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'Crisis' in Northern Ireland's A&Es, say doctors as more patients face over 12 hour wait for care

Survey finds shame and guilt from doctors over conditions

By Mark Edwards

Doctors in Northern Ireland have said emergency medicine in the province is in "crisis" as new figures show a threefold increase in the amount of patients waiting longer than 12 hours for treatment.

The Royal College of Emergency Medicine (RCEM) surveyed 70% of Northern Ireland's 88 emergency medicine consultants, with many saying they felt "ashamed, appalled, guilty and crushed" after a days' work.

The survey comes as figures released by the Department of Health for the first quarter of 2018 show that 9,567 people waited more than 12 hours to be treated and discharged or admitted, compared to 3,115 during the same period last year.  All Northern Ireland hospitals have a 95% target to treat all patients and nobody should have to wait longer than 12 hours according to official guidelines.

Almost two-thirds (65.5%) of patients attending A&E were treated within fours hours, a drop of 8% for the same period last year. There was also a decrease in the number of people being treated within two hours of being assessed.

The Health and Social Care board (HSCB) said initiatives are being rolled out to ensure people are discharged to be cared for at home or in the community when possible, in a bid to free up more hospital beds and reduce waiting times.

PANews BT_P-fafd6855-74ee-4e0f-8632-63e55f86679a_I1.jpg
The Royal College of Emergency Medicine said many consultants in Northern Ireland felt "ashamed, appalled, guilty and crushed" by the state of emergency care (stock photo)

Dr Ian Crawford, vice president of RCEM Northern Ireland, said: “The combination of a growing and ageing population along with insufficient health and social care resources to match patients’ needs has resulted in ‘exit block’, crowding in Emergency Departments and declining four-hour performance. 

We are not surprised by the findings of the survey. Northern Ireland’s emergency care workforce has been struggling to cope with the intense demands being placed upon them for a number of years. Dr Ian Crawford

“At the heart of this are patients. Patients whose welfare and dignity suffer whilst waiting in busy, crowded Emergency Departments for a vacant hospital bed, sometimes for 12 hours or even longer. Patients who may be harmed by a system that cannot cope.

“As the survey demonstrates, these impossible conditions bring anxiety and frustration to the clinical staff trying to treat patients to the best of their abilities.

“It is for the safety of our patients that we urge the Department of Health in Northern Ireland, NHS leaders and politicians to recognise the imminent need for sufficient capacity to meet demand. The implementation of the Bengoa Report alongside former Health Minister Michelle O'Neill’s 10-Year Vision has never been more crucial”.

Survey findings:

  • 98% of respondents think that Emergency Medicine in Northern Ireland is in a state of crisis.
  • 89% agreed that the situation in their Emergency Department felt worse than previous years.
  • 94% considered that patient dignity is compromised daily because of crowding in their ED.
  • 91% ‘strongly agreed’ that patients are at an increased risk of poorer outcomes due to crowding
  • in their Emergency Departments.
  • 98% of respondents agreed that there is an insufficient number of medical and nursing staff to
  • cope with current demand in EDs.
  • 97% said that they have at times felt stressed during their working day because of an inability to
  • deliver high-quality care to patients.
  • 91% do not believe that it is sustainable working in emergency care in the current environment.

The HSCB said the figures were an indication of a rising demand for emergency care.

“However, activity alone does not reflect the challenges facing our emergency care, acute and community services across the region,” a HSCB spokesman said.

“Across the health service, it is recognised that an ageing population, together with the range and complexity of conditions that people may have, can lead to longer hospital stays. 

“As medical beds are often fully occupied, this may result in insufficient available beds for people attending emergency department who require admission, leading to longer waiting times.

“Nobody in the HSC considers this to be an acceptable position and we would apologise to anyone who has had to wait for a long period in an emergency department to be seen, treated, and either admitted to hospital or discharged.”

DUP MLA Paula Bradley said: "The DUP secured significant extra funding for our health service which has not been fully utilised because Sinn Fein have blocked the Executive being restored. We want to see that money being used to benefit the public as soon as possible.

"That is why we will be urging the Secretary of State today to ensure that decisions are taken and the public do not suffer because of those who put their narrow agenda as a precondition to progress.”

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