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HSE Review of Unscheduled Care highlights dysfunction at heart of hospital overcrowding - David Cullinane TD

4 April, 2022 - by David Cullinane TD

Sinn Féin spokesperson on Health David Cullinane TD has said that the Independent Review of Unscheduled Care, obtained by the Irish Patients Association under FOI, highlights the dysfunction in the health service which is at the heart of the overcrowding crisis in Emergency Departments.

Teachta Cullinane criticised the HSE for not releasing the report sooner saying that the organisation lacked a culture of transparency.

He said that the report demonstrates that, for several years, the safety of patients has been at risk due to poor admissions practices in overcrowded hospitals.

Teachta Cullinane said that ED waits for 2022 are on track to be as severe as pre-pandemic levels, with more than 51,000 patients waiting longer than 12 hours in an emergency department so far this year, while more than 13,000 patients waited greater than 24 hours and nearly 4,000 waited longer than 36 hours for admission through an emergency department. More than 4,400 people aged over 75 waited longer than 24 hours for admission so far this year.

Teachta Cullinane said:

"The independent review of unscheduled care is a damning indictment of process and leadership failures across the health service.

"This report is as relevant now as ever as more than 51,000 patients waited over 12 hours for admission through an emergency department so far this year, according to information I have received from the HSE. ED overcrowding is set to be as severe this year as it was before the pandemic.

“While we accept that changes have been made and that many hospitals, such as UH Waterford, have made significant improvements despite inequity in investment, as the figures demonstrate we still have a serious challenge with so many people presenting and waiting for more than a day in emergency departments or placed haphazardly around hospitals.

"Overcrowding is still a major problem, from Cork to Letterkenny, with a tsunami of missed care facing the health service which is clearly not fit to cope without cancellations.

"If the Minister cannot end the reliance on cancellations to maintain safe levels, we will never see the end of long waiting lists.

"We need an urgent zero tolerance plan for Emergency Department overcrowding and long waits led by the Minister for Health.

"There is no single solution. We need capacity put in where it is needed, but as importantly, essential Sláintecare reforms need to be advanced quickly.

“To respond to the challenge, reducing ED waits has to be seen as part of wider reform efforts. It can only be tackled by investing in community and GP capacity to reduce hospital admissions. A minimalist approach to healthcare reform will not work.

"Regional Health Areas need to get up and running with significant autonomy to implement community reforms, deliver capacity expansions, recruit and retain staff, and implement best practice across sites in patient and staff management.

"Every patient should have a discharge plan with a recovery bed in a community setting. Patients should be out of hospital quickly, not left languishing on trolleys in random ward corners and corridors. 

"Crucially, we need to roll out specialist medical wards and fill the vacant consultant posts. 

"The fact that the HSE sought to bury this report and had to be forced to hand it over again shows that the organisation lacks a culture of transparency. 

"The review is clear that none of the hospitals were able to follow safe practices with occupancy levels well above 85% - and often at or above 100%. In some hospitals, staff did not know who was in charge of patients, and patients were languishing for days on trolleys.

"Previous Governments have been happy to let hospitals run like this despite the clear risks to patients.

"Some hospitals have significantly improved since 2019 by implementing the recommendations of the report, particularly in relation to specialist wards, and have stopped placing patients in any free space they can find.

"But many of the hospitals examined are still struggling with unacceptable emergency department overcrowding.

"A specific plan is needed in each instance and we also need a culture change across the HSE towards transparency. The Minister must lead from the front."

The data is available to view hereherehere and here.

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