Consultant orthopaedic surgeon Mr. Peter O’Rourke in his office at Letterkenny University Hospital. Picture: Declan Doherty
MORE than forty operations have been cancelled in Letterkenny University Hospital since the start of the year, new figures reveal.
Seven cases have been deferred this week alone, leading two surgeons to question the new System Wide Escalation Framework escalation protocol agreement which they believe “effectively castrates local bed management”.
The escalation protocol, issued as a directive to acute hospitals last November by the minister, Leo Varadkar, makes it compulsory for hospitals to take specific steps to address emergency department overcrowding when it reaches crisis levels, including cancellation of non-urgent surgery.
Mr Peter O’Rourke, Consultant Orthopaedic Surgeon at LUH, likened it to ‘Groundhog day’.
“It’s the crisis that just keeps on giving. I’ve arrived into work this morning (Wednesday) to find that my list has been cancelled again – the same four patients as last week.
“My orthopaedic colleague’s list was cancelled yesterday (Tuesday) and half of the general surgery list too,” Mr O’Rourke said.
The consultant orthopaedic surgeon, who previously had to cancel four out of five hip operations planned in early February, blamed the health minister’s new escalation protocol which he said ‘effectively castrates local bed management’.
“There’s five empty beds on the Orthopaedic Ward. They’re not suitable for patients currently in ED but we can’t use these beds because of escalation policy. I really don’t know,” he added.
Another consultant, who asked not to be named, wondered whether somebody would have to die before common sense prevails.
“What is the likelihood that some of these patients will re-appear as emergency patients through the ED and the question should be asked if lives are being put at risk due to the ongoing cancellation of such theatre lists,” he said.
It’s ironic, therefore, that figures released by the Irish Nurses and Midwives Organisation (INMO) this week found that there was a huge reduction in the number of admitted patients on trolleys in LUH, in February 2016 compared to February 2015.
The figures, arising from analysis of its Trolley/Ward Watch figures, confirm that there were 154 admitted patients on trolleys in Letterkenny as compared 537 in same month in 2015 – drop in 373.
In reply, a spokesperson for Saolta Hospital Group confirmed that the Emergency Department at Letterkenny University Hospital had been extremely busy over the last number of days and, as a result, there has been an increase in the number of patients waiting for admission.
“Due to this increased level of activity and subsequent admissions, it is regrettable that some patients may experience a delay in being transferred from the Emergency Department to a hospital bed,” she said.
The hospital is taking immediate steps to respond appropriately and the measures being put in place include the deferral of most elective surgery and ensuring that all available bed capacity is being utilised, the statement said.
“We regret having to postpone any elective procedure and recognise that it can be distressing for the patients and their families.
“Convalescence beds are being procured on a daily basis from private nursing homes to facilitate discharge and we’re working closely with all the hospitals in the Group to ensure that capacity on all sites is maximised,” the spokeswoman said.
The Saolta Hospital Group was also quick to dismiss any suggestion that lives were being put at risk due to the ongoing cancellation of such theatre lists.
“Definitely not. All cancellations are scheduled or planned admissions only, all urgent cases or those that are cancer related proceed as usual. The latter includes all life limiting conditions,” she said.
What plans are in place to ensure that waiting lists are monitored and controlled?
There is a weekly meeting to monitor access to scheduled care and to plan arrangements around ensuring that those who are waiting longer than expected have their procedure done in a timely fashion,” she said.
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