FOLLOWING on from last week’s article about bed management at University Hospital Waterford and ambulance delays, new figures reveal that almost three quarters (74%) of ambulances bringing patients to University Hospital Waterford (UHW) are being held up for more than half an hour.
The figures, which were obtained by Fianna Fáil General Election candidate Cllr Eddie Mulligan, show a significant increase of 52% from the same time in 2017.
“Last week’s report in the Waterford News & Star gave a very telling insight into why the Emergency Department is so regularly backed up, and why we’re seeing so many ambulance delays,” Cllr Mulligan said. “It’s obvious that urgent action must be taken to address the huge deterioration in ambulance turnaround times over the past two years, which is preventing them ensuring an adequate response to potentially life threatening emergencies.”
Ambulance turnaround times measure the time interval from ambulance arrival at a hospital, to when the crew is ready to accept another call. The HSE monitors it at 30 minutes with a target of 95% compliance compared to UHW’s 28% achieved turnaround, in that time. The Health Information and Quality Authority (HIQA) have said that all hospitals in Ireland should monitor the implementation of 95% of patients being handed over from an ambulance crew to the emergency department staff in less than 20 minutes, and where this is not met, corrective action should be taken. In the case of UHW, the 20 minute target has only 14% compliance, one in seven ambulances, compared to one in four two years ago.
“I’ve previously highlighted the practice of ambulances stacked at the doors of UHW Emergency Department acting as mobile emergency trollies with ambulance staff being utilised as emergency department support,” Cllr Mulligan said. “It’s become obvious that the HSE’s failure to deal with the trolley crisis is impacting our emergency ambulances capacity to respond to life threatening emergencies.”
A spokesperson for ambulance staff locally confirmed to the Waterford News & Star that the ED turnaround times were “concerning” for them.
“Delays in offloading patients are a result of ongoing overcrowding in the ED,” the spokesperson said. “The issue has worsened this year, with no let-up in the ED over the summer. Some crews have been delayed for upwards of three hours, which obviously affects our ability to respond to emergency calls.”
Earlier this year, UNITE attempted to engage with UHW management to introduce a “Fit to Sit” system, which would help to free up ambulance crews depending on the condition of the patient. It required cooperation from hospital management but, according to a UNITE source, that wasn’t provided, despite a similar system being introduced in Wexford General Hospital and St Luke’s, with some success.
Delays are expected to worsen over the next two months when the annual winter surge hits. The Waterford News & Star contacted the South South West Hospital Group to confirm their plans to deal with this year’s winter surge.
A spokesperson for SSWHG replied, “University Hospital Waterford is part of the Winter Action Plan that has been developed in collaboration with South East Community Healthcare. Once off funding of €26m has been allocated nationally to support the Winter Plan for 2019/2020 across all Hospital Groups and Community Healthcare Organisations.”
Unfortunately, having looked at the plan, there is no breakdown of where that €26m is being spent and the only reference to UHW is that it is part of Winter Action Group 5, stating that the hospital will receive “additional medical, nursing, therapies support, pharmacy and lab staff to improve patient experience time, improve senior clinical decision making, reduce length of stay, diagnostic time and to facilitate weekend discharges”. The plan also includes the “purchase of Aids and Appliances to reduce delayed discharges” and the “provision of step down beds to aid Patient Flow and reduce delayed discharges” amongst other provision.
The Waterford News & Star will be following up on this plan to make sure all of those measures have been put in place.