Medics warn that under pressure A&E system is facing crisis

By David Young, PA

Northern Ireland’s under-pressure accident and emergency system is facing crisis, a body representing ED medics has warned.

The stark comments from the Royal College of Emergency Medicine come amid escalating capacity issues in A&E departments across the region.

On Wednesday evening, the Health and Social Care Board said EDs were experiencing severe pressure, with ambulance service crews also operating under extreme circumstances.

The over-capacity emergency departments are a symptom of wider systemic problems in a healthcare system blighted by spiralling waiting lists.

Earlier, Stormont’s Health Minister Robin Swann expressed concern that the problems in the health system were mounting at a time of political flux in the powersharing executive.

Mr Swann warned of the potential for political egos to destabilise the executive, thus risking vital reform of the healthcare system

Dr Paul Kerr, vice president of the Royal College of Emergency Medicine Northern Ireland, said EDs were facing “severe pressures”.

“In April we stated that pressures on EDs in Northern Ireland were rapidly increasing and we needed urgent action and a clear plan and support to meet the rise in demand,” he said.

“With a return of crowding and long stays, we called for the safe expansion of capacity. No such action has been taken yet.

“Right now, we have record numbers of emergency admissions delayed by over 12-hours. Things are deteriorating very quickly; Emergency Departments are facing crises over emergency cases delayed for long periods before being admitted.

“The focus on elective care is necessary but that must not come at the cost of urgent and emergency care. Any approach must see the connection between the two and be taken in tandem. We cannot neglect urgent and emergency care or these patients. And EDs cannot be used as extra capacity for elective care when we desperately need the capacity for our urgent and emergency care patients.”

Dr Kerr said departments were facing “major capacity issues”.

“Without any safe expansion of capacity or support for Emergency Departments, dangerous crowding, long stays and corridor care – that we are already seeing – could become more routine and put patient safety at risk – especially with Covid still present in the community,” he said.

“We must see steps be taken to support our EDs and a clear plan, beginning with finding a safe way to increase the number of beds.”

(Mr Swann is urging politicians to put the health of Northern Irish people before political point-scoring)

Mr Swann earlier expressed concern about the current political wrangling in the devolved administration. There is speculation the forthcoming renomination of the first and deputy first ministers – necessitated by the ousting of DUP leader Arlene Foster – could destabilise the institutions.

On a visit to Bangor, Co Down, Mr Swann was asked about the stability of the executive following the continued fall-out from the internal DUP heave that forced Mrs Foster from office.

While declining to be drawn on “party politics”, he added: “One thing that would concern me in regards to the stability of the executive is we have a long way to go on health. We’ve come through a pandemic, we’re now looking at the waiting lists, which are one of the biggest challenges. I think we now have a collective executive, it’s something I keep hearing that my executive colleagues want to tackle along with me.

“So I think it would be a dereliction of responsibility if somebody whose personality or ego or politics got in the way of actually serving the people of Northern Ireland.”

In separate comments, delivered in a speech to UUP colleagues on Wednesday, Mr Swann also warned of the potential for politicking to hinder decision making around reforms of the health and social care system.

He told a meeting of party colleagues that political point-scoring could spell the “death knell” for the health service.

“We don’t need more party-political division about health,” he said.

“We don’t need more cheap shots or point-scoring.

“And I’ll actually go further, party political point-scoring could be the death knell for our health service here in Northern Ireland.

“It’s always tempting to try to score those points – to issue that hard-hitting press release; to slam this or to slam that, and to demand that something must be done.

“We’ve seen that for years and years. Calls for more spending in different services – without any suggestion as to where the extra money or the extra staff would actually come from.”

The A&Es have been under intensifying pressure this week.

On Wednesday evening, the Health and Social Care Board urged patients to only attend A&E for emergency care.

“Whilst staff are continuing to work hard to ensure that patients receive the treatment and care that they need, it is regrettable that some people are having to wait longer to be treated in Emergency Departments, or to be admitted to hospital, than normal,” said a spokesman.

“If you have a life-threatening condition or are seriously ill or injured then the Emergency Department is the appropriate place to go. On arrival at Emergency Departments all patients are assessed by a triage nurse and then dealt with in clinical priority.

“Patients who are most ill must be seen first. Patients not assessed as emergency cases are likely to have to wait for a long time.

“Also, the need to prevent crowding in our Emergency Departments remains a key priority in reducing the risk of Covid-19 transmission. Please do not attend unless you require emergency care.”

(The Health Minister has warned that unstable politics could destabilise the entire health service in Northern Ireland)