Number of patients attending emergency department hits new record

Increase in attendances the key challenge for HSE this winter as Covid and flu cases remain stable

The number of people attending a hospital emergency department (ED) hit a new record last week, as pre-winter pressures on the health service continue to mount.

A total of 30,120 people attended an ED last week, and 7,256 were admitted – the fourth highest figure on record.

While Covid-19 and flu figures are stable so far, the sustained increase in attendances at EDs is emerging as the key challenge for an overloaded health service heading into the winter period.

So far this year, more than one million people have attended a hospital emergency department, up 5 per cent on last year. Admissions have risen by just 1 per cent, but by 8 per cent among often frailer over-75s.

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Health bosses were working with frontline staff to deal with these pressures “as best they can”, interim HSE chief executive Stephen Mulvany told a media briefing on Thursday.

He acknowledged that waiting lists were “too long” but signalled that non-urgent work may be “curtailed” again early in the new year if demand surges after Christmas in the same way as it has in previous years.

The outlook for Covid this winter remains uncertain, said HSE chief clinical officer Dr Colm Henry, though he predicted hospitalisations and ICU admissions may be similar to last winter.

An early rise in respiratory viruses affecting children may be the result of young people’s immunity “not being as strong as it used to be” after the pandemic, he said.

Flu levels remain low, though the number of cases jumped 24 per cent last week. The HSE reported 43 hospitalisations with flu, up 39 per cent on the previous week. Two people were admitted to ICU and there was one death.

Covid cases fell 1 per cent last week, and hospitalisations were down 5 per cent. However, the number of hospital outbreaks rose to 20, from 14 the previous week.

The BA.5 subvariant of Omicron remains dominant in Ireland, but a new subvariant, BQ.1, is growing rapidly; it accounted for 25 per cent of cases sequenced last week.

There is no evidence so far that BQ.1 will result in more serious illness, Dr Henry cautioned, though it has a growth advantage on other variants.

No new variant of concern is “on the horizon” at present, he said, but the current “soup” of new subvariants is making winter surges hard to predict.

Asked about the pressures on nurses and other health professionals from cost-of-living pressures and understaffing, Mr Mulvany urged staff to “stick with it” in the interests of providing better services to patients.

Staff retention is a significant priority for the HSE, he said, but it was competing in an international labour market and many staff who couldn’t travel during the pandemic were now taking the opportunity to work abroad.

Dr Henry acknowledged low staffing levels are unsafe but he warned things were not going to get better overnight due to the competition internationally for staff.

“There is no quick fix to this. We’re on a journey to create multiple opportunities for people who want to remain in Ireland, both in hospitals and in the community.”

The HSE will ask the National Immunisation Advisory Committee to consider expanding access to further boosters for carers of vulnerable people, said Eileen Whelan, head of the HSE’s test and trace programme.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times