Patient discharges, ambulance limit and using chairs: NI hospital plan for easing pressure

Emergency measures have been launched by Northern Ireland Health Trusts to try and relieve some of the massive strain on hospitals. In a desperate bid to free up beds the Trusts have ordered that patients who are deemed medically fit for discharge must leave hospital within 48 hours provided there is an alternative for them.

The Trusts pledged there will be no cost to the patient or their family for an alternative interim placement and it will not impact on their place on any waiting list for their longer term option.

Trusts and Care Homes will work closely together to make best use of any and all available capacity. This will include new shared arrangements for pre-admission assessment for care homes seven days a week.

Also, Ambulance handovers at Emergency Departments must not exceed three hours. This limit is expected to be further reduced.

The Trusts have said the measures are necessary to "reduce the risk to patients waiting in unacceptable circumstances in ambulances and EDs". In a joint statement Health Trust leaders said they are “deeply distressed at the ongoing situation in our hospitals". They added that although "strenuous efforts" are being made to alleviate the pressures, there is a serious capacity deficit.

The Trusts said that much of the impact is falling on frail and ill older people and on the staff caring for them. There is concern that pressures on services will intensify further after Christmas and into the early months of 2023. Space within hospitals is to be used to improve patient flow out of overcrowded Emergency Departments. This will also include, where appropriate, use of chairs rather than beds for patients medically fit to leave hospitals. In a joint statement from the chief executives of the Trusts they said they were expecting pressure on the system to get worse.

“These are not steps that we ever wanted or indeed imagined having to introduce," they said.

"The case for long-term investment and reform to effectively build capacity has been well made. Right now, however, we have to use whatever levers are available to us to reduce delays and prioritise patient safety."

Their statement continued: "What we absolutely require is a long-term funding settlement and a health and care system which properly reflects demographic trends and is capable of meeting rising levels of demand.

"In the meantime, we cannot passively accept the status quo, with all that it means for patient care and safety."

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