A&E waiting times increased

A new report by the State's spending watchdog has found that the number of patients who had to wait for lengthy periods in emergency departments for admission to hospitals was longer last year than in 2008.

The report of the Comptroller and Auditor General, which was published today, found that more patients requiring admission had to wait longer than 12 hours in the first five months of 2009 than in the same period in the previous year.

“[A total of] 46 per cent of patients were waiting 12 hours or more in early 2009," the report stated.

The review said the provision of appropriate care for emergency cases in hospitals within a reasonable timeframe was being adversely affected by the restricted availability of key resources.

The report said 23 of the 33 hospital emergency departments examined as part of the review had delays in accessing senior decision makers.

It found that access to consultations from specialities within the wider hospital was rated as unsatisfactory in most cases.

It also maintained that in most cases, there was considerable scope to improve the timeliness of diagnostic support and that four emergency departments, in the South Infirmary in Cork, Roscommon, Nenagh and St John's in Limerick, had unsatisfactory access to those services.

"The waiting time for bed accommodation following decisions to hospitalise emergency patients was unsatisfactorily long in most cases," the report also stated.

The C&AG's report also said there were considerable differences in the cost of treating patients who presented at emergency departments in hospitals around the country.

The report said the number of patients dealt with by medical staff ranged from 8.15 to 30.57 per day across the different emergency departments.

It also said the cost of treating patients who presented at emergency departments ranged from €85 to €281 per attendance.

The report also found there were considerable differences in emergency department capacities.

The review involved an examination of emergency departments in 33 of the country's 50 acute public hospitals.

It said that in 2008 the departments examined as part of the review had had over one million attendances. Approximately 25 per cent of emergency cases were admitted to hospital following assessment while the remainder were treated and discharged.

"While the direct cost of emergency departments before taking account of overheads is estimated at €196 million, ultimately in the hospitals examined, care for those patients who had to be admitted cost an additional €1.5 billion in 2008," the report stated.

It said the provision of alternatives to acute hospital care by means of strengthening primary and community care services could reduce reliance on the acute hospital services and demand on emergency departments.

However it said community initiatives needed to be evaluated to determine their relative cost effectiveness and, to the extent that they are found to be more economic and effective, integrated into the primary care team model. It said that this could also help reduce recourse to the emergency services.

Minister for Health Mary Harney said a considerable number of actions had been taken to improve the delivery of services in Emergency Departments, many of which were consistent with the recommendations in the report.

The HSE said 54 per cent of patients who require admission have access to a bed within six hours.

However the Labour Party said that the report was nothing short of damning. Labour Party health spokeswoman JanO’Sullivan stated: “The report points out in black and white, what we all have heard at local level, that the situation is getting worse."