Trust's nurse staffing 'stretched'
Senior medics have claimed nurse staffing levels in some Belfast hospitals were left stretched outside normal office hours.
Clinicians told inspectors of services at nights and weekends that the number of staff to manage patients was stretched, a review said.
The hospitals' own senior experts recommended greater access be granted to specialities such as cardiac investigations.
A report by the Regulation and Quality Improvement Authority (RQIA) found many examples of good practice but said: "In the Belfast Trust: nurse staffing levels were considered to be stretched to manage the complexity of patients in hospitals; clerical support is limited at weekends which can delay processes; there can be delays in discharging patients at weekends and transferring patients at night.
"At Ulster Hospital, nurse staffing was also considered to be stretched and arranging discharges and transfers could be difficult at nights and weekends."
The RQIA reviewed standards of care after concerns were raised about significant patient death rates in Great Britain.
It said at times pressures to accommodate emergency admissions during the night can lead to the transfer of patients between wards, and there may also be difficulties in providing staff to accompany those who need to be transferred between hospitals at night.
RQIA chief executive Glenn Houston said: "During the review, RQIA found that there were differences between acute hospitals in the availability of services and staffing at nights and weekends."
The report said effective handovers between day and night medical teams were an essential component of safe practice in hospitals, and the review team welcomed the introduction of multidisciplinary Hospital at Night teams, which have enhanced coordination and handover arrangements.
"However, the review team recommends that trusts examine arrangements for handover to staff coming on duty, particularly after night shifts," it added.