Unprecedented waiting times at Altnagelvin's A&E

Altnagelvin's Emergency Department- alongside emergency departments across Northern Ireland- are experiencing immense pressure as patients face unprecedented waiting times.

At the beginning of the week, 110 patients were waiting in Altnagelvin's A&E, with 40 of those waiting for a bed for further treatment.

Altnagelvin Hospital was sitting at 104% capacity as a result. The public are being advised on several occasions of long waits at Emergency Departments due to capacity issues.

The Western Trust requested the public to consider whether the Emergency Department is the best place for them to attend for their particular condition but if you are suffering from an emergency or life-threatening condition, including a mental health emergency, then call 999 or attend your nearest Emergency Department without delay.

They said: "Our Emergency Department at Altnagelvin Hospital remains under extreme pressure following what has been another very busy weekend.

"We would therefore ask the public to please consider whether our ED is the best place for them to attend for their particular condition before making the journey to ED.

"If you are suffering from an emergency or life-threatening condition, including a mental health emergency, then please call 999 or attend your nearest Emergency Department without delay.

"For all other urgent matters please use the Phone First service, where medical personnel will direct you to the best place for treatment. 

"Phone First operates from 8.00am – midnight, seven days a week. The number to ring is 0300 020 6000."

All patients are triaged as soon as possible following their arrival to A&E. Those who are triaged as most urgent or unwell will be dealt with first. 

If you are triaged as less urgent, you will face a wait of several hours in the Emergency Department before seeing a doctor.

The Trust added: "As always, we thank the public for their cooperation, and for supporting our staff who are trying their best in difficult circumstances."As a result of exceeding capacity, The Western Trust is also asking patients and their families to assist the Trust by supporting timely discharge from hospitals as the health service continues to deal with pressures on Emergency Departments.

The Trust wrote: "To help free up essential beds, which are required for very sick patients, we are appealing to both patients and families to assist by considering
if patients are deemed medically fit by the consultant/senior doctor to go home, they and their families should ensure there are arrangements in place to be picked up promptly on the day of discharge. Medical and nursing teams can help you make these arrangements.

"Also, if patients are deemed medically fit by the consultant/senior doctor to go home and are waiting on a care home placement, Trust staff will allocate the first place that is suitable for you. 
"This may not necessarily be your first choice but it is important to note that the Western Trust will work closely with you to move your family member to your first choice at a later date.

"Finally, if you are deemed medically fit by the consultant/senior doctor to go home, and there is a delay in sourcing new or additional home care (domiciliary care), you may be discharged and these elements of your care package will be organised when you get home. Additional family support may be required until the home care package is finalised."
 
The immense pressure on Emergency Departments and hospitals worsens as new data revealed that ambulance handover targets had been missed on hundreds of occasions across the country.

A new target which set a maximum limit of three hours for patients to be handed over from ambulances to Emergency Departments in Northern Ireland’s hospitals.

Health chiefs set the target in December as part of a series of measures to alleviate pressures in Emergency Departments.

However, new figures released by Northern Ireland Ambulance Service (NIAS) show the target has been missed on 16% of occasions when ambulances have arrived at hospital, with one area failing to meet the three-hour limit on more than a third of occasions.

Between the target being introduced on December 20 and January 2, the total number of ambulance arrivals at hospitals was 4,385, and the three-hour target was missed 709 times (16%).

However, The Western trust region had the best handover rate, with the three-hour maximum wait being missed 22 times from 878 arrivals (3%).

In the Northern trust region, there were 926 arrivals, with the target missed 242 times (26%).

In the Southern trust region there were 852 arrivals, with the target missed 167 times (20%).

In the Belfast region there were 1,165 arrivals, with target missed 89 times (8%).

The South Eastern trust area had the worst rate – from 564 arrivals the target was missed 189 times (34%).

 An NIAS spokesman said: “A number of measures were announced by all HSC trusts, including NIAS, prior to Christmas to improve the flow of patients through hospitals to reduce the risk to patients associated with overcrowded emergency departments and delayed ambulance responses.

“One of these measures related specifically to ambulance handover times which have been a significant factor in delayed ambulance response to those patients in the community whose need is most urgent.

“Pressures across the health and social care system have resulted in handover times lengthening over the past number of years.

“It has not been unusual for NIAS staff to wait in excess of three hours and, on occasion, significantly longer to hand patients over to staff at under-pressure emergency departments.

“The measure announced prior to Christmas was to ensure, while not losing sight of the fact that the handover target for ambulances at EDs remains at 15 minutes, that no patient should have to wait in excess of three hours in an ambulance.

“Ongoing monitoring by ambulance staff and clinicians from within the ED would remain in place to safeguard against deterioration in any patient’s condition.

“Any deterioration observed would be escalated to ED staff, who would then take appropriate steps to provide the clinical care necessary to address the patient’s needs.

“The timing of this measure, in advance of Christmas, was to embed the process in time for an anticipated surge in demand throughout January and February.

“The figures provided cover the period 20 December to 2 January and the intention and hope remains that over the coming weeks the number of handover times greater than three hours will reduce significantly.”