A&E overcrowding may get worse, HSE admits

The Health Service Executive believes the worst of the hospital emergency department overcrowding crisis may not be over and that the situation could deteriorate further before improving.

Last night consultants in emergency medicine warned patients will die unless measures were taken to relieve the pressure on crowded hospital units.

Dr Fergal Hickey, an emergency medicine consultant at Sligo General Hospital and spokesman for the Irish Association for Emergency Medicine said: "If they don't fix it, patients will die. They should have fixed this 10 years ago but people are continuing to die because of inactivity and a reluctance to face up to both the scale of the problem and the need to fix it."

He added: “Some 300-350 Irish patients a year are dying unnecessarily as a result of emergency department overcrowding.”

Varadkar returns

As the controversy over the record numbers of patients on trolleys awaiting admission to hospital beds intensified, Minister for Health Leo Varadkar was understood to be returning to Ireland from a short break in the United States and is expected to respond to the situation on Wednesday.

It is understood he has been monitoring the situation while abroad and has been in contact with officials.

Figures compiled by the Irish Nurses and Midwives Organisation (INMO) showed that at one stage on Tuesday more than 600 patients were awaiting admission to a hospital bed. The HSE said the numbers on trolleys eased later in the day but that the figures could increase again on Wednesday.

The HSE has received some information that a number of admissions in the midlands may be linked to influenza but this will not be confirmed until later in the week.

In the event of an influenza outbreak the HSE is planning new initiatives including moves to provide greater supports to allow patients in nursing homes with the condition to be treated there rather than in hospital emergency departments.

Crisis measures

Hospitals around the country have put in place a variety of measures to deal with the crisis. While the HSE has not ordered a blanket directive for hospitals to cancel elective or non-urgent admissions, it is understood many hospitals have decided to do so as part of their individual “escalation” plans.

Hospitals are opening additional overflow areas and it is understood that up to 400 beds may be provided across the country as part of this process.Some five-day wards may be opened full-time and in cases of severe overcrowding, day surgery units could be used to accommodate patients.

The HSE said €25 million had been provided to deal with the issue of delayed discharges – patients who have completed acute hospital treatment but who are currently occupying a bed. It said this money was being used to provide homecare packages and short-stay beds for the greater Dublin area.

The Irish Times understands that before the budget last October the HSE lobbied the Government to provide an additional €106.5 million to tackle overcrowding in emergency departments.