Thirteen thousand people faced “absolutely brutal” waits of more than 12 hours in Northern Ireland emergency departments in just one month, latest figures show.
The latest Department of Health figures show the staggering number of patients kept waiting over 12 hours in September is 85 times as many as was recorded a decade ago in September 2016, at 150 patients. And a senior emergency medicine doctor warned that the spiralling long waits are “dangerous” for patients.
The number of long waits is despite a broadly similar number of patients being treated, with 72,000 patients attending EDs last month compared to 65,000 in September 2016.
Even at the December peak in 2016, the highest number of patients waiting over 12 hours was 855.
The Royal College of Emergency Medicine says A&E staff are facing “an impossible situation” this winter and demanded the Executive take steps to “avoid a total breakdown in the Emergency Care system”.
Dr Michael Perry, RCEM Northern Ireland Vice President, described the latest waits in EDs as “absolutely brutal”.
“Emergency Departments in Northern Ireland are in a dire state. Thousands of patients face waits of more than 12 hours, many experiencing the indignities of corridor care,” he told The Irish News.
“These long waits are also dangerous, and we know there is a link between long waits and a higher chance of mortality, among patients who come to us and are in need of admission into a hospital bed.
“But it was not always this way. In the last decade, 12-hour waits have skyrocketed. This has been driven in large part by an ageing population putting strain on a neglected social care system on one side, and an associated failure to make beds available in hospitals for us, in A&E, to admit people.
“This state of affairs is what causes delayed discharges in hospitals, which in turn prevent us from moving people out of EDs.”
Dr Perry said the huge increases could not be explained alone by a rising demand for services, noting a “fairly modest” rise in ED attendance in the last decade.
“Despite this, many of the solutions put forward by policymakers over the last decade have focused on demand management at the ‘front door’ of the hospital – which does not solve the problem.
“We need beds to be freed up and extended opening hours in parts of the hospital required to discharge patients. These measures will make the difference.”
A further breakdown of the figures showed that less than a third of those attending Type 1 EDs in September (32%) were there for less than four hours, which the RCEM called “the worst performance for this time of year ever”.
The median time for ED patients to be discharged was five-and-a-half hours, and 14.5 hours for those admitted to hospital.
The longest individual waits at EDs for patients admitted to hospital in September showed one of 114 hours in Derry’s Altnagelvin Hospital, compared to the median wait of 19 hours.
The longest individual waits in both Antrim and Causeway hospitals were close to 90 hours as well as nearly 60 hours in Craigavon.
The Ulster Hospital in Dundonald had the most patients waiting over 12 hours in September at 2,500, with EDs at Belfast’s Royal Victoria Hospital and Craigavon also having over 2,000.
Efforts to reduce ED attendances have included use of the Phone First system, which received over 18,000 calls in September - diverting 12,000 to EDs and 6,000 elsewhere.
A Department of Health spokesperson said tackling ED waiting times required “a whole hospital, whole system approach”.
“Staff in EDs are making every effort to provide optimal clinical outcomes and keep waiting times as short as possible in challenging circumstances,” they said.
“As winter approaches we can’t control what extra pressures it might bring, but we can use our learning from previous years to plan to mitigate those pressures.”
They said winter plans from health trusts to reduce ED pressures included efforts to provide more care closer to home, improving care for those who do need hospital treatment and helping patients return home as soon as they are ready.
Initiatives from the ambulance service include ‘hear and treat’ and ‘see and treat’ were also said to make sure people get timely care in the right place.
As well as a flu and Covid booster vaccination programme, the public were also reminded about other options like Urgent Care Centres, minor injury units and GP Out of Hours services.
