Hospitals are stretched to the limit across the country, the Irish Nurses and Midwives Organization said, saying it had never seen this level of overcrowding before at this time of year.
The organization said that all hospitals, large and small, are struggling and staff are finding it difficult to provide safe care.
The INMO wants public and private hospitals to act as one to alleviate the pressure and prevent the situation from worsening.
Phil Ni Sheaghdha said that “any emergency measures that are required must be taken immediately because if this worsens it will be impossible to treat safely.”
She said “normally we wouldn’t see numbers as high as today, 570 people sick enough to be admitted to hospital and not enough beds.” Ms. Ni Sheaghdha said that traditionally you wouldn’t see him until early in the new year.
“We have never recorded figures like this, at this level of overcrowding.”
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She said INMO members say people have no choice but to attend emergency departments because they can’t see their GP.
“We know that this is going to get worse, so we have called for all services to be available, public and private hospitals to work together to alleviate the pressure on public facilities,” he said.
The Health Service Executive agreed to support GPs to run additional clinics during the current period of high pressure on the health system.
Follow discussions between HSE, with support from the Department of Health, and the Irish Medical Organization.
The Irish Medical Organization said there is a significant increase in patient demand for GPs due to the prevalence of influenza, covid and other respiratory diseases.
In a letter to GPs, the HSE said the current “exceptional” pressure on them and acute care hospitals is expected to last for several weeks.
The measures include grants and grants to allow them to expand existing clinics or run additional clinics, although both the HSE and IMO say they recognize that not all practices will be in a position to do this.
The IMO said that GPs can schedule additional or extended clinics in the afternoons on weekdays from 5:00 pm to 7:00 pm and between 9:00 am and 1:00 pm on Saturdays.
The organization said there has been a significant increase in demand for GP care due to the prevalence of influenza, Covid-19 and other respiratory illnesses.
The latest figures from the Center for Health Protection Surveillance show that there were 737 confirmed cases of Covid-19 in the hospital at 8am this morning, 35 of whom were in intensive care.
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‘Situations getting worse’
Irish Emergency Medicine Association president Dr Fergal Hickey said the current pressure on emergency departments is “the latest in a series of worsening situations”.
Speaking on RTÉ’s Drivetime programme, Dr Hickey, who was also a consultant at Sligo University Hospital, said Ireland entered the clinical winter of 2022/2023 with very few hospital beds and “the dogs in the street know”.
“Emergency departments have been under pressure for months and this is just the latest in a series of worsening situations,” he said.
Dr Hickey added that Ireland has 2.8 acute hospital beds per thousand inhabitants, compared to the OECD average of 4.3.
He said there are normally little to no electives active in Christmas week so the high number of patients on trolleys at hospitals across the country is a reflection of the emergency workload.
Dr Hickey said he doesn’t hold out much hope that additional GP hours or an overtime solution will make a difference.
“The people who end up in the carts are the ones who need hospital admission, so whether they come directly to the ER or are referred by a GP, if there is no bed for them, they are going to end up in a situation where that they will be in carts,” he said.
He added that any additional capacity in primary care is welcome, but it will not solve the bed capacity problem.
Dr Denis McCauley, chair of the IMO GPs subcommittee, said he was “unsure” how many GPs will volunteer for the scheme, citing capacity issues.
“It’s not that general practice is silent, that you can actually do this,” he told RTÉ’s Morning Ireland.
“We are very busy, we also have our own capacity issues. There will come a stage around 4 pm or 5 pm in the afternoon where it will be so busy that we won’t be able to extend our surgeries and see these patients.”
Dr McCauley added that many GPs are at risk of burning out after such a long period of intense demand for doctors.
He explained that Letterkenny University Hospital is under a ‘code black’ emergency “96% of the time”, because the hospital does not have the capacity to treat patients with flu and other winter viruses.
After the recent outbreak of strep A, he stressed that there may be a shortage of antibiotics.
“Concern about strep A has made patients and parents more inclined to attend early, and as a result of that … there is a relative shortage of antibiotics from time to time,” he said.
‘Crisis in the GP workforce’
Irish College of General Practitioners (ICGP) Medical Director Dr Diarmuid Quinlan said there is a crisis in the general practice workforce.
Dr Quinlan said that while HSE’s expansion of GP clinics is welcome, many GPs are already working to capacity.
Dr Quinlan said the ICGP published a paper in October calling on the government to set up a task force to look at solutions to the workforce crisis and workload in general practice.
“And we ask the minister to establish this working group, considering the future of general medicine as an urgent requirement, in early January 2023 so that we can analyze and implement the innovative solutions and also provide resources for these solutions,” he said. .
On antibiotics, Dr. Quinlan said there is no cause for concern in terms of stocks in the country.
“I reviewed this this morning and we have an adequate stock of antibiotics in the country for the needs of our population,” he said.
However, he said some pharmacies are experiencing distribution problems, but he is “absolutely certain” there is adequate stock.
Dr Illona Duffy, medical director of Monaghan-based North-East Doctor on Call, said most GPs don’t have the capacity or ability to extend surgery hours, so he doesn’t see many GPs being able to do the extra work.
Speaking on RTÉ’s Drivetime programme, he said many GPs are frustrated because there is a feeling there will be an expectation that they will work longer hours.
Advice for elderly and vulnerable people
Meanwhile, the Department of Health’s director of nursing, Rachel Kenna, issued tips to help the elderly and vulnerable stay healthy through the rest of Christmas.
Speaking to RTÉ’s News At One programme, Ms Kenna said: “It’s really important to make sure older people have social contact and that we check on older and vulnerable neighbors and relatives to make sure they have things like medicine, that they keep warm and that they are well and well”.
Ms Keena said the elderly and vulnerable should wear masks if people visit their homes and should also ask visitors to wear masks.
He also said it’s important to make sure immunizations and boosters are up to date.
“It’s okay not to allow people to visit you at home or where you live if they have any symptoms,” added Ms Kenna.
“In fact, we are advising anyone with symptoms to stay at home and not move around.”
She said that if people do congregate, they need to make sure it’s a ventilated area and that people are wearing masks.
She said Covid, the flu and respiratory syncytial virus (RSV) are being seen in submissions to emergency departments.
“There are many things you can do, stay well fed, stay warm, and most importantly stay active,” said Ms. Kenna.
Emergency departments are open, and while under pressure, people can attend and get the care they need, he added.
He also urged people to use other resources for care, such as pharmacies, GPs “where we can” and minor injury units.
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