Concern for patient outcomes across the North East as hospital waiting lists grow and Emergency Departments overstretched

• 7,370 additional people added to outpatient and inpatient/ day case waiting lists since October 2015;
• Government on course to miss waiting list reduction target by 3,870; 
• Orthopaedics, Urology, Dermatology, Rheumatology and Cardiology outpatient waiting lists in North East hospitals increase by 51% on average;
• One in four approved permanent hospital Consultant posts in the region are not filled as needed;
• Capacity deficits resulting in average Emergency Department wait times of 10 hours at Our Lady of Lourdes Hospital;
• 1 in 7 patients aged 75 years and older waiting longer than 24 hours for admission or discharge;
• IHCA President Professor Rob Landers: “The waiting lists and wait times in the North East confirm Consultant’s fears that without addressing the very obvious shortages of Consultants, hospital beds, theatres, diagnostic and other facilities the Government will not address the core problems facing our public hospitals in the region.”

The Irish Hospital Consultants Association (IHCA) has warned that patient outcomes across the North East are being compromised due to increasing waiting lists, overstretched emergency departments and growing hospital cancellations. 

Severe public hospital capacity deficits across the region along with an ongoing shortage of Consultants is restricting patients from accessing timely, high-quality medical and surgical care.
 
New analysis from the IHCA shows that between October 2015 and October 2023, an additional 7,370 (+26%) people have been added to hospital outpatient, inpatient and day case waiting lists across the North East.  A total of 36,300 people are currently waiting for hospital care.¹
 
The latest National Treatment Purchase Fund (NTPF) figures also show an increase in the number of people waiting for treatment at the four hospitals in the region this year. It means that the Government is on course to miss reduction targets set out in the Waiting List Action Plan for 2023 by a wide margin. 

The €443 million plan aims to reduce waiting lists for outpatient, inpatient and day case appointments and procedures by 10% or 69,000 nationally by the end of the year, compared with the number waiting at the start of 2023. 

This would equate to a reduction of around 3,500 people at Our Lady of Lourdes, Drogheda, Cavan General Hospital, Louth County Hospital and Our Lady’s Hospital, Navan.

However, 10 months into 2023 and instead of an expected reduction of around 2,950 people by the end of October, an additional 920 (+3%) people have been added to the three main waiting lists across the region’s hospitals, resulting in a shortfall of 3,870 against the waiting list target.

The five specialties of Orthopaedics, Urology, Dermatology, Rheumatology and Cardiology have seen some of the largest increases in waiting lists. These patients run the risk of either a delayed diagnosis of skin and other cancers, an undiagnosed heart condition, or may be living with increased pain while awaiting hip or knee surgery or treatment for arthritis. These lists have increased by an average of 51% since 2015:
 

 
The busiest hospital in the region, Our Lady of Lourdes in Drogheda, has seen its overall outpatient waiting list increase by 38% over the past eight years to almost 15,500. 
 
Drogheda consistently has one of the largest number of patients in any hospital who are medically fit for discharge but whose discharge is delayed, with almost 4,600 bed days lost at the hospital due to these delayed discharges in the first half of 2023 alone.² 
 
Capacity deficits also mean patients presenting to Drogheda’s Emergency Department (ED) face long waits, with an average waiting time of 10.1 hours in the first 6 months of 2023 – a 40% increase on the average 7.2 hour wait for the same period in 2019.³ 
 
For those aged 75 and over, the average wait in ED is even longer at 13.6 hours with one in seven elderly patients having to wait longer than 24 hours the first quarter of 2023.⁴ 
 
Of the 1,000 additional hospital beds which have been added nationwide since 2020 only 74 extra beds have been opened across the North East,5 while none of the 162 additional hospitals beds planned for 2023 are located in the region.⁶ 
 
This has contributed to 1,480 cancelled hospital appointments and operations across the region in the first half of the year.⁷
 
In parallel, the number of Hospital Consultant posts that are not filled as needed in the North East is estimated at 27%, which is resulting in longer delays for patients awaiting treatment.⁸
 
Commenting on the waiting lists and wait times, IHCA President Professor Rob Landers, said: “The waiting lists and wait times in the North East confirm Consultant’s fears that without addressing the very obvious shortages of Consultants, hospital beds, theatres, diagnostic and other facilities the Government will not address the core problems facing our public hospitals in the region. 
 
“The North East has one of the lowest numbers of acute beds on a population basis in Ireland at 1.89 beds per 1,000 population.⁹ We know that over 500 additional beds are needed to bring the region up to the national average.
 
“It is unlikely the Government’s Health Budget for 2024 will result in any significant additional hospital capacity for patients in the North East. 
 
“The recently announced recruitment embargo will also have a negative impact on the medical teams and other supports required by Consultants to provide timely high quality safe care to their patients.
 
ENDS
 
1.    Latest NTFP data: https://www.ntpf.ie/home/nwld.htm.
2.    HSE PQ response to Deputy David Cullinane, 26 July 2023: https://www.ihca.ie/_fileupload/DTOCDE~2.PDF
3.    HSE PQ response to Deputy David Cullinane, 24 July 2023: https://www.ihca.ie/_fileupload/ED%20PET%20Jan%20to%20June%202018%20to%202023%20pq-35062-23-david-cullinane_merge.pdf
4.    HSE PQ response to Deputy David Cullinane, 15th May 2023: https://www.ihca.ie/_fileupload/ED%20attendances%20and%20PETs%20by%20group%20pq-20866-23-david-cullinane.pdf  
5.    The 74 additional hospital beds include 31 at Our Lady’s Hospital, Navan, 29 at OLOL, Drogheda, and 14 at Cavan/Monaghan General Hospital; HSE PQ response to Deputy Jim O’Callaghan, 15 February 2023; https://www.hse.ie/eng/about/personalpq/pq/2023-pq-responses/january-2023/pq-4772-23-jim-o-callaghan.pdf
6.    HSE Capital Plan 2023, 2 March 2023, https://www.hse.ie/eng/services/publications/capital-plan-2023.pdf 
7.    HSE PQ response to Deputy David Cullinane, 25 July 2023; https://www.ihca.ie/_fileupload/Hospital%20Cancellations%20Jan%20to%20June%202023%20pq-35070-23-david-cullinane_merge(1).pdf 
8.    HSE PQ response to Deputy David Cullinane, 28 June 2022; https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/june-2022/pq-31525-22-david-cullinane.pdf
9.    The hospitals in the North East (Cavan/Monaghan, Louth County Hospital, Our Lady’s Navan, Our Lady of Lourdes, Drogheda) collectively had 957 inpatient/day case beds available in April 2023; HSE PQ response to Deputy Cathal Crowe, 8 August 2023; https://www.ihca.ie/_fileupload/Hospital%20Beds%20in%202019%20and%202023%20to%20April%202023%20pq-36610-23-cathal-crowe_merge.pdf. The population of the North East region (Cavan, Louth, Meath and Monaghan) was 507,500 in 2022 (CSO) which gives a ratio of 1.89 beds per 1,000 population. The EU average is 4.83 hospital beds per 1,000 population.
 
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