Elderly patients spend five days in ED

Two elderly patients have been in the emergency department of the Royal Victoria Hospital (RVH) in Belfast awaiting admission for more than five days, BBC News NI can reveal.

This comes after more than 500 patients were unable to be discharged from the hospital on Sunday night, despite being medically fit.

With no suitable care for them in the community, it meant they remained in beds preventing other sick people from being admitted to hospital wards.

On Sunday, more than 400 people who attended Northern Ireland’s emergency departments were told they would have at least a 12-hour wait for a hospital bed.

The Department of Health said longer-term solutions required sustained investment and reform.

At the RVH on Monday, BBC News NI heard one person with flu was being treated in a unused tea room.

Three others have been in the same area for four days.

Emergency department lead nurse Claire Wilmont said that staff were “treating the most vulnerable elderly sick patients in an intolerable environment”.

“We are dealing with the really elderly, vulnerable and really sick patients at the minute and due to the rising level of flu, we are really struggling to look after people,” Nurse Wilmont said.

She explained that staff were stretched on a daily basis.

“The staff are trying their best, but there are delays and the care at times can be very challenging,” she added.

With the current cold snap and flu figures yet to peak in Northern Ireland the health service is bracing itself for a difficult week.

Some of those working over the weekend told BBC News NI that the longer wait was a concern – as delays increase the likelihood that some patients will come to harm.

One emergency department (ED) consultant said it was disgraceful that corridor care in emergency medicine had become “almost normalised”.

Another said that until social care was addressed in Northern Ireland, the predictable Christmas spike would not change.

Dr Ian Carl explained that hospital flow was a major issue.

“Our acute sites are inferably at capacity in fact beyond capacity, it currently exists at 140% capacity but most days we run at 120% capacity,” Dr Carl said.

He added that patients who are fit to be home, but remain in a hospital environment, hold up beds for those waiting in emergency departments.

“We have patients who need care packages, patients that need to go to a care bed in a nursing or residential home, and also people who need permanent residence. It’s a massive problem we face,” he said.

Health unions have told BBC News NI that while the flu spike was widely predicted, little was done on the ground to address the inevitable.

Among the possible scenarios being discussed by staff was to bring in the Army during December and January for additional support on the wards and in ambulatory care.

It was also suggested the health regulator, the RQIA, should be more flexible about rules in nursing homes, which require residents being sent to EDs rather than being cared for within the home.

To help reduce the spread of infection including flu, several hospitals in England have restricted hospital visits and have asked patients and visitors to wear face masks to prevent further spread of flu.

The freezing conditions will put the system under further pressure with calls for the public to be cautious and perhaps think twice about venturing out.

Figures seen by BBC News NI show that on Sunday evening the number of people waiting more than 12 hours were:

• 61 at Craigavon Area Hospital
• 51 at Antrim Area Hospital
• 49 at the Royal Victoria Hospital
• 48 at the Ulster Hospital
• 42 at Altnagelvin Hospital
• 35 at Causeway Hospital
• 24 at Daisy Hill Hospital
• 21 at the Mater Infirmorum Hospital
• 19 at the South Western Acute Hospital

Longer-term solutions require sustained investment and reform, according to the Department of Health.

A spokesperson said demand for care was currently more than what the health service could provide.

The statement added that in recent days, the health minister had met emergency department staff, and had held discussions with both the Royal College of Nursing and the Royal College of Emergency Medicine.

“The minister shares their serious concerns about the impact of the immense pressures on staff and patients and will follow up with further engagement in the coming weeks,” the spokesperson said.

The vice chair of the Royal College of Emergency Medicine in Northern Ireland has said it is “impossible to manage” the number of patients arriving to emergency departments.

A 12-hour wait for a bed was probably “a conservative estimate”, he said.

“Every department in this country will tell you there’s been patients waiting for three or four days,” he added.

“We are at the worst we’ve ever been, regarding the headlines today, to emergency medical staff, we knew this was going to happen, it hasn’t surprised us because this has been the trend for so long.

“There’s just no physical space to bring people in to get them assessed.”

Dr Nicola Herron, a Londonderry-based GP, said a drop in vaccine uptake has fuelled the surge in respiratory infections.

“Then inevitably in years where there is a poor uptake we see a massive surge in respiratory tract infections, coughs, colds, flus, and this year the added worry of something like Covid… flu seems to be the predominant one this year,” she told BBC Radio Foyle’s North West Today programme.

The Public Health Agency (PHA) said it was not too late for people to get the flu vaccine as cases had yet to peak, and it would protect the public and the health service well beyond the winter months.

“We’re in the middle of our winter virus season,” Dr Joanne McClean told BBC’s Good Morning Ulster programme.

“All during the year our hospitals and ED’s are really busy, and during winter, on-top of the usual pressures, we get winter viruses, mainly Covid, flu and RSV (respiratory syncytial virus).”

A possible reason for this may be that “people have forgotten that flu can be a very serious illness”, Dr McClean added.

“We need to have our flu vaccine updated every year because flu changes every year.”