A&E departments across Northern Ireland are currently under extreme pressure as a result of a lack of available bed space and Covid.
The Department of Health has issued an appeal to members of the public to help with hospital discharges as they face growing pressures over a lack of beds for waiting patients.
A&E departments across Northern Ireland have said they have been under extreme pressure over the past few weeks. The Ulster Hospital said on Wednesday morning that it had 92 patients in its department and 65 waiting for admission.
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The pressures on the departments at this time of year are not common, as there is not normally such high demand for A&E facilities during the summer months compared with the autumn and winter ones.
Speaking to Belfast Live, Medical Director of the Western Health and Social Care Trust, Brendan Lavery, said that an inability to move patients through hospitals to vacant beds has been one of the main causes of the issues within the hospitals, along with staff absences due to Covid.
He said: "Generally A&E departments are quieter during the summer months than the winter months.
"Covid is not the main driver of the pressures in the departments at the moment, but it is one of the contributing factors. The biggest issue is our ability to move patients through the hospital to vacant beds and there has been difficulty in freeing these spaces up.
"Getting patients discharged from the hospital efficiently will go a long way in helping to address the delays and we are asking members of the public to support us in ensuring that when their family member is safely able to leave the hospital that they are collected or supported to do so as quickly as possible.
"The lack of available beds can have a knock-on effect throughout our services and can lead to delays in ambulances reaching people as they are occupied by waiting to transfer patients into available beds in hospital."
The Medical Director said that while Covid infections are currently high, hospitals are not seeing the same rate of admissions. However, the infection rate is having an impact on staffing levels as those who are positive for the virus have to isolate.
He continued: "We are currently seeing high levels of Covid within the community but we are not seeing high numbers of admissions into hospitals.
"The infection rate is around one in twenty at the moment, which means we have around one in twenty staff members who are isolating and this will have an impact on all of our departments.
"We don't know yet how this current wave will affect us in the coming months, but usually after a wave like this we do begin to see a drop in the number of Covid infections."
The Department of Health has called for members of the public to support hospitals in discharging patients in a timely manner in order to ease the pressures on A&E departments.
It said: "Like elsewhere in the UK, hospitals in Northern Ireland continue to experience relentless pressure which manifests itself in long waits at our Emergency Departments. The NI hospital system has for over a year been consistently operating at, or above, 100% bed capacity. This is against the best practice of 85% bed occupancy. The long waits in our EDs are directly linked to the overall hospital pressures, with those waiting to be admitted from ED experiencing long waits due to the fact that most hospitals are operating at, or above, bed capacity.
"To address these issues, the Health Minister published the No More Silos Action Plan which has piloted a number of initiatives in some parts of Northern Ireland such as ‘Phone First’, Urgent Care Centres, Direct Access Pathways and Hospital at Home. The emerging outcomes are positive and to date more than 200,000 patients have used Phone First and Urgent Care Centre services. Of these 23% were discharged with advice or referred back to their GP; 51% were scheduled for appointment at an Emergency Department, Urgent Care Centre or alternative pathway; and 26% were referred directly to an Emergency Department. Work is also underway to improve discharge from hospital and to improve the coordination and performance of the entire system.
"Earlier this year, the Minister also launched the Urgent & Emergency Care Review for public consultation, which closed on 1 July. This consultation built on No More Silos and set out three strategic priorities to improve urgent and emergency care services in NI. As a next step, Departmental officials will now analyse and consider the responses to the consultation."
The DoH has issued an urgent appeal to families with advice on how they can help the health service.
It said: "Timely discharge from hospitals will help our health service deal with severe and ongoing pressures. Staff continue to do their best to provide hospital care to all those who need it. Hospital patients and their families can play their part by supporting timely discharge - helping to free up much needed beds.
"The service is currently under severe pressure with demand on hospital services escalating over the past few days. All of our hospitals are working beyond capacity at present with many very ill patients waiting for hospital beds.
"The essential co-operation of patients, and their families and carers on discharge, will help free up beds during this extremely challenging time.
"To help us free up essential beds, required for very sick patients, HSC is sending out an urgent appeal to patients and families:
- If patients are deemed medically fit by the consultant/senior doctor to go home, they and their families should ensure there are arrangements in place to be picked up promptly on the day of discharge. Medical and nursing teams can help you make these arrangements.
- If patients are deemed medically fit by the consultant/senior doctor to go home and are waiting on a care home placement, HSC Trust staff will allocate the first place that is suitable for you. This may not necessarily be your first choice but it is important to note that HSC Trusts will work closely with you to move your family member to your first choice at a later date.
- If you are deemed medically fit by the consultant/senior doctor to go home, and there is a delay in sourcing new or additional home care (domiciliary care), you may be discharged and these elements of your care package will be organised when you get home. Additional family support may be required until the home care package is finalised.
- Agreeing to discharge rather than remaining in hospital will not disadvantage you and does not mean you have to wait longer for your domiciliary care package.
"Staff are continuing to work hard to ensure that patients receive the treatment and care that they need. To help them, we are asking that patients do not remain in hospital any longer than necessary and we also need families to provide transport to transfer loved ones from the hospital in a timely manner when required.
"The HSC system is in very challenging times and we are asking you to help us so we can help others who are very ill and need a hospital bed.
"Put simply, we need your support urgently."
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