A patient at a Northern Ireland hospital has been kept waiting more than 100 hours in an under-pressure A&E, health chiefs have admitted.
The figure emerged as NHS bosses briefed the media on the state of the local health service - and outlined a raft of major issues including long waits for ambulances and hospital beds.
Chief Medical Officer Michael McBride said he has “very serious concerns about the ability of the health service to get through this winter”.
Stat’s included the number of patients waiting to be admitted to hospital wards after ending up in ED. The Departrment of Health says that on Tuesday at 9am there were 399 people with a ‘Decision to Admit’ sitting in local emergency departments. The figure was described as “one of the highest I recall”, by Department Deputy Secretary Sharon Gallagher.
On Wednesday morning the number of people with a Decision to Admit within Emergency Departments was down to 335. However, the grim statistics also show that by 9am on Wednesday morning there were a total of 542 people in local emergency departments.
Of those 542 people, 447 had been waiting longer than four hours for either admission or discharge to hospital and 300 had been waiting longer than 12 Hours. But one person had waited 107 hours and 43 minutes, the figures show. No more details of the person’s ordeal were shared.
The Department figures also showed that at that time there were 22 ambulances outside Emergency Departments on Wednesday morning with six en route. Northern Ireland Ambulance Service Chief Executive Michael Bloomfield outlined details of the pressure crews and patients are under.
He said that the average number of 999 calls received during the last four weeks was 800, but peaked at 1,000 on Monday of this week. Regarding response times, he said that over the weekend the most serious ‘Category 1’ calls that should be ‘responded to’ within eight minutes were taking 14 minutes and 30 seconds. Still serious ‘Category 2’
calls were being responded to in an hour and 32 minutes rather than the target of 18 minutes, with some people waiting “up to four hours”, he admitted. For ‘Category 3’ calls people were waiting as long as 24 hours, he said.
Mr Bloomfield said “capacity is being lost with ambulances waiting at EDs” to discharge patients with an average of 25% to 30% of “operational capacity” tied up in queues at hospitals.
The Department added that at midnight on Tuesday there were 569 people ‘Declared Medically Fit’ so able to be discharged from hospital. However, offiicals say that while the number of domiciliary care hours being delivered currently (1.143 million hours) is on a par with 2019, more people are having to stay in hospital as the appropriate care package is not available.
Health chiefs say this is largely down to an ageing population which has more complex needs to be treated on their discharge from an acute hospital setting. They say the ‘overall trend’ over the last few years is that the number of ‘complex delays’ where patients are taking over 48 hours to be discharged is increasing.
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.
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.
Sir Michael said: “As chief medical officer I have very serious concerns about the ability of the health service to get through this winter.
“I cannot recall a time when concerns across the system were at this level. Our workforce is exhausted, our health service is still dealing with the many consequences of the pandemic.
“The cumulative impact of industrial action, and the seasonal impacts of flu and coronavirus >Covid, are likely to cause further pressures after the Christmas holidays. The health service is extremely fragile and an extraordinary effort by staff has been required for many months up to now. We will all need to play our part in supporting our staff to get through the coming weeks.
“We, the public, need to get our flu and Covid-19 vaccines to protect ourselves, others and the health service from potential surges from these viruses. If you need urgent help then our health service is here for you, but we do need to use it wisely, and I ask everyone to work with hospital teams to support the discharge of your relatives when their medical care is complete.
“This winter will be about providing the best care we can, minimising harm and supporting staff while yet again they take the strain.”
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