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NHS crisis: Northern Ireland emergency care figures 'as bad as can be'

For the past month I have been travelling round the UK reporting on the health service.

Scotland, Wales and England have all documented their NHS performance and I’ve been in hospitals to see what’s going on and what’s going wrong.

In all, the same issues have cropped up; a rise in demand for A&E, ageing patients, staff shortages and lack of GP services.

Unsurprisingly, it’s no different in Northern Ireland, where I am on Thursday.

Performance figures for A&E are as bad as they could be, the number of patients waiting more than 12 hours over the Christmas period tripled on the year before and Thursday's figures for the last three months of 2019 mirror that.

Jessica-Lee has been sleeping in a make-shift ward in a corridor at an hospital. Credit: ITV News

An astonishing 14,216 patients spent more than 12 hours in emergency departments between October and December last year.

From April - December, the number spending the same time (12 hours) in A&E doubled on the year before, from 15,106 to 32,326.

This is staggering - the four hour wait target appears to have gone out of the window, just 54.8% of patients in December were seen in this time.

It’s more than half, granted, but the target is 95%.

One of the doctors at the Consultant Emergency Antrim Area Hospital, Mark Jenkins, told ITV News: "Capacity is always going to be an issue.

"This place was built for 90,000 people, six years ago.

"We've breached that already with 95,000 this year so we will always have a capacity issue within our system."

Mr Jenkins said: "But as long as we can maintain our patient's safety, care and needs and that is what we have to do as doctors.

He adds: "We strive to make our patient's needs as best as we can with the resources that we have

"And that's ultimately what you do, you come in as a doctor or a nurse and you're professional... the main focus is on the patient so we're trying to do the best that we can for the patients."

Northern Ireland waiting times crunched:

  • More than half (54.8%) of attendances at A&E departments in December 2019 were treated and discharged, or admitted within four hours of their arrival, compared with 62.2% in December 2018.
  • Almost four in five (78.9%) patients attending a specialty A&E (for example, dental) in December 2019 were treated and discharged, or admitted within four hours of their arrival, compared with 82.7% in December 2018.
  • Between December 2018 and December 2019, the number waiting longer than 12 hours more than doubled from 1,991 to 5,280, accounting for 8.1% of all attendances in December 2019.

There are a number of things going on in Northern Ireland which are exacerbating the problem and aren’t affecting the rest of the UK.

The first is GP surgery closures.

A lack of doctors and funding is forcing dozens of surgeries to close, meaning thousands of patients are without a GP and the only option they have is to visit A&E when they’re ill.

We spoke to Dr Michael McKenna who runs a single GP surgery in Belfast.

He’s been trying to recruit a second doctor to help with this work load for months but says no one wants the role.

His patients have increased by 800 in the last 10 years and he now sees up to 60 patients day, his situation he told us, is desperate.

From April - December, the number spending the same time (12 hours) in A&E doubled on the year before. Credit: ITV News

Another problem facing Northern Ireland are the nursing strikes.

Nurses are fighting for safe staffing measures and pay parity with the rest of the UK.

They have staged a number of strikes, adding to pressure in hospitals which are already short staffed.

The knock on effect is huge, it’s not just emergency departments affected but surgical procedures have been cancelled as well as thousands of outpatient appointments.

The backlog will take months to clear.

That, along with winter, has created a perfect storm in Northern Ireland’s health service.

Another problem facing Northern Ireland are the nursing strikes. Credit: PA

So bad the situation, one of the country’s top doctors has warned that the sector has "fallen over the cliff edge".

Dr Ian Crawford is the Vice President of the Royal College of Emergency Medicine there, he told us that patient safety is being put at risk.

The notes of caution we used to hear have gone, doctors are now openly warning that something bad is going to happen unless the system is fixed.

What’s worrying or perhaps scandalous is a better word, is that it’s patients who will and are suffering.

Doctors and nurses are doing everything they possibly can to keep patients safe but ultimately it will be a patient who suffers the consequences and that will be a scandal.

Northern Ireland Health Minister Robin Swann said the waiting times were 'simply not good enough. Credit: ITV News

Northern Ireland Health Minister Robin Swann said the waiting times were "simply not good enough".

He added: "The people of Northern Ireland deserve better.

"I have written to the chief executives of each of the Trusts, requesting detailed assessments of the situation.

“We all owe a debt of gratitude to the staff who continue to work through these pressures, however, we need to fix things for their sake as well as for patients.

"I fully recognise that there are no quick or easy solutions.

"As with other parts of the health service, sustained investment is required alongside reforms to the way services are delivered...

"Looking to the longer-term, I welcome the fact that the Department [of Health] is progressing a clinically-led review of urgent and emergency care, with a view to transforming services.

"An initial report is expected shortly, which will outline the current challenges and explore some potential solutions.”