Doctors fear trolley numbers could hit 1,000 within days

University Hospital Limerick does not have enough hospital beds to cater for an 'unprecedented' high number of emergency patients, says management. Picture: Brendan Gleeson

Health Minister Stephen Donnelly has conceded people will die due to emergency department overcrowding, as doctors warned there could be 1,000 patients on trolleys across the country within days.

As the crisis worsens and with calls for its members to be available around the clock, the Irish Hospital Consultants Association (IHCA) has said plans to hire an extra 51 full-time emergency department consultants have not materialised. It says only around 20 locum doctors have been recruited and it took, on average, nine months for those positions to be filled.

At University Hospital Limerick (UHL), which consistently has the highest number of patients waiting on trolleys, staff representatives have told the Irish Examiner that nurses are contacting them in tears saying they are struggling to cope.

The Limerick fire department is so concerned about the impact of overcrowding at UHL that it sent in an inspection team on Tuesday. A final report is awaited and is expected to be shared publicly when complete.

The hospital, whose management has said it does not have enough hospital beds to cater for an “unprecedented” high number of emergency patients, has now cancelled many elective operations for this week.

The Irish Nurses and Midwives Organisation (INMO) has called for emergency department consultants to be rostered on the hospital floors around the clock during the crisis.

“The immediate issue is to ensure that the senior decision-makers are available and on-site during this crisis period, 24/7 or else as close to 24/7 as is possible,” said INMO assistant director of industrial relations Mary Fogarty.

Nurses 'overwhelmed'

She warned that specialist emergency department nurses are now so “overwhelmed” they are leaving the profession.

The IHCA said consultants are on call 24/7, "often practising over and above recommended levels".

"The reality is there simply aren’t enough of us to meet increased demand. We are still working with 40% less consultant staffing in Ireland, compared to the EU average,” it said. 

“In the few hospitals which aren’t seeing the same level of severe pressures as others, we know that’s down to effective local decision-making, the delivery of capacity, and the recruitment of additional consultants.”

Mr Donnelly told Cabinet colleagues on Wednesday the number of people lying on trolleys in hospitals is to remain “at high levels” for the rest of the week.

He said hospital consultants have also been asked to work late nights and on weekends outside their normal rostered hours in a bid to ease the pressure on the system while ambulance staff have also been asked to work overtime in a bid to manage the crisis.

Mr Donnelly told ministers that flu cases are much higher than previous years. Up to Christmas week, 2,331 laboratory-confirmed cases of flu were identified compared with around 1,000 cases in the same period in 2019, the last year before the pandemic hit. Of these, 637 were hospitalised compared to 350 in 2019.

Ministers were told that Covid hospitalisations have remained high but relatively stable, as have RSV cases.

Mr Donnelly said a significant increase in presentations to emergency departments has come from older patients. The 191,038 over-75s attending EDs up to the week before Christmas represented a 14% increase on 2019 levels.

Mr Donnelly also outlined several measures being introduced to tackle the crisis, including:

• Increased funding for GP out-of-hours services;
• Expanded opening hours for minor injury units;
• Curtailment of elective activity and addition of surge capacity where possible;
• Hospitals partnering with private hospitals to access additional beds for urgent or emergency admissions.

Meanwhile, as children begin to return to schools, Chief Medical Officer Breda Smyth has urged parents to keep their children at home if they are sick or displaying new symptoms of illness.

'Keep children at home'

“If your child has any new-onset flu-like symptoms such as congestion, cough, runny nose, or high temperature, parents should continue to be mindful of others and, if possible, keep their children at home from school or childcare facilities," said Prof Smyth.

Children should be kept at home for at least 48 hours after their symptoms have fully or substantially resolved, she added.