Mater hospital: Steps should be taken to expand the treatment space in A&E. May require Portakabins.
It is not uncommon for a patient to undergo all their treatment without ever getting a bed.
There are around 4,100 patients attending A&E every month and over 70 per cent are seen within four hours. Some patients who, despite being regarded as urgent, wait eight hours or more.
Between May and December 2004, 17,658 patients self-referred while 3,803 turned up with a letter from their GP. A further 6,809 were referred by a GP out-of-hours deputising service.
There is a shortage of GPs in catchment area.
Discharging elderly people is a problem. Issue exacerbated by closure of Leas Cross Home.
Hospital must discharge more at weekends.
St James's hospital: Common for patients to be waiting on a trolley for up to 24 hours in A&E.
More people over the age of 85 with complex care needs have been presenting. One of the hospital's greatest challenges is trying to discharge older people who have received treatment they need.
Several hundred nursing home beds were taken out of the system and were not replaced.
Four days is meant to be the optimum length of stay, but acute unit is "experiencing increasing problems in discharging patients". Average length of stay "increasing to six days".
In 2004 total A&E attendances were 44,482, down 2 per cent on previous year.
Significantly fewer patients discharged at weekends.
St Vincent's hospital: Dealing with delayed discharges is the single most important issue affecting patient flow.
In April 2005 the number of delayed discharges was over 90 "accounting for around three wards".
Significant amount of bureaucracy associated with nursing home subvention applications. "There are also challenges that families and carers might not accept first places available and refuse to condone a move from hospital. Hospital could look "at the possibility of charging, where discharge is blocked because of preferences".
There were 36,580 A&E attendances in 2004, a 3 per cent increase on previous year. Approximately 21,000 patients self-referred and 7,000 were referred by GPs, 5,000 arriving by ambulance.
Tallaght hospital: There is inadequate consultant cover in A&E. Two more emergency consultants should be employed.
There were 44,179 A&E attendances at the adult wing in 2004, an increase of 3 per cent on previous year. 29,533 attendances (67 per cent) were self-referrals, 6,799 (15 per cent) were referred by GP. Over half of attendances "fall into lower urgency categories".
Alternatives to A&E are very limited in the area.
Ambulances bring patients to the A&E irrespective of their acuity.
Patients can be on trolleys for seven nights, but there is only one toilet and shower within the A&E department.