Updated Emergency Department data now available daily from hse.ie

Our acute hospitals have been busy this week with significant numbers of patients on trolleys awaiting an in-patient bed. The HSE regrets that any patient has a bad experience while waiting to access our services including those who have to wait in emergency departments beyond an acceptable timeframe. In particular, the HSE acknowledges that long waiting times are very difficult for older people and those who find themselves in vulnerable situations and we remain committed to trying to ensure that their care and comfort will be a priority even when some waiting is unavoidable.

The trolley numbers have been far too high, though suggestions that this year has seen the highest number on record are not correct. This year has seen some improvement on the position over last year and we intend to pursue that continuously in the coming weeks. Trolley numbers are down on the same period last year, despite a steep increase in attendances. For example 24hr breaches for over 75s are down 11%, despite the fact that ED attendances for patients aged over 75 are up almost 19% on the same week last year and 34% on the same week in 2019. 8am trolley average is also down 6.7% on the same period last year, based on latest available data.

From this week we are publishing on hse.ie data giving a clear understanding of the factors which make up the hospital position. At 2pm daily we will show the distinction between people waiting on trolleys in ED, waiting on trolleys in wards and it is these two numbers which are unacceptable to us and we will target. 

We will also show those requiring admission placed in surge capacity and we are satisfied this is a more appropriate form of care above that of waiting in ED or on a ward. Finally we will show the numbers of Delayed Transfer of Care (DTOC) again which we pursue with all options daily. But while our numbers may still differ from day to day, HSE staff and management are in complete agreement that they are far too high.

While we have made improvements this year we are not satisfied with the position and a seven day management programme focused entirely on this is in place. The CEO and / or COO chair a daily meeting of Hospital Group CEOs and Community Healthcare Chief Officers to ensure timely management of the system based on 8 a m counts. Frontline staff and management will work together relentlessly over the Christmas period and beyond to ensure our hospitals work as efficiently as possible.

We have seen an increase in the number of confirmed flu cases and a doubling of the number of patients who require admission to hospital due to flu. RSV cases continue to be exceptionally high, although we have seen a slight decrease in the number of patients with RSV in recent days. RSV particularly impacts small children and older people. Across our acute hospitals, we are currently managing a significant number of outbreaks of respiratory illness and this impacts on the availability of beds as impacted wards are closed to admission of new patients. We are using all available resources and additional supports including private hospitals to respond and we will continue to do so.

As we did with critical periods during the year we have made available additional supports to all hospital and community services where the support is directly linked to ED avoidance, a better management of flow in ED, a speedy flow in hospital and a fully supported discharge into the Community.

The HSE is urges the public to consider all care options, including their GPs, pharmacists, local Injury Unit and out of hours services before presenting at emergency departments (EDs). As always, people who do require emergency care are encouraged to attend EDs where they will be prioritised. We urge those in target groups to avail of the vaccines available against flu and Covid-19.

Regarding HSE staffing pause, our staff are undeniably our greatest asset, with their dedication, expertise, and passion delivering exceptional service for our patients and service users. An enormous increase in demand for our services has and continues to be responded to, and new developments and improvements have been enabled.

It must be noted, the Government funded the HSE to recruit to over 6,100 new posts in 2023 to support the development of services. We reached that target and at end November had in fact employed an additional 7300 Wholetime Equivalent. We continue to exempt some posts but also have a clear expectation of flexibility from our workforce to ensure systems of patient flow can function over seven days, particularly at this time of year.

The HSE has a net increase in nurses of over 2000 for the year to date and over 7500 since January 2020. In terms of the recruitment pause, we have committed to recruiting all nurse and midwifery graduates 2023. We are also ensuring that contractual commitments are honoured and this includes for international nurses.

The HSE workforce is at its highest since 2006, which is good news for the public and staff throughout the country and reflects an expanding health service. In 2024 we will add further to that for specific developments and targeting both unscheduled care and waiting lists. We must equally operate within a more appropriate control environment.