Tackling hospital overcrowding and growing in and out-patient waiting lists are top of the Saolta University Health Care Group's priorities for September.
As the country's hospitals grapple with what has been described by the Irish Nurses and Midwives' Organisation (INMO ) as the worst hospital overcrowding since the Covid-19 pandemic began, the Saolta boss describes the issue as "a major concern".
"If you were to look at what is putting our hospitals under the most pressure now, it's not Covid-19 but overcrowding," says Tony Canavan, the chief executive of the hospital group which runs seven public hospitals on five sites in Galway, Mayo, Roscommon, Sligo, and Donegal.
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"Our emergency departments continue to be really busy, both with people attending, and with people awaiting admission on trolleys. The overall pattern for May, June, and July is very, very high levels of attendance."
Some 225 people attended UHG's emergency department on Monday and there were in excess of 200 on Tuesday, 54 of whom were awaiting admission on trolleys. Twenty of these patients were accommodated in the acute medical unit and 34 waited for beds in corridors. The INMO reported there were 32 patients waiting on trolleys yesterday (Wednesday ) at UHG while there were seven people awaiting beds in Portiuncula University Hospital's emergency department and a further seven waiting in wards elsewhere in the facility.
Patients on trollies
The Ballinasloe hospital's ED department has been "extremely busy" in the last fortnight, according to the Saolta CEO.
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"There were 14 patients waiting on trolleys on Monday and there have been 20 on occasion. This is a very, very high level for Portiuncula which is a medium sized hospital."
He says it is upsetting seeing people on trolleys, waiting for beds "behind closed folded curtains used to preserve their dignity". "That's no way to provide care for a patient."
Patients who deferred care during the pandemic due to fears about contracting Covid-19, the cyber attack on the HSE's IT systems, and some people using the emergency department as an alternative to attending their GPs are the main causes of the overcrowding, he says.
Cyber attack
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"Some people put off seeking care [during the pandemic]. They said: 'I'll get by' but eventually they can't get by and they need medical care. They account for quite a few cases. When you defer care, your health may worsen and your care demands may be higher."
The Galway and Mayo hospitals recovered "very significantly" from the cyber attack on the HSE's IT systems, he says. "Nearly all our systems have recovered but that does not mean that everything is back to 100 per cent. But, by and large, the impact on patient care is minimal. There is a slight difference in the north-west, in the Sligo and Letterkenny hospitals. Some of their IT systems were on a slightly different system to the ones in Galway, Mayo, and Roscommon so it is taking longer to get these up and running."
ED as an alternative to the GP
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Some patients choose to attend the emergency department rather than their GP, he says. This is contributing to the overcrowding issue, also.
"We are still seeing patients attending the ED as an alternative to going to their GP or pharmacy. Maybe their GP is not seeing as many patients or there are transport or timing issues. Some people turning up at the ED could have received care in a different setting."
Tackling the increasing hospital waiting-lists is of major concern to the Saolta group, according to Mr Canavan. "This is an area we plan to target. They have grown quite considerably because of Covid-19 and the cyber attack."
