CUH chief seeks 'honesty' on trolley crisis

In a blog published on the CUH website, Tony McNamara also said “many patients are appropriately on trolleys in Assessment Units in our hospitals awaiting a decision as to whether they require admission or not”.

His querying of the INMO figures brought a withering response from its general secretary, Phil Ní Sheaghdha, who said: “I would prefer if the CEO of CUH refocussed his attention from shooting the messenger to working with us to solve the problem.”

Yesterday the INMO said it had recorded a record total of 2,408 patient on trolleys during the first week of this year — an increase of 10% compared with the same week in 2017.

Both Taoiseach Leo Varadkar and Health Minister Simon Harris have apologised this week for the crisis, but in his blog Mr McNamara said any inference that all of these patients were in emergency departments is “factually misplaced”.

In the blog post, entitled ‘Emergency Departments — In Pursuit of an Honest National Debate’, he referenced INMO figures showing the daily trolley count had exceeded 600 in the past week. He said 460 patients were actually on trolleys in EDs, similar to the HSE figure of 457 patients.

“Many patients are appropriately on trolleys in Assessment Units in our hospitals awaiting a decision as to whether they require admission or not,” he wrote, adding “The INMO count includes patients [on] trolleys in hospitals such as Bantry and Ennis General Hospitals that do not actually have Emergency Departments”.

However, Ms Ní Sheaghdha said the INMO counts people in EDs and inappropriately placed on wards, and from next week would also be counting those in pediatric units. She said the HSE did not dispute the INMO’s figures and added: “If the INMO were not counting figures since 2004 you can be sure the HSE would not be publishing their figures at all.”

Mr McNamara wrote there was “no denying” the actual number of people on ED trolleys was “unacceptable” but said tens of millions of euro has been allocated to tackling the issue and the contention that more resources will substantially resolve the problem in EDs “needs to be challenged”.

He said more work is needed “to create an improved, integrated (if not symbiotic) collective approach to the flow of patients in to and out of our hospitals”.

He referenced the situation in CUH on Christmas Day 2017: “There were 138 patients in the Hospital for over 14 days while the average length of stay is six days. Astonishingly of this number (138) there were 28 patients who were medically discharged and should have been in alternative settings in the community and this is despite a weekly meeting which I chair as CEO with our community colleagues at which we discuss every patient who is in the hospital over 14 days.

“Finally of note on Christmas Day there were 12 patients in our hospital who were there for over 100 days and 3 patients were over 300 days in CUH. I do accept that there are a very small number of very complex discharges who for social reasons pose particular challenges for community services.”