HSE hits back at criticism of A&E plans

The HSE tonight hit back at criticisms of plans to have patients admitted or discharged within six hours of arriving in an emergency department by the end of the year.

The Health Service Executive vowed to implement a 12-hour target – from time of a decision being made by medics to admission – within the next three months.

This comes as a task force, set up to examine ways to tackle A&E overcrowding, is expected to recommend the HSE deal with all patients within six hours of attending a casualty unit.

It is believed it will also highlight the need for a two week target for alternative care for patients once they are fit to be discharged.

It also suggests hospitals count how long a patient is waiting from the moment they register at A&E, not from the time a decision is made that they be admitted, which is the current system.

Liam Doran of the Irish Nurses Organisation (INO) said targets were unrealistic and impossible without additional resources.

“We look forward to having discussions with the HSE on what measures and resources they have to allow these targets be met,” he said.

“Just because these targets have been set, it does not mean they can be met. These targets can not be achieved in all hospitals.”

The report, which is not yet published, makes general recommendations for all hospitals, as well as specific recommendations for up to 15 hospitals that have experienced ongoing A&E overcrowding.

“When the A&E Taskforce was initiated in March 2006, 18 hospitals were consistently experiencing problems with undue waiting times,” said a HSE spokesperson.

“Figures available for yesterday and today indicate that only two hospitals have people waiting over 24 hours.

“The number of hospitals that are experiencing difficulties in their A&Es has reduced considerably and is now confined to a relatively small cluster of hospitals.”

Emergency departments around the country see an average of more than 3,300 people daily, with around 825 (25%) requiring hospital admission.

The INO claims that 266 patients are waiting in A&E units today, including 24 in the Mater and Our Lady of Lourdes Hospitals, 34 in Letterkenny and 29 in Wexford.

Figures released from the HSE showed the total at 119, with 54 patients waiting up to six hours for admission from the time they were referred by an A&E team, 26 waiting up to 12 hours, 34 waiting up to 24 hours, while 5 were up to 24 hours.

Yesterday, the HSE said 138 patients had been waiting, while the INO recorded 260 patients on trolleys across the state.

“The figure of 119 waiting for admission today is 48% lower than the comparable figure of 230 at this time last year,” continued the spokesperson.

“There are 11 hospitals with no-one waiting for admission and two hospitals with people waiting over 24 hours for admission.

“The HSE is working to ensure that the length of this transfer wait is kept to a minimum.“.

Labour’s spokesperson on Health Liz McManus said the report highlights the unacceptable crisis in the A&E sector.

“Some steps have been taken to address the A&E crisis, but too often this has had a negative impact on access to treatment for elective patients,” she said.

“Implementing the recommendations of this report will have major cost implications.

“Experience elsewhere would indicate that if these targets are to be met significant investment will be needed.

“Extending diagnostic services to operate on a round-the-clock basis; improving A&E facilities; and delivering on more acute beds will all require significant investment.”

Dr Liam Twomey, Fine Gael’s health spokesperson, added that it is impossible to get a true picture of the problems in A&E unless waiting times are assessed from the time a patient presents and it is impossible to effectively tackle those problems without this accurate information.

“The difficulties in the health services may be unpalatable but trying to cover up the harsh facts is a sure-fire way of perpetuating the problems,” he said.