We need more hospital beds: Derry GP

I think it’s time the public was made aware of some of the primary reasons for issues associated with A&E (Emergency Department), writes Dr Paul Molloy.

A&E departments across the NHS are busy environments.
A&E departments across the NHS are busy environments.

It’s not wholly the number of patients turning up at ED that is the problem, but that, when they are in ED, they are usually sick and are unable to be moved as there are no beds in hospital wards to move them to. If you can’t move people out, you can’t bring anyone in.

So, for example, if 30 people are waiting, it’s partly because there’s nowhere to see them as all the cubicles in ED are full. If the doctors could free up the rooms the patients in ER are in - by moving them to wards - they could, then, bring in the next group waiting.

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If patients could be seen, assessed and moved on from ED, staff would have capacity to see the patients that are waiting.

There has been a push for years to reduce the number of hospital beds when, in reality, we have increasing numbers of old people getting sick and needing hospital at some stage - hence the need for ongoing realistic increases in hospital beds.

About 10 years ago, GPs were able to admit a patient directly to a ward. Then we were no longer able to and, when we wanted to admit someone, we were told to send them to A&E (ED).

While I appreciate GP surgeries obviously have access issues, as evidenced by what I’m told, and there are reasons for that (workforce etc.), it is important the public realise that GPs are not the reason that waiting times at ED are very long. The real reason is, as stated, they can’t move sick patients out of ED into hospital beds or care home beds due to a lack of these and, as such, there isn’t anywhere in ED to see patients as everything backs up.

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Sort out how to get people out of ED once the medical team has decided on the treatment they need, and that will help resolve the waiting times. That’s the problem, however. It just seems that sorting that out is too difficult or too expensive.

I have no doubt our hospital colleagues are working under extreme pressure and they want to deliver a more responsive service. There’s no doubt more staff and funding would help - but we still need to solve the way out of ED.

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We have been hammering away for years at reducing the numbers going to ED and making sure they go to the right place, but it’s clear that it’s not going to make a big enough difference without acknowledging the need for more hospital beds or places to treat patients after they leave ED and before they are fit to go home.

I would also like to stress that I support my hospital colleagues in any way possible.

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Paul Molloy is a GP working in Derry.