The State's healthcare system is under "unprecedented strain" due to record emergency department attendances, an ageing population, the after-effects of Covid restrictions and a shortage of GPs in the community, the health watchdog has said.
Patients in hospital emergency departments often have to wait 80 to 90 hours to get a bed, the Health Information and Quality Authority (Hiqa) warns in the report published on Wednesday.
Inspections of seven emergency departments by Hiqa found the number of patients presenting is "significantly higher" than in previous years.
“Emergency department overcrowding needs to be recognised as a whole health system problem, and the normalisation of comparatively poor performance should not be tolerated,” it said.
Hiqa inspected services at emergency departments including Sligo University Hospital, St Vincent’s University Hospital, Mayo University Hospital and St Michael’s Hospital in Dublin over two days in August and September.
Responding to the report, Hiqa's director of healthcare, Sean Egan, said overcrowding in emergency departments continues to “compromise the dignity and respect of patients, and poses a risk to the health and safety of patients”.
Speaking to the News at One on RTÉ Radio 1, Mr Egan said that there is a "fundamental mismatch" between available capacity within the health system, both in the acute and community setting, which is manifesting itself in overcrowding in emergency department.
"We have seen deficits in terms of nursing staffing and also medical staffing. That coupled with unprecedented levels to emergency departments....sheer volumes of patients presenting which have reached levels that we have never really seen before in emergency departments.
"It is contributing to a system where capacity outstrips demand and ability to provide timely services."
Mr Egan believes there is a need for better local leadership.
"I think one of the interesting findings from the sample of inspections we conducted is that we have identified that it is not a homogeneous problem across all hospitals. There are variances in terms of the way is managed across various hospitals.
"Some hospitals cope better than others and what we are really talking about there are a more rigorous and more efficient application of a number of the measures that we know improve flow for patients through the emergency department and in to inpatient beds and equally in to a more appropriate setting which is often in the community.
"So many hospitals have progressed a number of different initiatives we know can reduce the pressure on emergency departments. Others continue to travel that journey. And we see that as something that needs to be focused on in terms of improving leadership and management at a local level."
Hiqa said more hospitals need to be urgently built in order to provide additional capacity in acute and community care.
The watchdog also recommended a more effective approach to workforce planning to better anticipate and manage staff shortages, as well as more responsive leadership, governance and management arrangements.