Hospital emergency departments have become ‘warehouses’ of patients

Emergency departments (EDs) have become “warehouses” of patients waiting for admission to hospital, with “apocalyptic” predictions for the pressure on the health service now becoming a reality, the Irish Association for Emergency Medicine (IAEM) has said.

A total of 571 patients were on trolleys in hospitals on Wednesday morning, which is “very out of kilter” for this period, which normally has fewer people waiting on beds due to the reduction in elective care over the Christmas period.

According to the Irish Nurses and Midwives Organisation’s (INMO) trolley watch, of those waiting on trolleys, 456 were in EDs around the country, with 115 being in wards.

University Hospital Limerick (UHL) had the highest number of patients on trolleys on Wednesday with 79, followed by St Luke’s Hospital in Kilkenny at 57.

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The number of patients in hospital with Covid-19 has also increased in recent weeks, with 737 confirmed cases in Irish hospitals as of 8am on Wednesday morning, a 50 per cent increase when compared with two weeks earlier.

Overcrowding in adult and children hospitals is being driven by the surge in winter respiratory viruses, including coronavirus, flu and RSV (respiratory syncytial virus).

Dr Fergal Hickey, a consultant in emergency medicine at Sligo hospital, and spokesman for the IAEM, said things were “really bad”, which had a “very negative impact” on patient care.

“We now have additional pressures on the system and what has happened is the system has fallen over. There are extraordinary delays for people to be seen in EDs because there’s no physical space for people to be seen,” he said.

“Emergency departments are just being used as a warehouse for patients which in the current climate [with respiratory illnesses being high] is just completely daft.”

Dr Colm Henry, the HSE’s chief clinical officer, said the upward trajectory of flu cases closely matched the 2019 flu season, which saw the highest number of cases and hospitalisations in the past six years. There was “no sense” of this wave of flu cases peaking yet, Dr Henry added.

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General practice is also seeing a surge in demand, with Tom O’Dowd, a west Dublin GP, saying demand is now higher than it has ever been before.

“There’s a lot of acute work but there’s also a lot of planned work, which has created an additional workload. Then there’s a kind of a tripledemic, really, with Covid, RSV and influenza,” he said.

“I’ve long felt it wasn’t possible to keep up with demand. It’s just unrelenting demand at the minute.”

Support has been provided to GP out-of-hours services to meet demand, a spokesman for the HSE said. An additional 3,000 people were seen by GP out-of-hours services last week, bringing the total number of patients seen to 28,000.

The spokesman added that there had been a reduction in planned surgeries and procedures, but “every effort” was being made to proceed with time-sensitive and urgent surgery.

“Hospitals are experiencing a serious surge in cases of Covid and influenza. However, arrangements are in place to support clinical and management oversight across all hospital and community settings,” the spokesman said.

“It should be noted that there are significant staff challenges in provision of services due to staff absenteeism arising from Covid-19, flu and other viruses.”

Meanwhile, an online petition has been started to stop an out-of-hours GP service in the Midlands from shutting on New Year’s Day.

The Midlands GP service Midoc, which had been running for 20 years, and covers the counties of Laois, Longford, Offaly and Westmeath with a combined population of 300,000, has come under financial strain.