Up to 60 A&E patients waiting for hospital beds every day in Western Trust

The Western Health and Social Care Trust (Western Trust) said in a briefing this week that they have experienced ‘continuing and sustained pressure’ on their services this year but that works are continuing to alleviate this.

The Trust’s Director of Unscheduled Care, Medicine, Cancer and Clinical Services, Geraldine McKay said: "Winter is typically a very challenging period for the Health and Social Care System in general, but the demands on our system have not decreased over the last number of months. We normally find a dip in our Summer/Autumn period but we didn't get that dip this year, so we have had continuing and sustained pressure being experienced across all our services.

"80 percent of those attending the emergency department discharged. We're very good at turning our patients around but one in five will require admission to hospital for further investigations or treatment. On any given day, we'll see between 40 to 60 patients waiting for beds in our emergency departments in the Western Trust. This impacts on the ability of our staff to see, triage and assess the volume of patients in our waiting area and across the Trust. We can have up to 300 to 350 patients per day. We have high numbers awaiting admission and lengthy ED waits for those that are triaged as non-urgent or could have went to alternative places.

"There are other hospitals across the system that are equally as busy or more busy on a daily basis and that makes transferring patients elsewhere difficult as well for us. In winter, typically we see an increase in respiratory illnesses and at this moment in time we have an increase in RSV in paediatrics so the pressure is definitely there. Also, I believe we're expecting snow by the end of the week and our weather also dictates how many patients may attend our ED with increased falls etcetera.”

Ms McKay said local emergency departments continue to see high numbers of attendees and an an increase in people aged 75 and over attending.

“Our patients are definitely elderly and more complex which would lead to a longer length of stay at times. We looked at the number of patients who arrive particularly from care homes and by ambulance and we sat down with our Care of the Elderly clinicians and we had had discussions around what type of model we would put in place and we hope to have either an outreach model or an in-reach model in place soon.

"The aim is to reduce those patients having to come to ED at all and there may be times where they might need a diagnostic etcetera that they may need to come to our same-day emergency care, which we're also expanding as part of that work. We don't want elderly people lying in our emergency departments so this is a bespoke model. It'll be a test for the region and we're just working through the detail of that at this minute in time but we hope to have it in place by January."

"This winter we have had no targeted winter pressure funding into secondary care in Trusts, however we have had some investment in the West in our No More Silos project, particularly in relation to expanding our ambulatory care capacity. This means patients who would maybe have attended our emergency department can go directly from their GP and access our ambulatory care pathways in that unit. We've had increased funding to expand that at Altnagelvin.

"We have really good ambulance turnaround times in the west, we're probably the best in the region at this minute in time although we did have a small dip in October because of work that was going on in the department. Our priority across our emergency departments is to offload ambulances as quickly as possible and prioritize those patients and get them into our departments and the reason for that is twofold; we don't want to hold up a crew that may be required elsewhere but we also know that a patient usually coming in an ambulance is a true emergency."

The Western Trust is emphasising the importance of timely discharge to ensure the smooth running of the hospital, particularly the emergency department.

"The importance of discharge early in the day is critical tin hospitals at this time of the year,” added Geraldine. “We have recently implemented a discharge lounge and, on Tuesday, we hit our benchmark of 13 patients through the lounge, which is what we hope to achieve on a daily basis.”