‘Dangerous’ cuts to step-down beds adding to Cork University Hospital overcrowding

The head of emergency medicine at Cork University Hospital (CUH) has said the closure of step-down beds is “dangerous” and is contributing to emergency department (ED) overcrowding.

There were 73 people on trolleys in CUH yesterday, 50 of them in the ED.

Professor Conor Deasy, clinical director of emergency medicine and acute care at CUH, told The Echo that “off-site regress beds” were being reduced in number in Cork, and this was having a knock-on effect in the ED.

“We have a reduction in beds at St Finbarr’s Hospital, we have a reduction of beds at Riverstick Transitional Care Facility, and the impact of that is patients can’t go from ward beds to those beds,” he said.

“When patients are stuck in ward beds in the hospital and not able to go to rehab beds, then patients cannot go from the emergency department to the ward beds.

“It creates congestion, that congestion manifests itself in the emergency department and results in ambulances not being able to offload patients.” 

It is understood that Riverstick has been reduced by as many as 13 beds, while St Finbarr’s has been reduced by at least nine beds.

Never been a greater need 

Prof Deasy said the reduction in step-down beds was coming "at a time when we have never had a greater need for beds”.

He added that problems were being exacerbated by the delayed delivery, until at least next year, of 20 neurorehabilitation beds at a new 50-bed rehabilitation and neurological facility at the former Blarney Hotel and Golf Resort.

“They need to be opened, they haven’t been staffed, but in the meantime, they are taking out beds from St Finbarr's, and that is completely at odds with what needs to happen.

“Reducing beds in any form is at odds with what needs to happen right now, but reducing beds at Riverstick, reducing beds at St Finbarr’s, is dangerous,” Prof Deasy said.

His comments come as CUH chief executive Jennifer Kearney warned this week that the hospital’s ED was working at double its capacity last Monday.

In an email to staff, which has been seen by The Echo, Ms Kearney said: “The emergency department is operating at 100% over its capacity, with no available space to assess additional patients”.

This, she said, was “comparable to January at the height of the flu and winter season”.

Fundamental services

Ms Kearney warned that there was no space in the intensive care unit or resuscitation unit, services she described as fundamental to the hospital’s operation.

She added that the ability to carry out elective procedures had also been reduced, with some patients being referred to alternative treatment pathways where appropriate.

The hospital chief executive cautioned staff that these pressures were likely to continue “for several days”.

Ms Kearney urged staff to focus on what they can control, saying: “our sole focus must be our patients".

Serious concerns around conditions in CUH were raised in an August letter from Ms Kearney to HSE management, when she warned that the hospital would not be safe going into winter under current staffing levels.

Sources at the hospital say there are currently in the region of 1,000 vacancies in CUH, but health minister Jennifer Carroll MacNeill has repeatedly dismissed concerns around staffing, saying the hospital has already hired twice as many staff as had it had been budgeted.

The HSE declined to comment.