Dr. Colm Henry:

Patients who come into emergency departments are triaged according to an established Manchester triage score and according to immediate, urgent need, which is category 1. Category 2 is where the patient needs to be seen within 15 or 20 minutes. Then, there is category 3 and so on. What we find with increasing demographic pressures is that more and more people coming in year after year are getting older and clearly have more urgent need as well.

Notwithstanding the safety implications of overcrowding, there are triage systems in place that generally operate to a good standard and allocate people to a triage category when they come in. If somebody, for example, is categorised as triage 1 and needs urgent, immediate resuscitation, that person will be diverted to the resuscitation room and the appropriate teams. Patients in category 2 are labelled as being of high importance to the staff. Where this system comes under threat, and Ms Day may want to elaborate on this, is where there is overcrowding and the teams in emergency departments experience demands on their care that are greater than their ability to deliver care in a timely way. That is why last winter and this winter we will have escalation plans in place to call teams down from the house, if needs be, to ensure that those who are triaged at the higher, more urgent category are seen in a timely way.

Ms Day may wish to add to that.