Chaos at Belfast's Royal Victoria Hospital: ex-Health Minister urges reopening of City Hospital's A&E
The reopening of the A&E department at the City Hospital in Belfast is essential to address the crisis in emergency medicine, the former Health Minister Michael McGimpsey has said.
Speaking publicly about a health issue for the first time since he left the post, Mr McGimpsey said additional staff and beds must be found.
He broke his silence after a Major Incident was declared in its A&E department on Wednesday night.
Amid chaotic scenes, staff and patients waited hours for treatment, comparing the hospital conditions as being "like Beirut".
At one stage during the night:
- 42 people were waiting on trolleys
- Many left in corridors for up to 12 hours until they were treated
- Trolleys from the emergency department were backed up into the X-ray department.
- Extra staff were called in to try an d ease the pressure on A&E staff
Medical chiefs said the action was taken after a spike in patients needing to be admitted to hospital created a "bottleneck" in the A&E department.
On average, around one in four patients who attends A&E needs to be admitted to hospital, but for a number of hours that night one in two people needed hospitalisation.
Health Minister Edwin Poots, who was booed by protesting staff during a visit to the hospital yesterday afternoon, said the incident was a "one-off" and "exceptional".
The trust insisted that had a major accident or similar incident happened on Wednesday night it would have been able to handle it.
But speaking to the Belfast Telegraph, an A&E nurse who was working in the emergency unit said the department was "at breaking point".
The nurse, who wished to remain anonymous, described it as like a "failed hospital in Afghanistan".
"There were patients lying everywhere, they were overflowing into corridors everywhere," they said.
"I had relatives coming up and saying: 'My dad is this, my dad is that, can you help?'
The nurse added: "It's always bad. These are very much normal working conditions, yes it was worse on Wednesday, but it wasn't much worse than the normal."
Pressure is building on Mr Poots to take action to change his strategy on the future of A&E departments after it was described as being in "meltdown".
Under plans, acute services would be centralised at main centres including Belfast.
The Major Incident was declared just days after the Downe Hospital in Downpatrick and Lagan Valley Hospital in Lisburn reduced their opening hours. This sparked concerns over the impact on existing units and staff across the country.
It's also emerged that ambulances had to be diverted from Craigavon Area Hospital earlier this week because of a surge in patients.
Mr McGimpsey said it had been clear for two-and-a-half years since the casualty at the City Hospital closed that the RVH A&E had a serious problem.
"Staff are being stretched to their limits with insufficient support," he said. "It is the simple law of supply and demand, there is not enough resources to meet the demand. This has clearly been miscalculated for some time."
Mr McGimpsey said the A&E unit at the City, which was closed temporarily in November 2011, needed to reopen its doors as part of the remedy.
"The Major Incident plan provides some answers; additional staff and additional beds," he said.
"It is essential that the reopening of the City Hospital A&E also be part of the remedy. Investment is the key and must be found for Belfast hospitals."
Sinn Fein's Maeve McLaughlin also called for a full report into why the Major Incident was declared.
In a statement, Mr Poots praised staff and said work was being done to ensure plans were in place to respond to higher demand in services.
"The Health and Social Care Board is working with trusts to ensure that effective escalation plans are in place to respond appropriately to any surge in hospital activity," he said.
"This includes being ready to expand hospital bed capacity and increase community care packages to support people at home.
"In addition, plans are being put in place to enhance GP out-of-hours arrangements," he vowed.
Staff burnout and cuts have units at crisis point: unions
A lack of resources and staff shortages are among the major problems that have led to the emergency departments reaching breaking point in Northern Ireland, health unions have said.
Staff burnout, pressure of waiting times and the reduction in hours of local A&E units in Lagan Valley and Downpatrick have also impacted on the crisis in Belfast.
Both Unison and the Royal College of Nursing (RCN) in Northern Ireland have said after the 'Major Incident' was declared at the Royal Victoria Hospital that urgent steps are needed to solve the problem that has escalated over the last two years.
RCN deputy director Garrett Martin said it had repeatedly warned the service was under immense pressure.
"It is frustrating as there have been numerous reviews saying the same thing that there are issues around medical staffing, patient safety and contributing factors to those.
"Have those contributing factors been addressed? We don't think so.
"It is now time for some courageous decisions."
Ray Rafferty from Unison said pressure of reaching ministerial waiting time targets had been a major issue, as was also a lack of beds.
He added: "The problem that is growing day by day is that there are not enough beds in the system to cope with the volume of admissions.
"The difficulty that has occurred in the last week is just an increase in what's been happening over the last couple of months – the volume of patients coming through is absolutely chronic."
At one point on Monday 50 ambulances arrived with patients in just one hour.
But Dr Ken Fullerton, medical director of the Belfast Health and Social Care Trust, said it coped by "rapidly increasing" the number of doctors and nurses in the unit on Wednesday.
He said 10 extra senior doctors were drafted in.
However, the number of extra nurses could not be confirmed.