System is at ‘bursting point’ says top doctor after latest A&E crisis

The latest crisis to hit accident and emergency units in Northern Ireland has led to calls for fresh thinking on service provision.

On Wednesday, the Royal Victoria Hospital’s AE unit had to implement its major incident plan when an unusually high number of patients required admission.

There have also been reports that Craigavon Area Hospital (CAH) experienced a similar spike in demand in recent days, with one MLA claiming there was a perception of a “serious risk” to patients.

Over 40 people were waiting on trolleys at the RVH by early Wednesday evening with the situation only returning to normal shortly before midnight.

During a visit to the hospital yesterday, Health Minister Edwin Poots was booed by protesting staff as the Unison union held a protest outside. The minister has described Wednesday’s upsurge as a “one-off” event.

The AE at the City Hospital closed in November 2011, and the opening hours of both the Downe and Lagan Valley units have been restricted, leading to an increasing number of patients being directed to the RVH.

GPs’ representative Dr Alan Stout said that any crises within the AE system are a reflection of similar pressures on local health centres. “I think the whole system is really at bursting point,” he said.

The deputy chairman of the BMA’s GP committee said: “Any practitioner that we speak to will tell you exactly the same – that the pressure, the increase in demand and the increase in work is virtually unsustainable at the moment.”

Commenting on complaints that too many people are being sent to AE departments, Dr Stout added: “There are no real community alternatives and that is one of the challenges we face in the health service as a whole.

“Each year we have more and more elderly people and by definition that means we will have more people living with chronic disease, and those patients are the ones who are likely to become very unwell and need an increased level of care.”

Upper Bann MLA Dolores Kelly said the situation at the CAH was a cause for concern.

“There is a serious resource issue across the north and this must be addressed as a matter of urgency by the minister for health. Patient safety must be the paramount concern and the kind of incident at Craigavon Area Hospital must not be allowed to reoccur,” she said.

UUP MLA Roy Beggs described the latest AE crisis as “a consequence of recent ill-thought-out decisions to reduce services and an abdication of political leadership from the current health minister”.

Kieran McCarthy of Alliance said: “Following the decision to reduce the opening hours at other hospitals, many people will question if there is an adequate level of resources at the Royal Victoria Hospital AE department.”

Health authorities have again stressed that anyone with less serious injuries should consider what alternatives are available – including out of hours GP services – before visiting an AE unit.

Minor injury units are in operation during normal working hours at the Bangor, Ards and Armagh community hospitals, with similar services at the South Tyrone in Dungannon, the Mid Ulster in Magherafelt and at Whiteabbey in Co Antrim.

A 24-hour minor injuries service is available at the Tyrone County Hospital in Omagh.

Types of injuries suitable for treatment at MIUs can include: injuries to upper and lower limbs; broken bones, sprains, bruises and wounds; bites – human, animal and insect; burns and scalds; abscesses and wound infections; minor head injuries; broken noses and nosebleeds as well as foreign bodies in the eyes and nose.

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