Audit Office report underlines need for radical change in health service
An Audit Office review of emergency admissions has reinforced the clear message of the recent Bengoa report that our healthcare system needs to be restructured for the demands it faces in the 21st century.
Essentially the long-awaited report said we need to move the emphasis away from hospital-centred care and place greater focus on the provision of community and primary care.
There is no doubt that our acute services are under enormous strain with patients waiting an unacceptable length of time to receive much-needed treatment.
The long waiting lists are a symptom of a wider problem which is also reflected in the intense pressure being placed on emergency departments.
A&E units are frequently struggling to cope with the volume of patients turning up and an associated shortage of available beds.
In the past year more than 166,000 people were admitted to hospital as emergencies, at a cost of more than £460 million in Northern Ireland. The number of admissions has increased by 10 per cent in the last few years and accounts for 28 per cent of all patients admitted to hospital.
However, a review by auditor general Kieran Donnelly has found that many patients are ending up in hospital when they could be treated more appropriately elsewhere. Department of Health figures show that 16 per cent of all patients admitted as an emergency may not have been necessary.
Furthermore, too many people brought in as emergencies faced delays in being discharged due to problems in securing care packages in the community.
This is a longstanding problem and in 2015-16 the department's target was that no patients with complex needs should remain in hospital for more than seven days after they were deemed fit for discharge.
Despite this target, more than 1,700 patients remained in hospital beyond this period which gives an idea of the scale of the issue facing the health service.
The Audit Office report provides further evidence why we need radical change in our health service.