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The Irish Association for Emergency Medicine (IAEM) has complained about the disappointing “sense of déjà vu” regarding the number of patients who are being treated on trolleys due to insufficient numbers of hospital beds.

The association has criticised the fact that 656 of our “most vulnerable citizens” are spending prolonged periods of time in “noisy, bright, busy, packed Emergency Departments (EDs) around the country”.

In an “a new and worrying trend”, children who need a hospital bed are also being held overnight in EDs.

The association stated: “This was always going to be how 2018 started in our EDs. Everyone, from the Minister for Health to the clinician at the frontline knew it, yet little of substance was done by the DoH & the HSE to address it.

“The Health Service is quite simply over-stretched with the ED, the part of our acute system that never says ‘no’ and therefore the place that patients come up against access block, the inability to access an acute hospital bed.

The highlighted parts of the system that are overstretched; Emergency Medicine, General Practice, the National Ambulance Service, Acute Medicine, Acute Paediatrics are all struggling.

The result of this is that non-urgent surgical care is being cancelled, creating frustration for surgeons who see their waiting lists extending and are aware of the further inconvenience for their patients.

Although there are now large numbers of patients on trolleys throughout the twelve months of the year, these figures are particularly high during the ‘flu season’ and the surge in respiratory admissions at this time of the year, which lead to an even worse crisis.

Currently, there are delays to see a triage nurse, a doctor, and for the 25-30 per cent of ED patients that need admission, most of whom usually cannot be dealt with in Primary Care or diverted to other services, there are lengthy waits for a hospital bed.

The IAEM commented: “No solutions seem to be in sight. HSE Plans are unambitious and token and are either not implemented or are too slow or too feeble to respond. “The Acute Bed Capacity Review will tell us what we have already known for years, namely that we need many more beds. In the longer term, investment in Primary Care may improve our nation’s health but this is currently little more than an aspiration”.

The association has demanded immediate solutions for this winter and the winters following. They have called for a reduction in the number of delayed discharges to free up beds, rather than adding any extra ones that would call for more staff, which at the moment is non-existent.

The association concluded: “We recognise that it is really tough being a patient in an ED currently. We are also aware just how difficult it is working in grossly crowded EDs at the moment.

“Our goal continues to be to attend to the sickest as soon as we can but we know that those that are less unwell will unfortunately wait longer. As we experience another predictable crisis, it is long overdue that the ‘national emergency’ declared in 2006 by the then Minister for Health, at a time far fewer were on trolleys, finally receives the attention it deserves. How many more have to die needlessly while inertia prevails?”