HSE seeks ‘new ideas’ as trolley numbers hit 8,000

By Caroline O'Doherty
Senior Reporter

Almost 8,000 patients were stuck on trolleys waiting for a hospital bed in the worst August on record for overcrowding.

The traditionally quiet August is now as bad as the worst month in 2014, when the problem was called a crisis and then health minister Leo Varadkar set up the emergency department taskforce in response.

Numbers have risen each year since. On average there were 1,000 more patients on trolleys each month to date this year than in the same period last year. Thirty of the patients on trolleys in August were children.

Health Minister Simon Harris is convening an “unscheduled care forum” next Tuesday, when he will meet frontline health and community care workers to hear their views.

The HSE said it is looking for “new ideas and suggestions for improvement in the area of unscheduled care”.

These ideas and suggestions will then be brought to the emergency department taskforce implementation group meeting as scheduled for September.

However, health chiefs are running out of time before the usual winter escalation. Phil Ní Sheaghdha, general secretary of the Irish Nurses and Midwives Organisation, said there was no mystery around one of the key contributors to the problem, that of chronic understaffing.

Without sufficient nurses, emergency departments can not work through patient backlogs quickly enough and can not make available a full complement of beds in wards even if there is capacity.

“The message from the frontline is clear,” she said. “This all comes down to pay. The HSE simply can not find enough nurses and midwives to work on these wages. It’s no coincidence that University Hospital Limerick has had such a bad month [969 on trolleys] as they have over 70 unfilled nursing vacancies.”

Emergency departments are short 220 nurses but there are 2,500 fewer nurses in the health service than 10 years ago. Some of the shortage is due to recruitment caps but even where posts have been sanctioned, vacancies are hard to fill, leaving doubts over whether the minister’s promise to provide 2,600 extra hospital beds by 2030 is realistic.

Stephen McMahon of the Irish Patients Association also questioned the need for next week’s forum. He called instead for the taskforce meeting due for September 27 to be brought forward to deal with the crisis.

“They’re calling a meeting about a meeting when there were 98,981 patients left waiting on trolleys last year and this year’s heading to be worse again. We’re four years into the taskforce and yet we still seem to be sitting down to discuss reform. We shouldn’t be looking for ideas. We’ve had ideas.

There’s supposed to be an escalation policy with a suite of measures for hospitals to take when the emergency departments start reaching over capacity but they’re not applied across the board and we don’t get feedback when they are applied,” he said.

Mr Harris says he hopes to frontload 2,600 extra beds by bringing the bulk into use in the next few years, and is planning the provision of 4,500 extra social care beds by 2030 to provide step-down care that would enable patients who are recovering but need some care to vacate acute hospital beds sooner.

This story originally appeared in the Irish Examiner.