Struggling A&Es could be 'pushed over the edge' if Northern Ireland patient deluge continues
If emergency departments in Northern Ireland's hospitals continue to be swamped, it could "push the health service over the edge", it has been claimed.
A spike in demand for treatment over the weekend led to an appeal for people to stay away from A&E departments if they could. The figures provided by the Health and Social Care Board (HSCB) showed the biggest increase was at the Ulster Hospital in Dundonald where there was a 25% rise in emergency department patients.
At Antrim Area Hospital there was a 17% rise, while Craigavon Area Hospital faced a 15% hike.
The board said delayed discharges from wards, due to difficulty getting nursing home places or care packages, was also a factor in the high level of pressure on emergency departments at the weekend, according to senior clinicians.
In the 14-day period between December 21 to January 3, there was an increase of around 3% in the number of people attending emergency departments compared to the same period last year and around a 10% increase compared to two years ago.
Ray Rafferty, joint Unison branch secretary at the Royal Victoria Hospital, said: "It appears that the Belfast Trust has done as much as it can to oil the machine and it is just about coping.
"But our concern is that if other trusts begin to divert patients to Belfast, that puts even more pressure on the doctors and nurses on this site. That could push us over the edge. Doctors and nurses are coping incredibly well given how busy it has been."
Calls have been made for urgent action to address the major problem of 'bed blocking' after it emerged more than 100 patients cannot be discharged as care packages cannot be organised.
It has emerged that by the end of November, 229 patients across Northern Ireland spent more than eight weeks waiting to be discharged. The Northern Trust had the highest number, with 160 people waiting over two months to be discharged and care packages implemented.
SDLP MLA Patsy McGlone, who met representatives of the Northern Trust yesterday, said he had been contacted by a number of people over the Christmas period unable to get the support they needed.
He said: "This is terrible for the patient and their family if they are fit to be discharged but aren't. The money is there but the people aren't."
A spokeswoman for the Northern Trust said the issue lies in "recruiting and retaining sufficient numbers of staff to meet the increased demand.
"The Trust has embarked on a structured programme of work in partnership with the independent providers and the regional board to address this shortfall through identifying areas of higher demand and actions which may be required to address these," she said.
Former Health Minister Michael McGimpsey said the situation was evidence of serious problems within the whole system.
"This is very poor management in play here. We do not have a severe flu circulating, or a cold, icy winter with queues at the fracture clinic. But the A&E departments in trusts cannot cope. That is bad management," he said.
"And patients unable to be discharged because care plans can't be organised is purely a revenue issue".
Janice Smyth from the Royal College of Nurses (RCN) said strong leadership is now needed.
"It is clear that workforce planning has been a disaster. There needs to be more investment in nurses and leadership to implement decisions," she said.
The RCN warned staffing problems were a issue after a survey showed that in July 2015 the private sector had 374 vacancies for full-time registered nurse posts.
"The lack of nurses right across the system is clearly affecting the flow of patients from the emergency department through to residential care and I have no doubt that the lack of community care investment is leading to patients going to A&E for treatment which is contributing to the problem now," said Ms Smyth.
A spokesperson for the Health and Social Care Board said: "The board is aware of the current challenges of providing a number of community services including domiciliary, residential and nursing care.
"In the short-term funding has been provided to ensure that sufficient capacity can be purchased, but the longer term issues of staff availability, sector stability and development require more detailed examination and resolution which the board is working closely with trusts and the department to resolve."