Overrun Emergency Departments can expect 'apocalyptic' conditions this winter, medic warns

Patients may experience delays at the emergency departments at CUH and MUH

An ambulance outside the emergency department at CUH. Picture: Denis Minihane.

“Apocalyptic” conditions can be expected in emergency departments this winter as A&Es are already struggling with capacity now during the summer, a medic has warned.

The HSE today urged people to stay away from already overstretched EDs nationwide as they struggled to cope with a surge in demand, complicated further by “the IT issues and manual work arrangements,” following the cyber hack.

“This is supposed to be the quiet time. If it’s like this in June, when the weather’s fine and we have low rates of respiratory illness I think it will be apocalyptic this winter,” Dr Mike Thompson, a GP in Midleton, East Cork, said.

The HSE warned this evening that many EDs are “very busy” and asked patients to consider all care options before presenting at hospitals.

"Patients needing urgent care will be prioritised, and those requiring non-urgent care should expect significant delays.

“We are asking the public to consider all care options including injury units, GP Out of Hours & pharmacies,” the HSE said.

But Dr Thompson said that other services, like GP out-of-hours, are also “swamped”. And “patient blaming” is unfair, he said.

“I think it’s unfair to direct people to out of hours services which are already at breaking point too," he said.

“The population is getting older, there are a lot of people living longer with very complex medical needs and maybe people deferred care during the height of the Covid crisis. But society is opening up again.

“It’s a sunny Saturday in the middle of summer. People are on holidays, there’s little respiratory illness around and yet the A&Es are saying they’re like they are in the January winter crisis.

“It’s concerning for patients.” The system is mired in such trouble that GPs now try to avoid sending patients to ED, Dr Thompson.

“Before you’d refer patients to Emergency for sanctuary and safety. Now, GPs are questioning whether we can avoid sending our patients to emergency departments at all.

“And it’s not the emergency departments’ fault. I think it’s due to chronic underfunding.

I can’t imagine working in an Emergency Department, I think morale must be dreadful. Which is a pity because we have great clinicians.

“A lot of A&Es are very efficient. But there are often no beds to send patients to in-house so they’re stuck on trolleys.

“We need root and branch reform. The system is wrong and we have to be able to question that system and its processes.” 

A new consultants contract, more hospital beds, more nurses, more elective hospitals, longer stays in hospitals and more homecare packages are just some of the changes that need to be made to bolster the ailing health service, he said.

“Huge investment” is also desperately needed in primary care out-of-hours services, he said.

The current workload for GPs who provide out-of-hours care on top of their full-time practice is both dangerous and untenable, he said.

Last year, he said that he worked 210 hours, the equivalent of more than five weeks of work, on top of running his own busy GP practice, working holidays like Christmas Day and Easter Sunday.

“We can’t get GPs to come to East Cork, even though it’s a lovely place to live and work, because when they hear how often they’ll have to work SouthDoc hours, they say ‘no thanks.’ “We work 14 hours on a Saturday, 14 hours on a Sunday in SouthDoc and then turn up for work in our own practices on a Monday morning, the airline industry wouldn’t allow that.

“The HSE needs to sit down with all stakeholders and get imaginative to fix this,” he said.

Private hospitals and urgent care centres are also currently “picking up the slack” for the HSE, seeing patients that may otherwise present at A&E.

A spokesperson for the South/South West Hospital Group said there are “a high number of presentations” to CUH and MUH at present

Earlier today, two hospitals in Cork appealed for the public to "explore all other options available" before opting to attend emergency departments.

A spokesperson for the South/South West Hospital Group said today that there were “a high number of presentations” to Cork University Hospital and Mercy University Hospital at present and as a result the EDs are “exceptionally” busy.

“Due to this increased level of activity and subsequent admissions, it is regrettable that some patients may experience a delay in the ED,” they added.

The public is being urged to consider attending their local GP, SouthDoc, the Local Injury Units at Bantry General Hospital or Mallow General Hospital, or St Mary's Health Campus in Gurranabraher before attending the ED at either CUH or MUH.

A statement from the HSE said: “Emergency Departments remain very busy with high numbers of patient attendances. As always patients needing urgent care will be prioritised.

"However, due to the IT issues and manual work arrangements now in place patients needing non-urgent care will continue to experience long delays.

"We ask the public this week to continue to consider all care options including Injury Units, GP Out of Hours and your local pharmacy in advance of attending Emergency Departments.

“If you are attending an emergency department please bring any information with you that will assist as we are not able to access our patient administration systems. This could be any document or record which includes your Medical Record Number (MRN) or Patient Chart Number (PCN).

"This information is usually on a sticker on hospital documentation, your current list of medications or prescriptions, or any hospital discharge information from a previous time spent in hospital.”