Trolley numbers down but ‘late’ flu will put hospitals under pressure

Emergency department overcrowding down by half on same day last year

The single biggest factor underlying the improvement in trolley figures is the later arrival of the flu this winter.

The single biggest factor underlying the improvement in trolley figures is the later arrival of the flu this winter.


Hospital overcrowding on the first working day after the Christmas holiday was significantly down on last year, confounding predictions of trolley numbers hitting a record in the new year.

However, Minister for Health Simon Harris, the Health Service Executive (HSE) and individual GPs warned of an imminent surge in flu cases after the holiday period, which is likely to put hospitals under increased pressure.

There were 366 patients waiting on trolleys or in wards for admission to hospital on Wednesday morning, according to the Irish Nurses and Midwives Organisation (INMO) TrolleyWatch count.

This was slightly up on the 357 patients recorded on New Year’s Eve, but significantly down on the 656 patients who were awaiting hospital admission on the same day last year.

The single biggest factor underlying the improvement in figures is the later arrival of the flu this winter. By mid-December, rates of flu were running at well below the threshold level. The disease accounted for one death, which is lower than average. In contrast, the flu hit early and hard last winter.

The mild weather over Christmas, as well as measures undertaken within hospitals – including the cancellation of many surgeries – may also have helped keep down the trolley figures.

However, Anne O’Connor, HSE deputy director general, said hospitals continued to be busy. “With trolley numbers this morning 54 per cent lower than the same day last year, flu is now starting to impact on presentations and is likely to get worse over the coming days.”

The HSE asked the public to avail of other options where possible, such as injury units, GPs and pharmacy services, before opting to go to an emergency department.

‘Significant reduction’

Mr Harris welcomed the “significant reduction” in trolley numbers and said it was due to the “incredible work” of staff, the provision of home-care packages and the lower number of flu cases. However, he warned that “undoubtedly, a surge will come”.

Although attendances at emergency departments grew by 24,000 last year, to a record 1.2 million, the HSE said the trend from May 2018 was downwards. Overall figures for last year were skewed by the bad weather in February and March, it maintained.

According to the INMO TrolleyWatch count, 246 patients were waiting for admission in emergency departments this morning, and 120 more were in wards elsewhere in hospitals.

The worst-hit hospitals were University Hospital Limerick, with 48 patients waiting for admission, followed by University Hospital Galway (with 30), and St Luke’s, Kilkenny and Letterkenny University Hospital (both 26).

Separate HSE figures also point to hospital overcrowding being much lower than last year so far. There were 236 patients on trolleys on Wednesday morning, of whom 94 were waiting over nine hours, according to the HSE’s TrolleyGar count, which counts three times daily the number of patients awaiting admission to a bed. This compares with 514 on the same day last year, when 212 patients were waiting over nine hours.

The number of children on trolleys was up, from six this day last year to eight on Wednesday morning.

The hospitals with the worst overcrowding on Wednesday morning, according to the HSE figures, were University Hospital Limerick (21 patients on trolleys) and the Mater hospital in Dublin (19).

The HSE counts patients on trolleys only. The INMO says its count is more accurate because it includes patients in wards who are also waiting to be admitted.

Trolley numbers may rise over the coming months as the number of flu cases increases, but health experts say the flu vaccine provided this winter is a good match for the strain of the disease expected to predominate.