Mary Harney (Dublin Mid West, Independent)

A number of emergency departments have been recording high numbers of patients waiting to be admitted to hospital in recent weeks. However, detailed sampling from 24 hospitals, which began in February last year, to the end of December indicate that 87% of all patients attending an emergency department were either discharged or admitted within the maximum target of six hours, and 94% of all patients who did not require an admission were discharged within this time.

I do not believe that the "trolley count" figures for patients awaiting admission are an adequate indicator of performance in emergency departments as they only record the waiting time from when a decision has been taken to admit. From the end of March, the HSE will record waiting time from when a patient arrives in the emergency department. This will be a far more meaningful record of patients' experience in emergency departments.

I have been monitoring the situation in emergency departments very closely. I met with the chairperson, CEO and members of the HSE management team recently to review progress and to ensure that all possible steps are being taken to minimise the waiting time for patients awaiting admission. I asked the HSE to streamline the administrative processes for dealing with applications under the fair deal so that the discharge of patients to a suitable long-stay facility is not delayed unnecessarily.

The HSE has put several actions in train including escalation plans to enable patients to be moved to wards, additional ward rounds to take place daily to help earlier discharges from hospitals and ensuring access to additional diagnostic facilities such as imaging to allow earlier decisions about admission or discharge. At my request, the HSE is also putting in place a system of early warning measures so that corrective action is taken as soon as problems in a particular hospital are identified. Hospitals have also been instructed to ensure that all escalation measures are implemented and reviewed as necessary and that appropriate liaison arrangements with primary and community services are in place.

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