Nearly 100,000 patients were put on trolleys in 2017, say nurses

INMO warns of potential post-Christmas surge of patients in emergency departments

University Hospital Limerick recorded the highest annual number of patients on trolleys at 8,869. File photograph: Emma Jervis/Press 22
University Hospital Limerick recorded the highest annual number of patients on trolleys at 8,869. File photograph: Emma Jervis/Press 22

Nearly 100,000 patients deemed to require admission to a hospital spent time on a trolley prior to being placed in a bed last year, nurses have claimed.

The Irish Nurses and Midwives Organisation (INMO) has also forecast that hospital emergency departments will face a surge in the coming days in the aftermath of the Christmas holidays.

Newly appointed INMO general secretary Phil Ní Sheaghdha said immediate and dramatic action was now required “if further misery and, yet again, record-breaking overcrowding levels are to be avoided as the new year dawns”.

The organisation, which monitors overcrowding in emergency departments on a daily basis, said the number of patients on trolleys increased 6 per cent last year.

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It said that throughout 2017 a total of 98,981 admitted patients were recorded as waiting for a bed after being determined by a doctor to require admission to a hospital. This compared with 93,621 in 2016.

University Hospital Limerick recorded the highest annual number of patients on trolleys at 8,869.

"The Mater University Hospital in Dublin was the capital's most overcrowded hospital, with 5,238 patients on trolleys during 2017. Smaller hospitals such as Our Lady's Hospital in Navan showed increases from 595 in 2016 to 2,435 in 2017 and Portiuncula Hospital in Ballinasloe recorded 1,569 trolley figures compared with 892 in 2016."

Improved hospitals

The INMO analysis also showed hospitals such as Beaumont in Dublin and Our Lady of Lourdes in Drogheda, which had experienced significant levels of overcrowding in previous years, saw trolleys numbers fall in 2017.

Ms Ní Sheaghdha said overcrowding in hospitals in late December and early January was getting worse.

She said for the second year running, the INMO trolley and ward watch figures heading into the final weekend of the year recorded more than 300 patients waiting on trolleys or on additional beds in wards of the country’s busiest hospitals.

She called on the HSE to explain "how the predictable increases in emergency department admissions remain outside of the scope of hospitals to manage and control".

“Despite investment in winter plans, smaller hospitals are now severely overcrowded, which is manifestly unsafe and leads to higher cross-infection and poorer outcomes for patients.

“Nursing staff, constantly working in this high-pressure, unsafe environment, cannot be expected to put up with this obvious neglect of duty of care to them and the patients they try to care for any longer. It appears to me that staff and patients on the front line were abandoned while the system shut down for Christmas and the new year.”

System abandoned

Ms Ní Sheaghdha, who takes over the role of co-chair over the HSE emergency department task force, said a system of de-escalation, which was mandatory for hospitals to follow before spreading overcrowding to the entire hospital, had been abandoned during the Christmas period

“Our figures show that on December 28th and 29th, 11 of the 29 hospitals used their full capacity protocol and placed additional patients on wards,” she said. “Under HSE policy, the joint chairs of the task force must be notified in advance of use of full capacity protocol. I can confirm that no notification was provided, by any hospital, to me, and that is proof enough to demonstrate an abandonment of the system for dealing with overcrowding.”

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.