The Northern Health and Social Care Trust has unveiled a six-point plan in a bid to reduce pressure on the emergency department at Antrim Hospital this winter.
With demand expected to peak during the first three weeks in January, staff at the hospital are bracing themselves for an escalation in demand.
With increasing numbers presenting themselves at the emergency department, in recent weeks, the Trust has had to take to social media in urging patients to consider alternatives unless they absolutely need urgent treatment.
In a bid to cope with the anticipated demand, early in the New Year, the Trust’s plan involves the recruitment of clinical staff, partnership with care providers in the community and promotion of staff well-being.
Yesterday, when the Times visited Antrim Hospital, 79 patients had arrived in the emergency department between midnight and 1.10 pm with 17 people still awaiting beds, three ambulances en route and a total of 67 ambulances expected by the end of the day.
One patient had been waiting almost 20 hours for a bed in a medical ward and another, 19 hours and 47 minutes.
On Tuesday, 48 patients had been waiting more than 12 hours for treatment.
One day last week, there were as many as 76 people waiting in casualty at one time with 27 arriving within one hour alone.
On average, 230 people attend Antrim Hospital’s emergency department each day. Approximately 88,500 are expected to have been treated this year. A quarter of this number have been childen.
Wendy Magowan, director of medicine and emergency medicine, said: “These pressures are not of Emergency Department’s making. When you run out of beds, people remain in the Emergency Department. There is nowhere to move on to. An acute hospital is so dependent on everyone else doing their job at the right time.
“It is not that ED is not putting the patients through, there is nowhere to put the patients to actually examine them. People in the waiting room worries staff.
“Our main issue is the workforce. There are not enough nurses.”
Currently there are 100 nursing vacancies at Antrim Hospital. The Trust is recruiting up to 30 nurses and six doctors who will go on to staff a new 24-bed ward when it opens in April.
The hospital also relies on the support of the Belfast hospitals and Ulster Hospital in Dundonald to help manage the load and vice versa.
“In a period of extreme escalation, our neighbouring Trusts are our greatest friends,” said Wendy.
“We need to work together to manage our workload,” she added.
She recalled a particularly hectic day lastJanuary when Antrim was also called upon to accommodate ten additional ambulances to help out the Ulster Hospital.
Antrim Hospital’s six point plan also includes promoting its direct assessment unit which caters for direct referrals from GPs in the Northern Trust area and paramedics and has halved admissions.
Antrim Hospital has also introduced a 1.00 pm discharge policy. Forty-two people with complex needs were expected to leave the hospital last Wednesday alone.
Assessments are carried out every two hours to see which beds have become available.
Some surgical beds will be redesignated to medical wards to cater for increasing numbers this winter.
The Trust’s six point plan also includes encouraging uptake of the flu vaccine among hospital staff with an uptake target of 40 per cent.
There will also be winter planning events with independent providers such as care homes and domiciliary care as well as “proactive GP rounds” at nursing homes.
The overall objective is “to prepare safely for an increased number of patients presenting at our acute hospitals this winter”.
Wendy added: “The hospital is too small for the population it serves. “
Currently, there is a “business case with the Department of Health for consideration for an additional new 72 bed unit.
The medical director maintained that despite the pressures, it remains “an extremely efficient hospital” and “compares very favourably with other hospitals in Northern Ireland”.