Overcrowded emergency care is crisis for entire health system, says hospital chief

Prof Brian Lenehan said all hospitals, community health services, GPs and nursing homes are “equally challenged” at present
Overcrowded emergency care is crisis for entire health system, says hospital chief

Vivienne Clarke

The current overcrowding crisis in emergency departments (EDs) is “a crisis for the whole of the health care system,” according to the chief clinical director of University Hospital Limerick (UHL).

Professor Brian Lenehan told RTÉ radio’s News at One that all hospitals, community health services, GPs and nursing homes are “equally challenged” at present.

The system remains in crisis with “persistently high” numbers attending EDs requiring admission, he said, adding the situation is very challenging for both patients and staff, who are finding it difficult to provide optimal care.

Prof Lenehan's comments come as the Irish Nurses and Midwives Organisation (INMO) said 931 patients were counted as waiting on trolleys in hospitals, the highest number without a hospital bed since the trade union began the count in 2006.

Of those, 767 were on trolleys in emergency departments while 164 were on trolleys elsewhere in hospitals.

Emergency attendances have been fuelled by a rapid increase in flu, Covid-19 and RSV (respiratory syncytial virus) cases, with nearly 1,500 people currently in hospital with those illnesses.

UHL declared a major internal incident on Monday after an “unprecedented” number of people presented seeking emergency care.

In a statement on Tuesday, the Health Service Executive (HSE) asked those who need medical care or assessment “to consider all options” before going to an ED during what “is going to be the busiest-ever period experienced by the health service”.

It said: “While this surge of winter virus infections was predicted and planned for, the trends being seen are following the more pessimistic of predicted models and also appear to be increasing earlier than had been hoped.

“While some patients will regrettably experience long wait times in our emergency departments, urgent patients will always be prioritised for treatment and care.”

Although RSV cases fell for several weeks, they are now also surging. Figures show there are almost 700 people in hospital with Covid-19, with 78 new cases confirmed in the past 24 hours.

Prof Lenehan said he was particularly concerned about patient safety, adding that all available staff are being deployed.

He said the situation was “suboptimal situation” that the hospital could not deliver the level of care they would wish.

In the circumstances, he added, it is very difficult to predict the eventual outcome for patients, as the best that could be done was to “try to flow” patients from the ED to a bed in a ward.

Trolley care was less adequate than care in an acute bed, Prof Lenehan explained.

He added that he hopes the flu surge will peak in the next few days, reducing patient attendances. – Additional reporting: PA

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