LAST UPDATE | 14 Dec 2022

THE HEALTH SERVICE is under “unprecedented strain” as it struggles to cater to a “significantly higher” number of patients than in previous years, according to the Health Information and Quality Authority.

Today HIQA published an overview of its report on monitoring adherence to national standards in seven emergency departments this year, which stated that it is not uncommon for them to find patients in emergency departments to wait “80-90 hours for an inpatient bed.”

In one extreme case HIQA inspectors witnessed a patient waiting in excess of 116 hours for an inpatient bed.

Its publication has sparked calls for an “urgent” meeting with Health Minister Stephen Donnelly from the country’s largest nursing and midwives trade union.

Across the seven hospitals assessed by HIQA the majority had management arrangements in place to address patient flow through the emergency department , the hospital and into the community, but these measures were not always found to be effective, and compliance plans were issued to five of the hospitals, and three hospitals were issued with high-risk letters.

Across all of the hospitals HIQA inspected, there were also delays in transfer of care cases in emergency departments. This ranged from 6 to 44 people waiting on a transfer of care on each day that inspectors visited hospitals.

The authority also published inspection reports on four public acute hospitals, and found that none of them met national standards.

Mayo University Hospital was so overcrowded that HIQA inspectors said the dignity and autonomy of patients was challenged, and patients were exposed to infection prevention and control risks, as minimum social distancing wasn’t being achieved.

Screening for Covid-19 was also not found to be in line with national guidance when inspectors visited the hospital on the 16 and 17 of August.

Despite the significant challenges the overcrowding caused, inspectors reported that service users said the staff were kind and respectful towards them.

Inspectors who visited St Vincent’s University Hospital in late August said that the emergency department was challenged by the high numbers of patients and limited capacity, adding that the deficit in staffing posed a patient safety risk.

Inspectors further found that overcrowding was an issue in Sligo University Hospital when inspectors visited also, as they witnessed patients being assessed in the emergency department while awaiting beds.

HIQA’S Director of Healthcare Sean Egan has said that overcrowding in EDs is causing issues nationally, and compromising the dignity and safety of patients.

He said: “The Irish healthcare system remains challenged by bed capacity and workforce shortages, and access and capacity issues in primary care.

“Emergency department overcrowding and insufficient access to acute and primary services will continue to occur unless a system-wide approach is taken to address major structural concerns,” he said, adding that “urgent efforts” to overhaul the health service “must be progressed”.

“Unacceptable”

The Irish Nurses and Midwives Organisation (INMO) have echoed Egan’s sentiments and have called for an emergency meeting with Minister Stephen Donnelly this week “to discuss how a more proactive approach can be taken to tackling the very serious challenges that exist in our emergency departments”.

In a statement today, INMO General Secretary, Phil Ní Sheaghdha, welcomed the publication of the report, but condemned the conditions in hospitals nationwide.

She said: “The report published by HIQA today compounds what the INMO has been consistently highlighting – our hospitals are under enormous pressure due to capacity issues and unsafe staffing.”

She went on to highlight the report’s “stark findings” in relation to safe staffing in hospitals, describing them as “unacceptable”. Of the seven emergency departments inspected, only one hospital was properly staffed, Ní Sheaghdha said.

We know that many nurses are leaving emergency departments because of the conditions that they are faced with. This phenomenon cannot continue into 2023.

“We are strongly of the view that emergency measures are now needed to prevent the unnecessary continuation of these inhumane and undignified conditions for patients and really unhealthy working conditions for nurses and midwives and other healthcare workers,” she added.

Additional reporting by Sarah McGuinness.