A seven-day service designed to keep acutely medically unwell patients out of the emergency department at Cork University Hospital (CUH) has been cut back to five days as the hospital recorded the second highest trolley figures in the country for the first seven months of the year.
CUH’s acute medical assessment unit extended its service from five to seven days last November but was forced to scale back in July when one of six consultants who was needed to sustain the seven-day service successfully applied for another post in the hospital. He had been acting in a locum capacity in the unit.
The result is that while the 13-bed unit is open at weekends, it is unable to assess acutely medically unwell patients and either admit them or send them home. Instead, it is being used, according to hospital sources, as an ‘overflow’ ward to take patients off trolleys in the emergency department, thereby “massaging the trolley figures”.
Figures released by the Irish Nurses and Midwives Organisation last week show CUH had the second highest trolley figures in the country for the first seven months of the year, at 3,949.
The latest Trolley Watch figures show more than 57,600 people were waiting for a bed in the first seven months of the year.
The use of acute medical assessment units as ‘boarding houses’ for patients awaiting transfer to an inpatient bed is an issue that has arisen nationally.
Last weekend, patients who had already been admitted to CUH via the emergency department but for whom there were no beds available, were sent to the acute medical assessment unit a hospital source said, saying that the previous weekend, the unit was idle, and nursing staff were redeployed to other areas.
Nursing and clerical staff are paid double time for providing the service at weekends. The Irish Examiner was also told as the service is not operating at weekends, oncology patients can end up in the emergency department. Asked why the hospital had scaled back the service after just 10 months, CUH said: “The acute medical assessment unit is open seven days a week.”
Asked how long the hospital planned to continue to use it as an overflow ward at weekends, the hospital said: “The acute medical assessment unit is utilised to stream patients to the most appropriate treatment area based on the patient’s presenting condition and triage category.”
Another source at the hospital said efforts were underway to find a replacement locum consultant with a view to resuming the full service as soon as possible.
CUH said the sixth consultant post in the acute medical assessment unit had been filled by a locum “pending the advertising of the permanent post by the Public Appointments Service”.
Last November, hospital chiefs were warned by the Government and the HSE they would be fined €10,000 for each breach of a mandatory directive designed to tackle overcrowding in emergency departments.
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