Portlaoise hospital A&E
Emergency Department (ED/A&E) nurses and doctors have warned the HSE and the Minister for Health that hospitals must not return to overcrowding as Covid-19 measures are eased.
The warning is contained in an unprecedented joint statement issued by the Irish Association for Emergency Medicine (IAEM) and the Irish Nurses and Midwives Organisation (INMO). The organisations represent frontline nurses and doctors in emergency departments across the country.
Their statement cautions that the “problems of the past” may emerge again as the health service gradually ramps up non-Covid-19 activities.
They warn that overcrowding and understaffing may lead to increased infection risk, poor patient outcomes, and unsafe workplaces.
The joint statement calls for measures to counteract this, including:
- Retention of access to private hospitals until a vaccine is secured.
- Immigration and travel priority for migrant health professionals.
- A commitment that no recruitment embargoes will apply to doctors or nurses.
- Extra priority and decision-making powers in the community to avoid unnecessary emergency department referrals.
- A working group to urgently look at staffing issues in the health service.
IAEM President, Dr Emily O’Conor, said: “We need to reset care in Irelands’ Emergency Departments and allow care continue to care for those patients that need EM expertise in a way that is safe for patients and staff.”
INMO General Secretary, Phil Ní Sheaghdha, said: “Overcrowding, understaffing and COVID-19 pose a triple threat to patients and staff alike.
“Emergency department and hospital overcrowding is always unacceptable, but it is exceptionally dangerous when added with the risk of COVID-19 infection.
“We have never seen trolley overcrowding figures as low as the past few weeks. We must build on that and resist any return to the problems of the past.
“In the short term, that means keeping the extra capacity of the private sector, prioritising immigration of migrant health professionals, and no more recruitment embargoes. We cannot repeat the mistakes of the past,” she said.
The full statement, sent to the HSE and Minister for Health, below:
Joint Statement from the Irish Nurses and Midwives Organisation and the Irish Association for Emergency Medicine
As healthcare professionals, we have been to the forefront of providing expert care at the frontline of the fight against the COVID-19 virus.
The healthcare service will gradually return to providing more non-COVID-19 services. We are concerned that, without action, conditions may worsen, and the problems of the past may return.
We share four essential aims:
1. Emergency Departments and hospital wards must not become reservoirs of healthcare-acquired infection for patients
2. Emergency Departments and hospitals must not become crowded again
3. Emergency care must be designed and resourced to look after vulnerable patients safely
4. Emergency Departments and hospitals must be safe workplaces for all staff
To achieve to these four aims, the INMO and IAEM jointly call for the following:
A. A permanent increase in bed capacity: in the short term this will involve retention of access to private acute hospitals and their services until (a) the majority of the population is immune to COVID-19 and (b) the health services have the capacity to deliver “COVID” and “non-COVID” care. A maximum occupancy rate of 85% across hospitals will be necessary for patient safety.
B. Adequate staffing to ensure good patient care despite staff sickness and the reduced productivity related to use of PPE. This should include prioritised immigration and travel arrangements for nurses and doctors, a renewed recruitment campaign and terms and conditions that would make the HSE an employer of choice. No further recruitment embargoes should apply to nurses or doctors.
C. A high-level working group, to report within one month of the formation of a new government, to examine and set the nursing, midwifery, and medical workforce priorities for the health service over the coming year. This would examine the staffing deficits experienced by these essential front-line workers, set out where additional staff are needed and prioritise services to fully return to work.
D. That staff health and safety is not compromised, ensuring the ongoing provision of adequate PPE and intensive mental health supports.
E. Universal provision of supports needed for decision-making by clinical teams in the community to ensure care is delivered as close to the patient as possible and that unnecessary referral to Emergency Departments are avoided.
F. Investment in expanding Community Intervention Teams and maximising care in the community to ensure adequate capacity for step-down, recovery and rehabilitation allowing acute hospitals return to their core purpose.