Navan A&E warning as trolley 'meltdown' takes effect

A strong warning that emergency services in the north-east would be 'banjaxed' if the government goes ahead in a few months' time with proposals to downgrade A&E services in Navan has come from Navan Hospital campaigner and general practicioner, Dr Ruairí Hanley. Calling for HIQA to carry out an investigation into the serious overcrowding this week at Our Lady of Lourdes Hospital in Drogheda, he warned the HSE's proposals to shut down the A&E dept in Navan would exacerbate the problems in Drogheda, where a large proportion of Meath patients are now treated. The situation in Drogheda was described this week as being in 'meltdown' by the Irish Nurses & Midwives Organisation (INMO). Dr Hanley, who was joined in his call for the HIQA investigation by Save Navan Hospital chairman, Deputy Peadar Toibin and Louth TD Gerry Adams, said the emergency department in Drogheda is now the worst in the state. He pointed out that more than 50 people were on trolleys in Drogheda earlier this week, and there were 19 patients on trolleys in Navan. "If the HSE go ahead with their plans for Navan, those 19 patients would join the 50 on trolleys in Drogheda," said Dr Hanley. The GP said that if HIQA carried out an investigation in Drogheda, it would highlight the stupidity of a plan to close the emergency dept in Navan. He said the situation in Drogheda was no reflection whatsoever on the medical and nursing staff there, who were doing "heroic work in dreadful circumstances". Earlier this year, the Irish Association of Emergency Medicine, representing consultants in this area, said that boarding hospital inpatients in emergency departments results in increased numbers of deaths among this group of ill patients, compared to similar patients who are admitted to a hospital ward in a timely fashion. Deputy Tóibín pointed out there were 53 patients on trolleys and chairs in Our Lady of Lourdes on Monday (this had reduced to 49 by Tuesday), the highest number of inpatients without beds in any hospital in the State. "This level of overcrowding is not an anomaly. Throughout the past month, the numbers of patients on trolleys in Drogheda has consistently exceeded 30. This has resulted in enormous pressure on the emergency department and represents a clear threat to patient safety and welfare," he said. "We find it hard to believe that HIQA has not felt it necessary to launch a full safety assessment of this hospital and the potential safety risk it represents to patients. This situation becomes even more incredible when we consider that the HSE regularly cites the HIQA 'Mallow' report as grounds for the potential closure of the emergency department of Our Lady's Hospital, Navan, with the intention of diverting yet more patients to Drogheda," Deputy Tóibín added. Tony Fitzpatrick of the INMO also called for a HIQA investigation of the hospital in Drogheda, and described the situation there as "meltdown". He has also called for a full independent review of the reconfiguration process in the north-east which has removed vital bed capacity and directed additional patient traffic to Our Lady of Lourdes Hospital, causing untold human suffering for patients. He said: "842 patients have spent time on trolleys in the emergency department at Our Lady of Lourdes Hospital, Drogheda, in September 2011 compared to 331 in September 2010 - an increase of 154 per cent. This situation will deteriorate even further in the coming months as the winter period is traditionally worse in emergency departments nationwide." A spokesperson for the HSE said that when a patient comes into the emergency department, their treatment begins at triage and anybody requiring urgent care receives it accordingly. The longest waits occur when patients are actually admitted and are awaiting bed allocation, rather than waiting for treatment. She said the Lout- Meath Hospital Group was implementing a two-pronged approach to the management of chronic overcrowding in the A&E in Our Lady of Lourdes Hospital, including managing scheduled care and unscheduled care, reviewing peaks and troughs and how to anticipate and respond to these peaks. She said they were also planning for the winter period to ensure senior decision-makers are available at all times. The spokesperson said the group is actively engaged in the implementation of the National Clinical Care Programmes which will see the Acute Medical Assessment Unit extending its opening hours. This requires the provision of additional staff or their redeployment and associated service curtailment. The spokesperson added that no decision has been taken at this stage with regard to services at Our Lady's Hospital, Navan.