proposed to deal with “systemic issues”, as well as a site-by-site analysis of the problems at particular hospitals.

In the letter, obtained under freedom of information, Mr Donnelly pointed to the “significant undersupply” of staff and the need to hire additional specialists in EDs. “While we are all in agreement that increasing consultant numbers in emergency medicine alone will not solve the challenges, it is an important part of the solution,” he told Mr Reid.

The Minister sought assurances that the new posts would be progressed “immediately as an integral part of winter preparedness”.

“I understand there can be multiple layers and delays before posts are progressed to the Consultant Applications Advisory Committee (CAAC). Given the pressure our EDs are under, these posts should be expedited directly for approval to CAAC,” he wrote.

Over the summer, the clinical lead for emergency medicine, Dr Gerry McCarthy, and other officials developed the workforce proposal, by identifying specific gaps in staffing in individual hospitals.

The new posts will be especially targeted at under-pressure ED sites, Mr Donnelly told The Irish Times last night. This is expected to include University Hospital Limerick and University Hospital Galway.

“Patients and staff need to see real change,” the Minister said. “I asked the HSE to develop a comprehensive site-by-site plan, and have worked closely with the executive and officials in my department on it. Building up our workforce will form a vital component of this plan, which will include more consultants in emergency medicine, as well as more nurses and more health and social care professionals.”

There are at present 110 whole-time equivalent consultant posts in emergency medicine, so the proposed increase represents a near 40 per cent expansion in staffing.

About 150,000 people now work in the health service, including almost 15,000 recruited since early 2020.