A former health service chief has warned that Northern Ireland's health system faces a "very difficult six to eight weeks ahead".
John Compton, a former chief executive of the health and social care board, says there's very little that can be done to fix the health service here this winter as extreme pressures are set to continue
He was speaking a day after health chiefs revealed that a patient waited four and a half days for treatment at an emergency department in a Northern Ireland hospital.
Read more: Patient kept waiting in NI emergency department for over 100 hours
It was also revealed that some non-urgent callers to the ambulance service are waiting up to 24 hours for a response.
Setting out the scale of the crisis facing the health service here, chief medical officer Sir Michael McBride said he had serious concerns about the ability of the health service to get through the winter.
Speaking on the BBC's Good Morning Ulster radio programme on Thursday morning, John Compton warned that this winter “can’t be anything but difficult” due to the current pressures.
He said: "I suspect that it will be a very busy time for the health service and that really there is no silver bullet to fix this.
"What we can do, I think what Professor Michael McBride said, is contribute as much as we can to the solution, use our system responsibly, do the things that we can do by taking the vaccine and so forth.
“But frankly there is nothing other than a very difficult six to eight weeks ahead for the health system. I can’t see anything other than the system having to mitigate as best it can."
Mr Compton added that the collapse of Stormont has been a “real problem” for the health system and there is also difficulty within communities when it comes to accepting change.
He urged people to be responsible about how they use the health system to ensure it operates effectively.
On the same programme, Dr Sean McGovern, a consultant in emergency medicine at the Ulster Hospital, said the extreme pressures on the health system are causing “avoidable harm” in NI hospitals.
Dr McGovern described the current situation as “heart-breaking and tragic”.
He added: “The pressures on the system are now being recognised, that there's avoidable harm happening in emergency departments and it is happening because of the back pressure where we see patients waiting in the community for longer response times from the ambulance service.
“So it is a time that is really worrisome. I’m privileged working for over 30 years in emergency medicine and I see things have never been as bad as they are now. Going forward we need to get together and rebuild very quickly to give people hope.”
Earlier this week health trust chief executives set out new measures to tackle hospital pressures, including patients leaving hospital no later than 48 hours after they are medically fit for discharge, where a suitable placement is available.
There will also be a maximum three-hour wait for ambulance handover. Health staff have been taking part in industrial action over pay, leading to disruption to services and hundreds of medical appointments postponed.
During a media briefing on Wednesday, health chiefs provided statistics to illustrate the pressure facing hospital services.
At 9am on Monday, there were 399 patients in emergency departments across Northern Ireland who had been given a decision to admit but had no bed immediately available.
This is understood to be one of the highest rates ever recorded. By 9am on Tuesday the number had reduced slightly to 335.
However, there were 542 patients in total in emergency departments waiting for treatment. Of these 447 had been waiting longer than four hours and 300 had been waiting longer than 12 hours.
The longest wait for treatment was recorded at 107 hours, 43 minutes.
At the same time there were 22 ambulances parked outside emergency departments with patients waiting to enter.
The statistics also revealed that at midnight on December 20, 569 patients in hospitals had been declared medically fit to leave but were waiting on care packages.
Health chiefs are concerned that the situation will deteriorate further at the beginning of next year, when there is historically a spike in numbers needing hospital treatment.
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