Misery of 12 hour waits in A&E

The waiting times target is that 95 per cent of patients should be seen within four hours.

Over the past four years, the four hour waiting time performance in Enniskillen has been declining for new A&E patients and patients returning without an appointment.

In 2011-12, 94 per cent of new patients and unplanned reviews were seen within four hours in the former Erne hospital. In 2012-13, following the move to SWAH, that was down to 91 per cent; in 2013-14 it was at 90 per cent and in 2014-15 it was down to 89.4 per cent.

More than 30,000 patients attended SWAH’s A&E department from April 2014 to March 2015, with 89.4 per cent seen within the target waiting time of four hours.

The Ministerial target for emergency care waiting times last year was 95 per cent of emergency department patients being treated and discharged home, or admitted, within four hours.

In addition, no patient attending any emergency department should wait longer than 12 hours.

The Northern Ireland Hospital Statistics: Emergency Care 2014-15 bulletin shows that SWAH encountered a total of 30,740 patients in its A&E last year: 28,072 were new patients; 1,739 were unplanned reviews (patients who showed up without an appointment for the same complaint for which they had previously attended in the last 30 days); and 929 were planned reviews. This was a slight increase on the previous year when there were 30,042 attendances at A&E.

Almost 90 per cent (26,647 people) were seen within four hours of arriving in A&E; 10.6 per cent (3,154 people) waited between four and 12 hours and 10 people waited more than 12 hours. SWAH’s performance was better than the Trust wide average of 82.6 per cent being seen within four hours and the Northern Ireland-wide average of 77.5 per cent being seen within four hours.

Commenting on the statistics for the South West Acute Hospital, Enniskillen, Geraldine McKay, Director of Acute Services for the Western Health and Social Care Trust said: “The performance of the Emergency Department at the South West Acute Hospital, Enniskillen against the four and 12 hour standard is one of the best in Northern Ireland and our staff must be commended for all their sustained efforts.

“The Western Trust is committed to ensuring that patients wait for as short a time as possible in our Emergency Departments. Like all other Trusts we are experiencing significant pressures and an increasing demand in our Emergency Departments but remain one of the highest performing Trusts in Northern Ireland against the ministerial standards.

“We are continuing to work closely with our commissioner the Health and Social Care Board (HSCB) to alleviate pressures in Emergency Departments and throughout the hospital system to ensure the number of patients waiting over four hours in our Emergency Departments are reduced further.” AMBULANCE The Western area also failed to meet the ministerial target of 72.5 per cent of Category A (life threatening) ambulance calls being responded to within eight minutes, 67.5 per cent in each Local Commissioning Group (LCG) Area. There were almost 24,000 urgent ambulance journeys across the Western Trust last year, with 57.7 per cent of category A (immediately life threatening) calls responded to within eight minutes.

A spokesman from the Northern Ireland Ambulance Service (NIAS) tells The Impartial Reporter that the targets "are challenging" for a number of reasons including "annual increase in demand on the service, acute service reconfiguration, continuing delays in hospital turnaround times and the rural nature of the region." He continues: "The NIAS Trust continues to address these issues in collaboration with our colleagues in the acute Trust setting and others in the HSCB and DHSSPS."

He continues: "At first glance these performance figures are disappointing but further analysis of the figures for the Western Trust area shows that NIAS is not only attending more calls in general and more Category A calls specifically but that we reached 75 more Category A patients in 2014/15 than we did in 2013/14.

"In 2014/15, in the Western Trust area, we attended a total of 27,017 999 calls, compared with 23,152 999 calls in 2013/14 – an increase of 3,865 calls (16.7 per cent).

"In 2014/15, we attended a total of 9,248 Category A calls compared with 8,204 Category A calls in 2013/14 – an increase of 1,044 calls (12.7 per cent).

"In 2014/15 we attended 5,539 Category A calls within 8 minutes compared with 5,464 Category A calls in 2013/14 – an increase of 75."

Commenting on the difference between performance in Derry Council and Fermanagh Council, the spokesman points to the challenge of getting to a rural location within eight minutes.

"It is obvious that in centres of dense population, 999 calls will involve shorter distances leading to a faster response than those areas which are situated further from NIAS response stations. However the Trust has always taken steps to ensure that the fastest response is provided to all who require our assistance. We have opened a number of deployment points throughout the Western Trust area including Irvinestown and Lisnaskea, to spread our resources throughout the rural area," he states.

"The NIAS Trust can also point to data which shows that per 10,000 head of population within Fermanagh district we plan 6.8 A&E shifts weekly compared to 3.43 in Derry.

"In 2014/15 we responded to 5,349 999 calls in Fermanagh compared to 10,906 999 calls in Derry.

"We responded to 87.2 per cent of Category A calls within 8 minutes in Enniskillen compared to a performance of 71.3 per cent within Derry."

He concludes: "NIAS recognises the immense efforts of our staff in delivering an increased number of sub 8 minute Category A responses despite the 12.7per cent increase in activity. It is the dedication and commitment of these staff – those in the frontline and those who act in all the various support roles – which ensures that we can maintain the confidence of the communities we serve."