‘Urgent escalations of people being moved from beds to corridors’ occurring weekly at Altnagelvin A&E, says MLA

Over a quarter of patients at the Derry A&E are routinely waiting longer than 12 hours to be treated, the Sinn Féin MLA also said at Stormont on Tuesday.

Mrs. Ferguson asked the Health Minister Mike Nesbitt what work his Department was undertaking with the Western Health and Social Care Trust to address waiting times at the Altnagelvin ED.

She raised the use of escalation beds in corridors.

“On a weekly basis there is an urgent escalation of people being removed from their beds and placed in corridors. Is additional work needed to address gaps in specialisms among medical staff and reduce the number of people waiting? In Altnagelvin, 28 per cent or 29 per cent of people wait for more than 12 hours in A&E,” claimed the Foyle MLA.

Mr. Nesbitt said he believed there was an issue with some patients being assessed by their GPs and then attending their local A&E only to be assessed for a second time. This, he said, was contributing to the pressures on the secondary care system.

"We are trying to remove the second assessment. A lot of people end up in a hospital because they start off with an assessment from their GP and are then sent to the emergency department of an acute hospital, where they are assessed for a second time.

"The future is to do away with that second assessment, wherever possible, so that the GP can refer the patient directly to a specialist service in the hospital.

"Some hospitals, as well as having emergency departments and minor injuries units, now have urgent care departments. That is what I am talking about: a situation where you can be referred by a GP directly to an urgent care department,” said Mr. Nesbitt.

The Health Minister pointed to ground-breaking initiatives that have been taken at Altnagelvin to ease pressure on its A&E.

"An enhanced minor injury unit was opened in March this year. It is a Phone First-led service that operates from 8.00 am to 9.00 pm, seven days a week.

"It is my expectation that the unit will see some 20,000 minor injury patients a year, and thus 20,000 people will avoid the need to attend the ED,” said Mr. Nesbitt.

Other initiatives include an enhanced ambulatory care unit that is expected to ‘provide almost 20,000 bookable appointments a year’ and a consultant-led respiratory hub with clinics operating two and a half days a week and offering capacity for 1,200 patients each year.

The Western Trust, meanwhile, has established ‘a control room in the hospital to proactively manage the flow of patients through the hospital site and into community services’.

"A discharge coordination team is promoting earlier discharges and improved weekend discharge rates for patients who have been assessed as medically fit.

"In addition, the trust has engaged with GP practices to embed direct referral pathways from primary care to the ‘Hospital at Home’ service.

"Work between the trusts and care homes is helping to avoid admissions for residents, with plans in place to manage agreed conditions by care home providers.

New A&E at Altnagelvin hangs on 'budget affordability' says Swann

"As well as redesigning seven general residential beds to increase capacity for patients with dementia, the trust will open a further 11 beds for dementia patients and eight general nursing beds to help improve flow through and discharge from Altnagelvin,” said Mr. Nesbitt.

SDLP MLA Mark H. Durkan asked the minister for an update on proposals to develop a new ED at Altnagelvin.

“I commend the heroic efforts of staff in the emergency department at Altnagelvin. Will the Minister provide an update on the Western Trust's business case for an enhanced emergency department at Altnagelvin?” he asked.

Mr. Nesbitt said: “I thank the Member for his question. I visited Altnagelvin a few weeks ago. We looked at some of the new facilities, and I was updated on the fact that there is a plan for a new emergency department.

"I will have to write to the Member if he is looking for exact details of what stage that outline business case is at and the timeline for its completion.”

Last March Mr. Nesbitt’s predecessor and party colleague Robin Swann said the Western Trust would be invited to submit a business case for a new ED at Altnagelvin once ‘budget affordability is confirmed’.

Altnagelvin new Minor Injuries Unit has already seen 2,000 patients and is easing pressure on A&E, staff say at launch

On Tuesday at Stormont East Antrim Alliance MLA Danny Donnelly spoke of pressures on A&Es across the North with ambulances often parked up outside facilities due to the lack of capacity.

"The Minister will be well aware of the overcrowding in A&Es across Northern Ireland, with increased pressures inside the departments and ambulances regularly stacked up outside departments for up to 12 hours.

"What work is the Department undertaking to reduce average waiting times across our A&E departments?” he asked.

Mr. Nesbitt described ambulance handover times as a crucial issue.

“To address ambulance handover times, which are critical, my Department has taken steps to improve waiting times at emergency departments.

"Reducing those handover delays has been a key priority because of the impact that it has on the Ambulance Service's capacity to respond to calls in the community, particularly category 1 and category 2 emergency calls.

"A regional process has been issued by my Department to all the geographic trusts for the release of ambulances from outside EDs when the Ambulance Service has an outstanding category 1 or category 2 call.

"Trusts have been working with the Ambulance Service to introduce new care pathways for patients to provide alternatives to conveying all patients to an ED,” said Mr. Nesbitt.

Altnagelvin will never be able to cope with pressures without new A&E says Delargy