A leading medic has said someone needs to take charge of Northern Ireland’s health service in the absence of an Executive at Stormont.
Dr Paul Kerr from the Royal College of Emergency Medicine was speaking as Antrim Area Hospital remained under extreme pressure on Monday after being forced to close its doors to new admissions over the weekend because conditions had become unsafe.
On Saturday night, the hospital declared a major incident and issued a statement asking people to “not attend under any circumstances” after it had reached full capacity due to the number of patients needing to be admitted.
Read more: Antrim Hospital major incident: 'This was a last resort' says Trust chief
Declaring a major incident is rare and a sign a hospital is under extreme pressure.
The Northern Health & Social Care Trust said the decision to close the ED was regrettable but it was the only safe response under the circumstances.
A social media post from the hospital said on Sunday the hospital was still under “extreme pressure”.
Also on Sunday, the Belfast Health Trust appealed for available nursing staff to go to hospitals to help alleviate pressures while the Western Trust said Altnagelvin Hospital in Derry was also under extreme pressure on Monday and urged the public only to attend the ED in emergency or life-threatening situations.
As hospitals across Northern Ireland continue to deal with capacity issues, the Ulster Hospital became the latest to warn that patients in Accident and Emergency will endure a long wait.
The South Eastern Health Trust said on Monday evening that 164 patients are in the emergency department (ED) at the Ulster with 53 waiting to be admitted.
Dr Kerr said the region is now “in a dangerous situation” and one that risks becoming unsafe for both patients and staff.
“We are losing staff and the whole system is propped up by staff,” he told the BBC.
“So if we don’t have our staff and if staff are leaving or perhaps coming back as agency staff, the costs are increasing and then we can’t do with that money what we should do in terms of increasing capacity in the system. It’s a poor situation.”
He also warned that one hospital closing its doors puts pressure on other hospitals.
"The domino effect occurs in the situation where one hospital says it has to close its doors and the next hospital is going to get more patients and they're going to face a critical incident.
"It's a very small system and we have to try and avoid this situation happening because that is going to put us all at risk of being in the same situation," Dr Kerr added.
Earlier Jennifer Welsh, the Chief Executive at the Northern Trust, said the decision to close Antrim’s A&E on Saturday night was “ a last resort”, adding that it has been a very difficult situation for staff to manage.
Ms Welsh said there were 45 patients in the ED on Monday morning for whom a decision to admit had been made, but for whom no bed is available.
Last week, the Royal College of Nursing confirmed nursing staff in Northern Ireland will walk out over “pay levels and patient safety concerns”.
They will join colleagues “across the UK at the majority of NHS employers” after results of the RCN’s first ever strike ballot across the UK were published.
Rita Devlin from the Royal College of Nursing (RCN) said the situation in Antrim should be ringing “alarm bells for everyone in Northern Ireland”.
“One of our members said she felt traumatised on Saturday,” she said.
“My concern is what is happening across Northern Ireland to stop that happening again? Where are the plans and people who are in charge of the health service - what are they doing to stop this happening again?”
Ms Devlin said health needed “fundamental transformation,” which was impossible without “political leadership”.
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