Five hospital sites accounted for almost half of all patients who waited on trolleys in the first nine months of last year, according to the Department of Health secretary general.
In a letter to the Health Service Executive, Robert Watt raised concerns about urgent and emergency care in advance of the winter period, when hospital overcrowding becomes worse.
Mr Watt told HSE chief executive Bernard Gloster he wanted to set out “shared concerns” relating to performance at certain hospital sites.
“Substantial progress has been made [year to date] YTD with regard to trolley numbers nationally, with 12 per cent fewer patients on trolleys in the first nine months of the year compared to the same period last year,” stated Mr Watt in his letter, dated October 1st.
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However, he said it has “become apparent” there is “significant variation” when it came to individual hospital performance.
Mr Watt said five sites: Cork University Hospital, Galway University Hospital, St James’s Hospital in Dublin, St Vincent’s hospital in Dublin and University Hospital Limerick had accounted for 44 per cent of all people on trolleys at 8am counts up to the beginning of October.
“The continued congestion levels at these sites is very concerning, particularly as we progress toward the busiest time of the year,” he said in the letter, released under Freedom of Information laws.
“The sites under the most pressure need to become the main area of focus over the winter period, to ensure they receive the support needed and that there is consistent implementation of the reforms and changes proven to work.”
He added: “Therefore, I am proposing that we stand up a group with a sole focus of providing oversight of these sites of concern.”
In response, Mr Gloster said he would “engage” directly with Mr Watt on the issues at those hospitals, but he would “not recommend the establishment of another group”.
“I am conscious that in wanting REOs [regional executive officers] and the system to perform and respond I have to minimise the amount of national groups they are being [a]sked to account to and report to,” he said. “I am satisfied that the full attention that can be applied is being so within our processes at this time.”
Minister for Health Jennifer Carroll MacNeill brought a memorandum to this week’s Cabinet meeting regarding the “spike” in trolley numbers over the February bank holiday weekend. The numbers increased from 253 patients to 617 over the three days.
The Minister said overcrowding is a “function” of low weekend discharge rates, noting that 2,560 patients were admitted in that time and 1,535 were discharged.
“Recognising that this is in large part connected to the presence of senior decision makers on site, I requested an analysis of the consultants rostered over the same period,” she said.
“It is clear in the hospitals for which we obtained initial data that approximately 10 per cent of consultants were rostered – either on-call or on-site. This is not enough.”
As of 8am on Wednesday 416 people were waiting on trolleys in hospitals, according to figures from the HSE. Of these, 295 were in emergency departments, with 141 in wards.
In addition, more than 500 patients were in surge capacity beds – additional inpatient beds operating temporarily to meet demand.
Emergency care demand has continuously increased in recent years, rising by 8 per cent last year in comparison to 2023, with nearly 1.58 million presentations. However, the number of patients waiting on trolleys fell by 11 per cent year on year.
