A&E task force ‘is failing to resolve problems’

A key member of the emergency department task force set up to tackle overcrowding said it has become expert at “measuring the problems, describing the problems, but not resolving them”.

“I am very disappointed that it has become a regular exercise in production of flow-charts, graphics and attendance records but it isn’t delivering in the hospitals,” said Liam Doran, general secretary of the Irish Nurses and Midwives Organisation. 

“It has a great ability to describe and measure but not to resolve”.

Mr Doran’s comments are in the context of record overcrowding with 57,674 left on trolleys after being admitted for care in the first seven months of the year. 

Figures also released this week show record numbers — 687,000 — awaiting procedures.

A&E task force ‘is failing to resolve problems’

The INMO figures show the worst overcrowding was at University Hospital Limerick, where 4,782 patients remained on trolleys. 

Asked if the opening at the end of May of a new €24m ED at the hospital would improve matters going forward, Mr Doran said without extra bed capacity in the region, the problems would remain.

“Yes, it’s a brilliant facility and people have more dignity and privacy but they haven’t properly developed Ennis or South Tipperary General hospitals, so there is nowhere to send people on to,” he said.

He said South Tipperary was among hospitals identified at the start of the year by Health Minister Simon Harris as suitable for a modular build — prefab-style accommodation as a short-term solution to the overcrowding crisis.

However, Mr Doran said when he asked at the last task force meeting if the HSE was still looking at using modular builds he was told “That matter continues to be under review”. “I got the Brussels Answer,” he said.

He said he was “deeply frustrated” with the task force which meets monthly and is now over two years old, and could not understand why its membership was all “national level people” and none of the CEOs of the hospital groups.

“The people who deliver are not there.” Instead it was HSE bureaucrats. 

“And between them the only thing they’ve enhanced their ability to do is to pass on the problem”.

Mr Doran said the “whole issue of the HSE at national level” had to be scrutinised, that without a corporate board and without statutory boards in the hospital groups, it was hard to hold anyone accountable.

The department said Mr Harris has been “in direct contact” with HSE chief Tony O’Brien and head of the HSE’s Special Delivery Unit, Grace Rothwell, “to express his concerns about the high trolley numbers and seek assurances that actions are being taken to address this urgently”.

The department said the minister will also be meeting with officials from the HSE officials, department and the National Treatment Purchase Fund next week. It said its is working on a plan “aimed at improving access to emergency care and reducing trolley numbers”.

The HSE said as of the end of June, attendance in EDs was 615, 874 patients, an increase of almost 2% on 2016.

“ED admissions for the same period in 2017 have increased by almost 3% year on year. Data in respect of persons aged 75 years and older for May 2017 indicates a 12% increase in attendances and an 11% increase in admissions for this cohort for May 2017 when compared with May 2016, with individual sites experiencing increases ranging from 2% to 32% in attendances and from 2% to 54% in admissions,” it said.

It said as of August 9, there were 59,102 on trolleys awaiting admission at 8am in the year to date, down 1.6% when compared to last year.


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