LAST UPDATE | 9 Jan 2023

THE HSE’S CHIEF clinical officer has said that the fall in the number of patients on trolleys was as a result of a “whole system response”, but that asking hospital staff to work across weekends is “not sustainable in the long run”. 

Dr Colm Henry said the health service is seeking additional capacity in the private hospital sector to cope with the current pressure on hospitals due to the surge in respiratory illnesses.

More consultants and senior decision makers were deployed in hospitals over the weekend to ensure a more consistent flow of discharges across Saturday and Sunday.

This morning, 489 admitted patients were waiting for beds, according the Irish Nurses and Midwives Organisation.

390 patients were waiting in emergency departments and 99 were in wards elsewhere in the hospitals.

Speaking on RTÉ’s Morning Ireland programme, Henry said there were 248 people on trolleys awaiting admission last night compared to the higher figures seen last week, when a record 931 patients were on trolleys on Tuesday.

He praised the “extraordinary efforts” of hospital staff who “heeded our call to address the patient safety issues clearly associated with long stays in emergency departments”.

“It was a whole system response. People talk about senior decision makers and we had more senior decision makers than we normally do,” he said.

“What we did over the weekend was bring in not just additional senior decision makers in the form of consultants and doctors and senior nurses, but also the support network around them to ensure that when they make decisions, identifying patients who could go home or could be transferred, that the right diagnostics were there, that the right managers were there, that the right support physiotherapist were there, and of course, the right community service were there to enable those additional discharges to take place on Saturday.

“We’ve asked for this extra effort from staff who are already quite understandably exhausted and depleted and themselves affected by the scenes in emergency departments, so we can address those clear issues concerning patient safety that we saw with those very high figures earlier in the week.”

However, he said that staff “will need a break” and that having them work additional hours across weekends “is not sustainable in the long run because our healthcare system is not configured to work the same way every single day of the week”.

He said the HSE is working with private hospitals in order to find additional capacity beds.

“We have 188 beds that have been provided to us. Of these, 148 patients are in those beds, and we’re seeking additional bands from the Private Hospitals Association in case this surge of viruses, which has not yet peaked, continues to cause impact, as it is across Europe, on our healthcare system.”

Henry said the HSE is “looking for as much as we can get” and that the number of beds available “completely depends on the workload of the private hospitals”.

As part of plans to ease overcrowding at University Hospital Limerick’s emergency department, ambulances will be able to bring patients directly to Ennis Hospital instead of them waiting on a trolley at UHL in a pilot project beginning today.

Henry said that prioritising patients presenting to emergency departments may lead to the delay or cancelation of elective surgeries at Ennis Hospital.

“From a clinical and from a patient safety perspective, our absolute priority are those people with acute unscheduled care who are presenting to emergency departments as well as time critical care people,” he said.

These are our priorities. Unfortunately, in prioritising those patients, it does involve curtailment of non-urgent care.

“It’s never a preferred option to cancel or curtail or delay a surgery for people who are awaiting surgery whether for pain or disability. But as I say, in any healthcare system, and we’re no different from other health care systems across Europe now in responding to what is a significant threat – an exceptional flu season coupled with Covid and RSV – is we must maximise the care of those people who have time critical care who are presenting in great numbers due to the surge of viral infection right across this country and right across Europe, prioritising the care of those with the greatest need.”

Asked when hospitals will no longer be working at 100% capacity, Henry said that the HSE needs additional capacity as well as “to build a health care service that isn’t focused on funnelling people through hospital emergency departments alone”.

Elsewhere, the INMO is to begin consulting with its members this week on possible industrial action.

INMO general secretary Phil Ní Sheaghda told RTÉ’s This Week programme yesterday that the INMO held an emergency meeting on Friday in response to the current overcrowding crisis in hospitals

“It is simply not acceptable that every single year around this time we have this crisis because the the effects of the crisis for patients actually is that they’re dying unnecessarily,” Ní Sheaghga said.

“Now, if that isn’t a stark enough issue to get all government action, we don’t know what is.”

Additional reporting by Lauren Boland