Christmas crisis facing Northern Ireland health service - with additional concern over possible flu surge

At a media briefing on Wednesday, it was revealed that one patient had to wait four-and-a-half days in a hospital emergency department, while other patients are spending up to ten hours in the back of an ambulance waiting to access an emergency department.

It was also revealed yesterday that a man died in recent days after waiting nine hours for an ambulance to arrive.

Setting out the scale of the crisis facing the health service in Northern Ireland, chief medical officer Sir Michael McBride said he had serious concerns about the ability of the health service to get through the winter.

Earlier this week health trust chief executives set out new measures to tackle hospital pressures, including patients leaving hospital no later than 48 hours after they are medically fit for discharge, where a suitable placement is available.

The high number of patients who are deemed fit to be discharged from an acute hospital setting but, for a variety of reasons, are not being progressed to their home environment or an appropriate care home, is a significant problem.

At midnight on December 20, a total of 569 patients in hospitals had been declared medically fit to leave but were waiting on care packages.

The knock-on effect of this is that almost 400 patients in emergency departments on Monday morning – who had been assessed as requiring hospital admission – had no bed available. This is understood to be one of the highest rates ever recorded.

The newly released figures also show that of 542 patients in total in emergency departments waiting for treatment, 447 had been waiting longer than four hours and 300 had been waiting longer than 12 hours.

The longest wait for treatment was recorded at 107 hours, 43 minutes.

At the same time there were 22 ambulances parked outside emergency departments with patients waiting to enter.

Health chiefs are concerned that the situation will deteriorate further at the beginning of next year, when there is historically a spike in numbers needing hospital treatment.

Sir Michael said: “As chief medical officer I have very serious concerns about the ability of the health service to get through this winter.

“I cannot recall a time when concerns across the system were at this level.

“Our workforce is exhausted, our health service is still dealing with the many consequences of the pandemic.”

Sir Michael also said that the strike action taken by nurses and other health workers was having an impact.

“The cumulative impact of industrial action, and the seasonal impacts of flu and Covid, are likely to cause further pressures after the Christmas holidays,” he said.

“The health service is extremely fragile and an extraordinary effort by staff has been required for many months up to now.”

Sir Michael said we “will all need to play our part in supporting our staff to get through the coming weeks,” and added: “We, the public, need to get our flu and Covid-19 vaccines to protect ourselves, others and the health service from potential surges from these viruses.

“If you need urgent help then our health service is here for you, but we do need to use it wisely, and I ask everyone to work with hospital teams to support the discharge of your relatives when their medical care is complete."

At the same briefing, the director of primary care and older people with the South Eastern Trust said a more elderly population presented particular challenges.

Nicki Patterson said: “Covid has not been kind to our frail, elderly population. So, in addition to all of the growing pressure that was emerging pre-Covid… the percentage of old in our population is rising inexorably and particularly the very old”.

Ms Patterson added: “While it should be celebrated that we have an older population, many of those individuals have come through Covid, have presented late around some of the challenges with their ongoing long-term illnesses… often their needs when it comes to the point of discharge are even more extensive than they would have been pre-pandemic”.