Emergency staff shortages compromising care

THE SEVERE shortage of medical staff on emergency wards throughout the State must be addressed as a matter of urgency, according to emergency consultants.

They have warned that recruitment difficulties “inevitably lead to longer delays for patients and a demonstrable fall in clinical standards”.

As proposals for a new “Acute Medicine Programme” aimed at improving standards of care for those with acute medical problems got a cautious welcome this week from consultants, research has shown that only 13 of the 31 emergency departments (EDs) around the State are properly staffed.

The study by the Irish Association for Emergency Medicine (IAEM) found that the vacancy rate was as high as 80 per cent in one hospital.

It shows a 13 per cent vacancy rate at registrar (middle grade) level nationally with 140 of 161 posts filled, while just 177 of 200 senior house officer (SHO) posts are occupied, representing a vacancy rate of 11.5 per cent.

The IAEM said staff shortages had led to some shifts not being covered or being covered by short-term locums who were “unable to provide the same standard of care” as doctors who had received the appropriate training and induction.

“Unfortunately, the paucity of consultants in emergency medicine nationally – there are currently 58 substantive consultants spread throughout 31 hospitals – means that Irish EDs are overly dependent on junior doctors, particularly doctors in the SHO grade,” the association cautioned.

The survey showed that staffing deficits were highest in the following hospitals: Our Lady’s Hospital, Navan (80 per cent vacancy rate); Kerry General Hospital, Tralee (66 per cent); Midland Regional Hospital, Portlaoise, Letterkenny General Hospital (50 per cent each); Mid Western Regional Hospital, Limerick (33 per cent), Mercy University Hospital, Cork (30 per cent); Mayo General Hospital, Castlebar (28 per cent); Sligo General Hospital, Wexford General Hospital (25 per cent each); Midland Regional Hospital, Mullingar (22 per cent); Cork University Hospital (18 per cent) and Portiuncula Hospital, Ballinasloe (16 per cent).

According to the association, other short-staffed hospitals include Cavan General Hospital; South Tipperary General Hospital, Clonmel; Waterford Regional Hospital; Midland Regional Hospital, Tullamore; Mater Misericordiae University Hospital; and Galway University Hospital.

The association has expressed concern that the situation will become “even worse” after the next change- over of junior medical staff in January 2011. It pointed out that hospitals which were recruiting had noted a significant drop in the number of applicants for jobs.

“This issue needs to be addressed as a matter of urgency,” the IAEM warned.

It urged that the system move away from the model where emergency departments were for the most part staffed by junior doctors who rotated every six months, saying what was needed was the appointment of permanent fully trained doctors.

Support for plan to cut hospital wait: News Focus, pages 4-5