How the hospital car crisis grew, although many A&E consultants worked weekends
Disparities in the weekend hours worked by consultants in accident and emergency (A&E) departments across the country are evident in data compiled for the Department of Health during the country’s worst winter overcrowding crisis.
The data provides a snapshot of A&E consultants’ working arrangements as of January 6 of this year.
It is understood the figures were compiled for Health Secretary Stephen Donnelly – who in December angered advisers by publicly telling them to work weekends as pressure on the health service peaked last month.
While all hospitals offer 24-hour A&E consultant coverage on weekends, 11 adult hospitals offered some form of structured on-site care, according to the data.
Numerous individual consultants said the doctors were already working every weekend
The hospital with the best record of controlling congestion and overcrowding had emergency consultants on site for at least a few hours on Saturdays and Sundays.
Waterford University Hospital’s six A&E consultants worked on “six-hour structured sessions” on Saturdays and Sundays and were on call thereafter.
The hospital was praised for handling the overcrowding crisis, with 68 people waiting for trolleys in January, according to daily Trolley Watch figures from the Irish Nurses and Midwives Organization (INMO).
However, Limerick University Hospital’s 11 A&E advisers worked Saturdays and Sundays from 8am to 1pm – yet the hospital was still at its worst overcrowding in the last month.
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Hospital patients wait for trolleys
The hospital had 1,180 patients waiting for trolleys in January, more than any other hospital, according to INMO figures.
Cork University Hospital had 7.5 consultant shifts in the emergency department working from 8am to 1pm at weekends. After that they were on call.
The hospital was the second worst performer in January with 1,145 patients awaiting trolleys.
Only one adviser was on call at Galway University Hospital over the weekend.
It had fewer A&E consultants than other busy city health facilities, with only two permanent consultants and 1.5 shifts of “temporary consultants.”
It was the third-worst performance in January, with 728 patients awaiting carriages.
Letterkenny University Hospital had the fourth-worst record in January with 650 patients on trolleys.
However, the hospital’s four A&E consultants worked on site Saturdays and Sundays from 8.30am to 6.30pm.
At two of Dublin’s major hospitals, counselors were on call at weekends rather than working on site.
The Mater and Tallaght were all overcrowded in January with 542 to 594 patients on trolleys.
A&E advisers at St James’s worked ‘structured weekend visits’ and 454 patients were waiting for trolleys in January.
At Beaumont and Connolly hospitals, A&E advisers were on call evenings and weekends with “some on-site presence”.
Fewer patients were waiting on trolleys at both hospitals, 247 at Beaumont and 64 at Connolly.
Mr Donnelly’s call for weekend work was followed up by the HSE with a “guideline” for increased on-site presence by senior clinical decision-makers and support staff as a short-term measure to deal with the crisis.
However, the Irish Hospital Consultants’ Association (IHCA) and numerous individual consultants said doctors were already working every weekend – on site and on call throughout the crisis.
The IHCA said it was dealing with a capacity crisis and a commitment to hire 51 emergency room consultants had not materialized.
The HSE said better access to weekend diagnostics, the presence of senior decision-makers and therapies have contributed to improved patient flow and patient experience times in emergency departments.
According to IHCA, staff are “working tirelessly,” but there simply aren’t enough consultants to keep up with the increased demand.
Hospitals have come under unprecedented pressure this winter as high levels of Covid-19, flu and respiratory viruses prompted a flood of people to seek emergency rooms.
In the worst case, almost 1,000 people were waiting on treatment trolleys for their treatment every day.
The Emergency Department Task Force was told last week that the HSE has initiated reviews of 12 serious “major incidents” that have occurred in Emergency Departments over the past two months.
The reviews were initiated in cases where patients were seriously harmed or died.
The task force was also told that the figures relate only to emergency department incidents and do not include patients on trolleys elsewhere in the hospital.
Cases include the death of teenager Aoife Johnston at University Hospital Limerick (UHL) in December. She had reportedly been awaiting treatment in the hospital’s emergency room before her death, prompting sadness and anger from the public.
On-call service: Weekend service by emergency chaplains in acute hospitals
- Waterford: “Six-hour structured sessions” on Saturdays and Sundays; then on demand
- Limerick: On site Saturdays and Sundays from 8am to 1pm; then on demand
- Cork: 8am to 1pm Saturdays and Sundays; then on demand
- St James’s: ‘Structured Weekend Attendance’ and 24 hour on call service
- Tallaght: On-call duty, evenings and weekends off-site
- St. Vincent’s: Scheduled weekend coverage, 8am to 8pm
- Beaumont: On call “with some local presence”
- Letterkenny: Saturdays and Sundays from 8:30 a.m. to 6:30 p.m.; then on demand
https://www.independent.ie/irish-news/news/how-hospital-trolley-crisis-grew-despite-many-a-and-e-consultants-working-weekends-42328184.html How the hospital car crisis grew, although many A&E consultants worked weekends
