The dramatic impact of a shortage of beds in Tallaght hospital which is expected to pick up patients from a downgraded Portlaoise hospital has been outlined by a senior HSE manager.
Both Portlaoise and Tallaght Hospitals are part of the Dublin Midlands Hospital Group (DMHG). A plan with the Department of Health would see patients currently seen in Portlaoise A&E re-directed to Tallaght, Tullamore, St James' and Naas hospitals.
Patients who cannot be treated in Portlaoise are already referred or transferred to Tallaght and these other hospitals.
In the past week nearly 160 patients had to resort to trollies at DMHG hospitals because of the bed shortage.
The new chief executive of the DMHG outlined the acute pressures on Tallaght as a result of the shortage of hospital beds.
Mr Trevor O’Callaghan replied to a question from Cllr Charlie O'Connor at the Dublin Mid-Leinster Health Forum in Tullamore on Wednesday, February 2. The Tallaght Fianna Fáil councillor asked for a full report on activity at the Emergency Department of Tallaght over the past two months detailing issues relating to the Trolley Crisis and confirming actions taken in respect of the matter.
Mr O'Callaghan painted a stark picture of the problems facing the hospital despite expansion.
"The Hospital has seen a 4% increase in ED attendances in December 2017 and January 2018 compared to the same period the previous year, the patients presenting are of a higher medical acuity as reflected in an increase in triage of category 1 and category 2 patients*.
"While increased attendance is a seasonal occurrence – population growth and significant demographic change in our catchment means we are seeing a rapid accelerated increase in demand for adult ED services and greater complexity in the cases presenting, year on year.
"ED attendance by persons over 75 years has increased by 44% since 2012. These patients tend to have more complex care requirements and a high proportion (50%) need admission and on average have double the length of stay than patients less than 75 years. Amongst this cohort of patients alone, it has created demand for an additional 35 beds every day, in a hospital that was already at full capacity more than five years ago.
"We now operate one of the largest ED’s in the country following a major expansion in 2015 which doubled the capacity of our facility. Adult ED attendances exceeded 50,000 in 2017 – an increase of almost 8,400 since 2012 or +20%," he said.
Mr O'Callaghan said that since opening the expanded ED additional nursing and NCHD staff have been recruited and the modern ED facility ensure a higher quality caring environment.
He added that process improvements, have also improved how patients are managed and this has resulted in a reduced length-of-stay (the lowest in three years).
However, he cautioned a bed shortage remains.
"It is clear that current demand for beds exceeds the hospital’s current available capacity and there is a clear underlying requirement to develop additional onsite bed capacity. We are currently in discussions with the HSE to develop a new 72 single bed facility at the Hospital to address these additional capacity requirements. The Hospital awaits the implementation of the Department of Health bed capacity review," he said.
* Category 1 indicates a patient in urgent need of medical attention
Category 2 indicated a patient in semi-urgent need of medical attention