Nurses' trolley crisis deal means surgery delay for patients on waiting lists
Thousands of patients on waiting lists for surgery are expected to have their operations cancelled in the coming weeks as hospitals are forced to comply with a new deal reached with nurses to relieve overcrowding in emergency departments.
However, other patients should be spared long delays on trolleys as they wait for a bed in dangerously crowded emergency departments.
The agreement, drawn up at marathon talks in the Workplace Relations Commission, will involve strict monitoring of a series of measures that must be triggered to free up beds when the number of patients waiting more than six hours on a trolley for a bed reaches a certain level.
The deal, which is being put to a ballot over the next three weeks by the Irish Nurses and Midwives Organisation (INMO), has led to the deferral of Thursday's nurses' strike in seven hospitals. As nurses decide how they will vote, their trust that the measures are being implemented on the ground will be crucial to any acceptance.
However, one of the consequences of the deal will be the cancellation of many planned operations for those already on waiting lists.
These patients cannot be admitted to hospital for their surgery because beds will be needed in order to reduce the number of patients waiting on trolleys.
Health Minister Leo Varadkar said he was pleased the nurses' union is recommending the deal for acceptance and he welcomed the proposals to enhance patient safety and delivery of care.
"I hope that emergency department nurses will regard the proposals as sufficiently detailed and robust to address their concerns around activation of the escalation policy, health and safety concerns and implementation of the agreement itself.
"In particular, I expect that a deeper level of trust will develop between hospital management and nursing staff through the active implementation and monitoring of the proposals."
The agreement sets out the criteria for when the measures, which include having doctors doing ward rounds to discharge patients, should kick in.
A crucial element will be strict monitoring of the agreed measures, with mandatory weekly meetings at hospital level between the chief executive, key managers, the director of nursing and a nursing union representative.
The surveillance will also extend to each hospital group, where a forum will be chaired by the group chief executive.
INMO chief Liam Doran said: "It is now imperative that the HSE, at national level and at senior level within all hospital groups, immediately commits to fully operate the revised proposals."
The agreement must be complied with round the clock and will continue until the end of March. There were 434 patients on trolleys yesterday, down from 550 last week.
The worst hit hospital was Our Lady of Lourdes in Drogheda where 42 patients were waiting for a bed. There were 31 patients waiting in St Vincent's Hospital, Dublin, and 23 in University Hospital, Waterford.
The agreement allows for a senior nurse manager to be present in emergency departments seven days a week with the necessary power to "immediately address all issues to ensure patient flow".
The HSE must also step up efforts to recruit more nurses.