herald

Wednesday 7 December 2016

Treatment of patients at Beaumont A&E likened to institutional abuse

emergency

The scene in Beaumount
The scene in Beaumount

Consultants at a Dublin hospital have warned that the impact of overcrowding on patients is nothing short of "institutional abuse".

consultants at a Dublin hospital have warned that the impact of overcrowding on patients is nothing short of “institutional abuse”.

Senior medics at Beaumont Hospital told how patients waiting for a bed are concerned that their plastic chairs will be taken if they get up to go to the toilet and are anxious for their own personal safety.

The emergency medicine consultants jointly expressed their concerns in relation to conditions faced by patients in the overcrowded department in a letter to HSE Director General Tony O’Brien in December, the Herald can reveal.

BeaumountH.jpg
Beaumont Hospital

“That any patient should have to wait for a hospital bed sitting on a plastic chair and be concerned that if they get up to go to the toilet their chair will be taken is nothing short of institutional abuse and yet it happens in Beaumont Hospital on a daily basis for in excess of 20 patients,” said the letter, which outlined the consultants’ “heartfelt” concerns about patient safety.

It appears the situation has not improved – figures from the Irish Nurses and Midwives Organisation (INMO) showed there were 447 patients on trolleys and wards nationwide yesterday, including 49 at Beaumont.

The letter, which was sent on December 16, pointed out that Beaumont has had major issues with the provision of acute hospital beds in a timely manner for those needing emergency admission whether that be through the emergency department or the out-patient department.

This situation is compounded by the fact that, persistently, 10pc of the hospital bed base is occupied by those who are awaiting step-down facilities, augmentation to home care arrangements, rehabilitation or ongoing nursing-home care, said the letter, which was signed by Dr Peadar Gilligan, Dr Abel Wakai, Ms Patricia Houlihan and Mr Aidan Gleeson.

The letter, released by the HSE to the Herald under the Freedom of Information Act, warned that the delivery of care to those who experience the first days of their acute hospital admission in the emergency department is “sub-optimal” and results in:

• Physical discomfort while spending hours and even days on a trolley or chair.

• Sleep deprivation.

• Difficulties maintaining personal hygiene.

• Lack of confidentiality.

• Anxiety for their own personal safety.

• Exposure to scenes that are distressing and disturbing.

• Loss of dignity and a sense that the staff are too busy to provide the level of care they would wish to and the patients would wish to receive; and all of this is superimposed on being unwell enough to require emergency hospitalisation, the letter said.

“The acute hospital system is failing patients requiring emergency admission and exposing them to significant further hardship,” it said.

Mr O’Brien responded to the letter on December 29. He said that additional funding of €25m had been provided in the HSE National Service Plan to alleviate the numbers of delayed discharges in hospitals.

In addition, he said that the Emergency Department Taskforce set up by Health Minister Leo Varadkar and the HSE would be focused on identifying and ensuring implementation of sustainable solutions.

A statement from the hospital yesterday said that “Beaumont Hospital regrets the difficult conditions experienced by patients and staff at its Emergency Department (ED)”.

It went on: “The hospital has one of the busiest EDs (emergency departments) in Ireland, providing services  to over 50,000 patients each year.

“A number of factors have contributed to the continuing difficult conditions in the ED.

“Since January, there has been an increase in the number of older patients requiring emergency admission.

“Delayed discharges, in particular, have led to considerable strain on resources. In 2015 there was an increase in influenza within the community and the hospital.”

The hospital said it has undertaken initiatives internally within teams and departments and externally with the HSE to improve the “patient pathway” both through the ED and the hospital, in addition to working closely with the community. All available bed capacity is open.

“Beaumont Hospital has been actively working with the community to increase discharges,” the hospital said.

“Nursing posts have been assigned to the ED to deal with the demand, while a wider recruitment drive for additional staff continues.”

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