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Any return to crowded A&Es of past will lead to disaster, says Royal College of Emergency Medicine


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Patients will die if lengthy trolley waits in emergency departments become the norm again (Andrew Matthews/PA)

Patients will die if lengthy trolley waits in emergency departments become the norm again (Andrew Matthews/PA)

PA

Patients will die if lengthy trolley waits in emergency departments become the norm again (Andrew Matthews/PA)

Patients will die if lengthy trolley waits in emergency departments become the norm again after the first Covid-19 surge, it has been warned.

The Royal College of Emergency Medicine (RCEM) has produced a series of recommendations looking at how best to provide emergency care in the months ahead as the health service prepares to resume non-Covid services.

A failure to meet the aims of the recommendations will result in people dying from hospital-acquired infection, the professional body has said.

Dr Paul Kerr

Dr Paul Kerr, vice president of the RCEM in Northern Ireland, said: "The recent history of our emergency departments (EDs) in Northern Ireland, prior to the Covid-19 pandemic, has witnessed severe crowding and trolley waits for admission.

"This was never acceptable but, in the context of Covid-19, would not be safe for patients and staff.

"It's not so much about attendances but managing of patients awaiting admission to a bed, and in some hospitals we have had 40 trolley waits, sometimes lying side-by-side, and we do not expect trusts would allow this to happen again.

"The review of urgent and emergency care in Northern Ireland is particularly important now and eagerly awaited."

Health officials have carried out a major review of the way emergency care here will be delivered in the future, which has involved consulting extensively with emergency care specialists.

It is not known when the document will be published as the Department of Health has concentrated its efforts in recent months in its Covid-19 response.

Attendances at GP surgeries, GP out-of-hours services and A&E departments have plummeted dramatically in recent months during the pandemic lockdown but numbers are starting to climb again.

Looking to the future, the RCEM has said it is vital that hospitals do not return to the status quo, claiming there is "a moral imperative to ensure our EDs never become crowded again".

The document states that it is "impossible for patients to maintain a safe distance if they are waiting on a trolley in a corridor".

RCEM president Dr Katherine Henderson said: "Going back to how we used to operate is not an option - patients will die if we do.

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Dr Katherine Henderson

Dr Katherine Henderson

Dr Katherine Henderson

"It was just four months ago when we were seeing overcrowding on a record scale in EDs.

"It was unacceptable then and put lives at risk. To go back to that now will lead to avoidable patient and staff illness or death.

"If departments are crowded, we cannot protect patients and staff. Crowding has long been associated with avoidable mortality, and Covid-19 reinforces and multiplies this risk.

"We must have a way to enforce social distancing in EDs to ensure that patients do not become infected while seeking healthcare.

"If supermarkets can get this right, then the very institution that people entrust with their health must do so, too.

"There is a need for wholesale change while embracing the new practices we've seen during this crisis, with patient and staff safety at the forefront of thinking.

"Our position statement outlines what we must achieve and the areas to focus on to get us there."

Belfast Telegraph