Health crisis: Cork University Hospital facing ‘potential winter catastrophe’

Health crisis: Cork University Hospital facing ‘potential winter catastrophe’
Patients on trolleys at Cork University Hospital.

MORE than 450 patients were left waiting in emergency departments for hospital beds in Cork in the space of six days last week — almost 35% of the total left waiting for the whole of October.

Figures from the Irish Nurses and Midwives Organisation show that, in the first six weekdays of this month, 319 patients were left waiting for a bed at Cork University Hospital, along with 103 at the Mercy and 29 at Bantry General.

More than 60 patients were waiting for beds at CUH on two separate occasions last week as the INMO reported record levels of overcrowding. If these trends continue or worsen, that figure could be eclipsed this month.

The alarming figures come amid reports of corridors full of trolleys, staff shortages and public hospitals being forced to taxi patients to private hospitals due to patient safety concerns.

With winter approaching and fears that a flu pandemic might hit the country, there are concerns that the situation in hospitals across Cork and Ireland will only worsen in the coming months.

The Echo revealed earlier this week that CUH was forced to pay for taxis to transfer patients to a private hospital in the region amid high demand and patient safety concerns in its emergency department (ED).

Nationally, there were 679 patients waiting without beds in Ireland’s hospitals on Tuesday — the highest daily figure in 2019 so far, and the second-highest ever recorded. Patients and doctors alike have spoken out about the conditions in hospital EDs, which have been likened to that of a “third world war zone”.

One patient, James Anthony told The Echo on Tuesday afternoon that he had been waiting in the ED at CUH for around 18 hours.

Stephen Casserly and Jessica Riley were also at the hospital on Tuesday afternoon after Stephen was advised by his doctor to attend for tests on his lungs. Ms Riley said that entire corridors at CUH are taken up with people on trolleys and that there were little or no seats available as the ED spilled out into adjacent corridors.

Dr Conor Deasy, a consultant in Emergency Medicine at CUH, told The Echo this week that staff at the hospital are “deeply concerned”.

“We have been highlighting the need for extra bed capacity in the hospital as well as increased rehabilitation bed capacity, access to step down beds in the community, nursing home beds and home care packages,” he said.

“The ED staff abhor the inhumanity, indignity and patient safety risk associated with treating patients, who require an inpatient hospital bed, on the corridor of the emergency department. Immediate steps are vital.”

Meanwhile, Cork GP Dr Nick Flynn said that GPs in the region are apologising to patients that they refer to hospital emergency departments due to the overcrowding crisis. He said patients do not want to go to the hospital and that their GPs only send them as a last resort.

He was speaking after CUH asked patients to contact their GP, SouthDoc or explore all other options before attending the hospital ED. A spokesperson for CUH said the hospital has been “exceptionally busy” in recent weeks and that some patients may experience delays as a result.

“Hospital management have requested that, where appropriate, the public contact their GP in the first instance and explore all other options available to them prior to attending the Emergency Department if their needs are not urgent,” she added.

Speaking to The Echo, Dr Flynn said he sent two patients to the ED on Thursday last week. “You’re apologising sending them, saying ‘ I wouldn’t be writing this referral letter if there was anywhere else to go, but it’s the only option’ — that’s where we’re at right now.

“People don’t want to go to hospital,” said Dr Flynn, referring to The Echo’s recent story on patients’ experiences in the ED at CUH last Tuesday.

Ambulance crews are often subject to long delays waiting for the return of their trolleys 
Ambulance crews are often subject to long delays waiting for the return of their trolleys 

“That is front and centre in people’s minds. They know A&Es are like a third world war zone and they don’t go there lightly.

“GPs do not send them there lightly.

“They’re in need of a hospital bed but, because of a lack of capacity, they’re left languishing on trolleys where there is no privacy, constant light and noise, and people will die because that’s not what hospital corridors are designed for.

“There is a reason why people who attend hospitals, in proper scenarios, are put into a ward with proper monitoring and healthcare equipment, but at the moment, that is not happening in Irish hospitals.”

Politicians have also weighed in on the issue, with Cork TD and Fianna Fáil leader Micheál Martin trading blows with Taoiseach Leo Varadkar in the Dáil last week.

Cork TD Donnchadh Ó Laoghaire (SF) warned that CUH is facing a “potential catastrophe” this winter.

“The health service is totally unprepared for the cold months ahead,” he said.

“The weather is only going to get worse and the patients presenting will only increase.

“It is very worrying in that context that CUH is asking people to stay away where possible,” he added.

“The current situation across the health service is abysmal.

“There is a recruitment ban in place despite a staffing crisis across nearly all professions and waiting lists are growing month on month.”

The HSE has denied there is a recruitment ban in place across the health sector.

However, the INMO has hit out at the lengthy recruitment practices employed by the health service.

The union said there are around 60 nursing vacancies in CUH alone that need to be filled.

“Every vacancy that materialises in Cork - that post then has to be approved nationally by the HSE,” said INMO Industrial Relations Officer for Cork, Liam Conway. “Local management will seek approval from the South-South West Hospitals Group for these positions.

“Then the South-South West Hospitals Group will try get approval nationally.

“What is happening is that’s taking a significant length of time.”

In a statement to The Echo, a HSE spokesperson said that the staffing environment in the HSE is “dynamic” and must operate within the funding provided in line with Government policy.

“The vacating of a position does not in itself create a vacancy, as the work of the position may be covered through redeployment, restructuring or reallocation,” the spokesperson said. “In addition, where a post has been approved for filling the duties may be covered by agency or overtime in the meantime.”

The HSE also say that no hospitals are currently precluded from hiring nurses, and say the number of nurses and midwives has increased by 683 across acute hospitals since September 2018.

With winter looming, the health service is hoping that specific winter plans can see it through the coming months.

Minister for Health Simon Harris announced in September that acute hospitals would have a dedicated plan to tackle ED overcrowding this winter.

It was reported last month that €26m will be made available for the plan but the INMO has raised concerns in recent days that this may not be the case.

Mr Conway told The Echo that local plans for winter have been in place for months but funding has not been made available nationally.

A spokesperson for the South/ South West Hospital Group said the group can confirm that a Winter Plan has been developed in collaboration with Cork Kerry Community Healthcare and South East Community Healthcare.

“Once off funding of €26m has been allocated nationally to support the Winter Plan for 2019/2020 across all Hospital Groups and Community Healthcare Organisations. The overall plan is expected to be announced shortly,” she added.

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