Ambulance delays of up to 14 hours as overcrowding and Covid-19 take toll

An ambulance’s turnaround time is measured from the point of its arrival at an emergency department to when it is ready to accept a new call.

An hour is double the time set as a target by the HSE.

However, the resurgence of the trolley crisis in recent months is leading to a return to major pre-pandemic delays where ambulances have to sit and wait until a patient can be placed on a trolley.

John McCamley of Siptu, the union which represents ambulance staff, said the upsurge in patients attending A&Es is having a knock-on impact.

He said the volume of calls to the national emergency operations centre for ambulances in January rose to 31,115.

This compares to 25,658 in 2019. Last month, calls rose to 23,776 compared to 22,529 for the same month in 2019.

“It is fair to assume any increase in call volume on its own would cause a knock-on effect in availability of ambulances,” Mr McCamley said. “But this, combined with delays in emergency departments, has caused additional pressure on the service and on ambulance crews.”

So far this year ambulances have been held up on three occasions for seven to 14 hours at Letterkenny General Hospital. They have been delayed for four to five hours on eight occasions at Waterford University Hospital.

And at Sligo Hospital, ambulances were kept back for four to five hours on five occasions.

Mr McCamley said the hospital emergency department has become a “choke point” for wider issues in the health service. The serious issues need to be tackled as a matter of urgency, he added.

Mr McCamley pointed to a shortage of radiographers and also porters which can slow patient flow through A&Es.

There is also an issue with more than 500 patients who cannot be discharged because they do not have the needed step-down supports, including home care.

Last month nearly 10,000 patients found themselves on trolleys – up from 8,515 in the same month pre-pandemic.

The worst-hit were University Hospital Limerick, Cork University Hospital, Letterkenny University Hospital, Galway University Hospital and Sligo University Hospital.

The Irish Nurses and Midwives Organisation (INMO) which collects the figures said that “we know if a patient is on a trolley for more than five hours it can have a significant knock-on impact on their health and mortality”.

“State agencies – such as the Department of Health, Hiqa and the HSE – need to step up to their responsibilities and take decisive action,” it added.

Other hospitals under serious pressure last month were St Vincent’s Hospital, Dublin, St Luke’s Hospital, Kilkenny, Tipperary University Hospital and Mullingar Hospital.

The HSE, in its service plan for this year, said there will be continued investment in community care to allow patient access the support they need and reduce the burden on A&Es. It said that “as we shift care to the community, the profile of patients presenting to emergency departments will likely have an increased severity of illness.”

However, the reality is that after the worst of the pandemic, more patients – including many elderly – are turning up to emergency departments in a frail state and needing a longer stay in hospital.

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