'Bad for patients and staff': CUH emergency department operating far beyond capacity

The Clinical Director of Emergency and Acute Care at Cork University Hospital (CUH) has warned that staff working in the emergency department (ED) at the hospital “have never seen it as intensely busy and challenging”.

Professor Conor Deasy, who is a professor in Emergency Medicine at both CUH and University College Cork (UCC) and President of the Irish Association for Emergency Medicine, said attendances at CUH are up 33% when compared to this time last year which he said is “bad for patients and bad for staff”.

“We have had a 33% increase in attendances this year compared to this time last year. Bearing in mind that we have 35 clinical spaces in the adult emergency department we have been running at 200 to 300% capacity in terms of number of patients versus number of clinical spaces to see these patients,” he told The Echo.

“This is bad for patients and bad for staff. Our emergency clinical space is taken up with patients on trolleys awaiting an inpatient bed because CUH is not right-sized for the work it does in terms of beds.

“Staff are in agreement that they have never seen it as intensely busy and challenging. There has been a 40% increase in over 75-year-old patients attending the emergency department this year compared to last year.

“These patients are often frail with complex medical needs and high medical and nursing requirements.

“The science tells us for every 22 patients who are over 75 years of age who are forced to spend a night in the ED on a trolley, there is an extra death at 30 days.

“Moral injury is caused to staff when they feel these patients are getting a raw deal and suffering unnecessarily for want of proper hospital infrastructure and staffing.” 

Mr Deasy called for the current cost-saving embargo on staff to be lifted immediately to help alleviate the pressures.

“There needs to be a rapid expansion in bed numbers including single rooms to reduce cross-infection of patients, intensive care, rehabilitation and community beds,” he added.

“Our population census has never been higher or older. This population deserves to have healthcare. Money is needed to deliver this. This government has a short window to demonstrate to voters, particularly our older adults, that it cares about this.” 

CUH was the second most overcrowded hospital across the country on Monday morning with 72 admitted patients on trolleys.

HSE statement

In a statement to

The Echo

, the HSE said: "Improving patient experience in our emergency departments is a priority for the HSE.

"Bernard Gloster, CEO, HSE said in an interview late last year: 'At the end of December last, there was 8,260 junior doctors in the Irish Health Service. We planned in the medical and dental grade code this year to increase that by 500, and by September we've already increased by 777. That's why the pause is there. So since December 2019, there's 1,760 additional junior doctors in the system.' 

"There are a number of key frontline positions which are exempt from this to ensure impact to services and patients is at a minimum."

They acknowledged that many hospitals were under pressure this week, and said that was partially due to ongoing admittance as a result of winter respiratory viruses.

"Several surge measures have been put in place as part of the HSE Urgent and Emergency Care Plan to reduce the number of patients waiting on trolleys for an acute bed and reduce the number of patients over the age of 75 waiting in emergency departments after a decision has been made to admit them for ongoing care and treatment.

"We have seen significant improvements in 2024 versus 2023. While we have seen increased attendance of close to 15%, we've seen some improvements in the number of patients delayed in hospitals, the average trolleys every week, and also the statistics for older people where we put a particular focus on to ensure that those patients over 75 were all seen within 24 hours.

"We have set ourselves a target that across our 29 Emergency Departments at 8am every morning, there should be no more than an average of 320 patients awaiting admission on trolleys – between July and December 2023 we achieved that target on 70% of days. We are, however, in no way complacent about these numbers and they are being exceeded significantly this week. Every part of our health and social care system is focused on ensuring the least number of people as possible are waiting for care.

"The HSE urges the public to consider all available care options, including injury units, their GP, and local pharmacy if they have a minor ailment," the statement concluded.