Seven A&E units unfit for patients, reveals HSE

AT LEAST seven accident and emergency units in the State are unfit for their purpose, a Health Service Executive report reveals.

Particular difficulties exist at the Mercy Hospital in Cork, Wexford General Hospital, Letterkenny General Hospital, Cavan General Hospital, Our Lady of Lourdes Hospital in Drogheda and the Mater and Beaumont hospitals in Dublin.

The emergency department task force report warned the situation in these A&Es militates against effective management of patient and waiting times.

It also noted that in other A&E departments, even the more modern ones, the overall space and design did not enable the effective streaming of patients.

The task force also warned that the country’s acute hospitals are operating at close to 100% capacity, instead of the internationally accepted optimum level of 85%.

The HSE stressed that while some of structural improvements being made to the A&Es identified as being unfit for their purpose would not be completed until mid-2009, other initiatives were being taken inthe meantime to relieve pressure.

The report also recommends that there should be a total waiting time target set of a maximum of six hours from arrival to discharge from any A&E department, which was in line with international best practice.

The HSE said it proposed to introduce a target time of 12 hours from decision to admit in October and said the target took account of the time it would take for improvements to be made, including the commissioning of 700 additional public long-stay beds and theestablishment of acute medical admission units.

The task force said there should be zero tolerance of having patients waiting on trolleys.

To ease pressure on A&Es, it says there should be greater access to diagnostic tests, and nearly 2,500 long-term beds over the next year, as well as improved chronic disease management.

Task force chairwoman Angela Fitzgerald said the overall cost of the improvements was about €35 million. About €15m had already been spent this year and the balance of €20m would be spent next year.

The task force had recommended that the target of a 12-hour-or-less wait time in A&E after a decision to admit should have been introduced by January 1 this year.

Ms Fitzgerald said they decided against having a lead in time because of the need to provide additional long-term beds

The HSE said it had no timeline for the introduction of a six-hour waiting time but would be keeping the matter under review.