Emergency departments

Sir, – The hospital length of stay figures ("30 per cent of admitted patients discharged within 24 hours 'crazy'", News, February 24th) are worthy of interrogation.

They include lots of really good short-stay patient care with early diagnostics and intervention, and we have been pushing to shorten length of stay for years; in addition, despite advances in medicine, a period of observation remains a cornerstone of paediatric care and is also really useful in many adult patients who present with undifferentiated symptoms.

The figures also reflect unhelpful variation in the definition and recording of what an admission actually means at the patient level, and real limitation in the type of healthcare available to Irish people at night and weekends in terms of clinical, diagnostic and allied services. The headline does not do justice to this complexity and does a disservice to the challenges of delivering 24/7 access to hospital care across so many sites in Ireland.

The opinion that doctors working in emergency departments at night “can’t make any sound clinical judgement” is untrue and infuriates those doctors that do so.

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We need to support doctors working in the public system, not undermine them.

Over 70 per cent of those who attend at emergency departments are assessed and discharged without being admitted, and it’s a team effort.

Finally let us not undo all the good progress that has been made in the fight for more public hospital beds.

Improvements in prevention, primary and community care will reduce the need for hospital beds in the long term, but even if and when that occurs, we will still need more beds than we do now. – Yours, etc,

Dr EMILY O’CONOR,

President,

Irish Association

for Emergency Medicine,

Consultant in

Emergency Medicine,

Connolly Hospital,

Blanchardstown,

Dublin 15.