Varadkar says overcrowding figures will continue to fluctuate

Minister for Health Leo Varadkar tonight said the HSE has confirmed that all hospitals have escalation plans in place to manage overcrowding in hospital emergency departments.

The numbers of patients on trolleys in hospitals across the State reached a record high of more than 600 yesterday.

In a statement released tonight, Mr Varadkar said the current situation with overcrowding “can’t go on” and that he is bringing forward a meeting of the emergency department task force to next week to give “urgent consideration” to matters pertaining to the crisis.

“There are lots of different factors that contribute to overcrowding in emergency departments and some of the precise reasons will vary from hospital to hospital and therefore the precise measures to be taken will also vary,” he said.

“Therefore I am convinced that the only way that this can be addressed is through local leadership and management and effective local communication. I want to satisfy myself that this is happening.”

Mr Varadkar also said the HSE anticipates the figures will continue to fluctuate, but that actions being taken by the HSE are “already having an impact” with trolley numbers this morning down 15 per cent on yesterday.

“The HSE has confirmed that all hospitals have escalation plans in place to manage not only patient flow but also patient safety in a responsive, controlled and planned way that supports and ensures the delivery of optimum patient care,” he said.

“These action plans include the opening of additional overflow areas, curtailing non-emergency surgery, providing additional diagnostics and strengthening discharge planning.

“Outside of the acute hospitals themselves, primary, acute and community care sectors are working together to ensure that all available capacity and options are utilised and brought to bear on the situation.”

On the issue of opening closed beds, he said hospitals regularly open additional beds to cope with surges.

“Each bed that is opened has to be adequately and safely staffed and we know that there are many difficulties with recruiting staff,” he said.

“Finally, and importantly, if you consider that a substantial proportion of our acute beds are occupied by people who no longer require acute care, then you can understand why the focus on these delayed discharges is key to efficient patient flow.

“Adding more facilities and more services is only effective if they are added where there is a genuine need – not as a sticking plaster for existing services which are not being managed effectively.”

He said the Government committed an additional €3 million last December and an additional €25 million for 2015 to address delayed discharges.

“This initiative, coupled with efficiencies which must continue to be sought within hospital services working with community and social care, will enable patients to move from acute or transitional care into long term care or to return home with appropriate supports,” he said.

“Thus far, this has allowed 109 patients to leave acute hospitals, which has had a beneficial effect on available bed capacity.

“I welcome recent efforts by the HSE to address administrative issues and cut red tape for Fair Deal applicants and I anticipate further progress in this regard in the coming weeks.

"The HSE has commenced a hospital redesign programme, starting with pilots in Tallaght Hospital and in Our Lady of Lourdes Hospital Drogheda, and this programme of work will be informed by the work of the taskforce."

He added that following the initial meeting of the emergency department taskforce on December 22nd, the HSE is working on an action plan to be finalised by the end of January to specifically address issues with a view to attaining a “significant reduction” in trolley waits over the course of 2015.