Emergency Departments – Topical Issue


Check against delivery


Speech by Minister for Health, Dr James Reilly T.D.

I would like to thank Deputy Kelleher for raising this issue today. This House is very aware that I regard trolley waits and other delays in the treatment of patients in ED to be unacceptable.   The Special Delivery Unit, which I established in 2011 is actively driving improvements in patient ED experiences through intensive engagement with the hospitals.

Provisional patient experience times for May 2014 show that 68.0% of patients attending Emergency Departments were discharged home or admitted within 6 hours and 82.0% of patients attending Emergency Departments were discharged home or admitted within 9 hours.

The 30 Day Moving Average INMO Trolley count continues to remain below 300 patients per day since May 2013. The current figure as of 6 June 2014 is just 227 patients, this is over 8% less than at this point last year.

Year to date the system has reported 8.4% fewer patients on trolleys compared to the same period in 2013, equivalent to a reduction of 2,578 patients. Relative to the baseline year of 2011, the percentage reduction in trolleys is 31.9%, equivalent to a reduction of 13,224 patients. However, the task of further system improvement continues. From the outset, the aim has always been to provide the right care at the right time in the right place. One of the most essential actions to help with this task is for patients to make use of the non-ED facilities which can cater for the majority of their injuries and episodes of acute illness; in many smaller hospitals.

Minor Injury Units and urgent care centres are under-utilised, even though they can provide the care needed with a rapid turn-around time, and I would urge people to make use of these facilities where appropriate.  I would also encourage GP’s to make full use of such facilities, as well as Medical Assessment Units so Emergency Departments have the time and the capacity to focus on their patients who do require emergency, critical care.

We have seen there is the potential for delays in the transfer of patient care from ambulance resources to emergency departments. To address this issue, the National Ambulance Service has developed a hospital turnaround framework.  The framework clarifies the process of clinical handover, establishing clear lines of responsibility and the standards expected.

The framework also sets out an escalation process for the NAS to alert management, both in the NAS and the wider healthcare system, to visible increases in emergency demand and activity or events which might delay the transfer of care of patients and the release of ambulances back into service.

I would like to conclude by assuring the House that Hospitals are working with the SDU to put in place all possible additional measures in order to support a safe and high quality patient care experience.