A leading emergency medicine consultant has accused the HSE of “fudging” patient waiting times in emergency departments (EDs).

Peadar Gilligan, who works in Beaumont Hospital, said that instead of starting the clock when the patient registers at the emergency department hatch, the waiting time is only measured from the time the decision is made to admit the patient.

“The HSE actually looks at the time of the bed being requested by the admitting team which oftentimes is four or five hours after the patient arrives.

“So what needs to happen is that it needs to be very clear — from the time the patient arrives until the time the patient goes to the ward or until the time the patient goes home — and that’s the metric that should be used and it should not be more than six hours,” said Prof Gilligan.

Prof Gilligan pointed out that by the time the decision is made to admit, the patient has been seen by the emergency department staff and the admitting team.

“The admitting team has agreed that hospitalisation is required and now they’ve got a protracted wait for a bed.”

He said internationally, emergency departments have time limits “for which it is acceptable to be in the ED”.

“In the NHS the target — achieved 95% of the time — is four hours. In Australia it’s six hours. In Ireland we have a target that is nominally six hours but we also have a target that is nine hours and in fact that is often times breached throughout the country — both nine and six-hour targets.

“The challenge in the hospital I work in — it is often about 16 hours after we request a bed before a bed is made available to the patient. So in other words, a patient requiring emergency admission that day waits until tomorrow until a bed becomes available to actually get into a ward,” he said.

Prof Gilligan, who was speaking at the weekend annual general meeting of the Irish Medical Organisation, said the challenge in Ireland was that once the decision is made to admit a patient “that’s when they start to experience a very significant delay in their treatment”.

Such delays occur in about a quarter of cases at Beaumont, he said.

Asked if emergency medicine consultants are coming under pressure from colleagues for highlighting emergency department overcrowding — leading to the introduction of a policy where scheduled surgeries must be cancelled if overcrowding reaches specified levels — Prof Gilligan said there were some frustrations around the knock-on effects of this policy.

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