A 'black escalation level' had to be declared at Cork University Hospital (CUH) as there was such a severe backlog of patients in the emergency department.
A black escalation, according to HSE guidelines, means the emergency department (ED) and other parts of the hospital are in a "critical position and clinically unsafe”.
Because of the extreme congestion being experienced at the hospital people were warned on Monday night that they would have to wait over 12 hours for treatment.
There were 70 admitted patients waiting for beds at CUH yesterday when management moved the status of its ED down to “high demand”.
Tanaiste Simon Coveney was quizzed by Opposition leaders and TDs in the Dáil about the need to issue a status black escalation warning.
Sinn Féin president, Mary Lou McDonald said she understood a status black escalation was declared on Monday night when the hospital was at maximum capacity and when it was deemed unsafe to admit further patients.
She said there were reports that during the status black escalation up to eight ambulances were lined up outside CUH's emergency department waiting to transfer patients.
“I am told that one of those ambulances was forced to wait for more than four hours. That is the sort of situation that puts patients and staff at serious risk and it is unacceptable,” she said.
Mr Coveney said Ms McDonald was right that a serious challenge had arisen in CUH and they were responding with the seriousness that was needed.
“We need to and are putting the extra resources and the priority systems in place to respond to that in accordance with the needs of patients there,” Mr Coveney added.
.@MaryLouMcDonald has called on the Govt to take radical action on capacity crisis in our hospitals.
Last night in Cork, the patients attending the Emergency Department faced extreme delays of up to twelve hours, with services reaching breaking point. pic.twitter.com/ub9OjqqCTf— Sinn Féin (@sinnfeinireland) April 2, 2019
Ms McDonald also pointed out there were more patients on trolleys in University Hospital Limerick than in Dublin's nine hospitals combined on Monday.
“I am sure the Tánaiste will agree this is shocking,” she said.
A spokesperson for CUH said its ED was experiencing severe congestion over the last 24-48 hours due to "increased patient attendances".
She said management were implementing additional measures and patient safety was the "utmost priority".
- additional reporting by Evelyn Ring
Update 3.55pm: Major crowding issues at Cork University Hospital on Monday evening and Tuesday morning dominated proceedings in the Dáil during Leaders' Questions.
Tánaiste Simon Coveney was questioned by Opposition leaders and TDs about the need to issue a 'Status Black' escalation warning at the hospital, with patients attending the emergency department facing extreme delays of up to 12 hours and with services reaching breaking point.
“A status black escalation is declared, I understand, when the hospital is at maximum capacity and when it is deemed unsafe to admit further patients,” Sinn Féin President Mary Lou McDonald said.
“There were 70 patients on trolleys in Cork University Hospital this morning, with 570 patients on trolleys across the State. Yesterday, in Limerick there were more patients on trolleys than in Dublin's nine hospitals combined, according to the INMO. I am sure the Tánaiste will agree that this is shocking,” she said.
There are also reports that during the status black escalation up to eight ambulances were lined up outside the accident and emergency at Cork University Hospital waiting to hand over patients, she said.
In response, Mr Coveney said the number of patients waiting on trolleys in Cork University Hospital was 55 and on Tuesday morning the Health Service Executive, HSE, trolley system reported 431 patients waiting on trolleys nationally.
This is an increase on the same day last year when there were 296 patients on trolleys, he said.
“The number of patients waiting on trolleys at Cork University Hospital this morning is exceptionally high. The HSE identified specific issues and challenges on the site,” he said.
"The first was a significant capacity demand mismatch, with high rates of attendance and admission and a low rate of discharges."
The hospital remains in a full-capacity protocol, with the highest trolley count this year on the site.
Key actions are now underway in Cork University Hospital to improve the position for patients and these actions include full mobilisation of all resources, escalation meetings with both the group chief executive officer and chief compliance officer and meetings scheduled with consultants, Mr Coveney added.
“The Deputy is right that a serious challenge has arisen in CUH as of last night and again today. We are responding with the seriousness that is needed. We need to and are putting the extra resources and the priority systems in place to respond to that in accordance with the needs of patients there,” Mr Coveney added.
In response 2 @MaryLouMcDonald Tanaiste just described the situation for staff in Cork University Hospital last night as ‘difficult’ Am sure that staff working in the intolerable unsafe conditions created by govt policy would use a very different word @INMO_IRL @IMO_IRL @SIPTU— Louise O’Reilly TD for Dublin Fingal (@loreillysf) April 2, 2019
Ms McDonald responded by saying the status black escalation, as the Tánaiste knows, is essentially a declaration that a hospital is no longer safe.
“It was dangerous. I described the scenario for the Tánaiste, with ambulances lined up outside the hospital and one that I know of that waited for more than four hours to hand over a patient.
"This is a very serious accident waiting to happen and it is playing out on this Government's watch,” she said.