Alex White (Dublin South, Labour) | Oireachtas source

I thank the Senator for raising this issue. Between 2012 and 2013, a 14% reduction was achieved nationally in the number of emergency department patients waiting for ward bed accommodation. When compared to the baseline year of 2011, there was a 33.8% reduction in 2013. This is equivalent to 29,200 fewer patients waiting on trolleys, a reflection of the willingness and ability of the system to manage each temporary crisis that occurs. A total of 4,015 fewer patients have had to face trolley waits since we began to actively address this problem in 2011, quite an achievement in the face of the ongoing crisis referred to by the Senator.

The trolley counts for the first few weeks of 2014 in some hospitals are disappointing for the Department, the INMO, the HSE and the special delivery unit, but much more so for the patients and their families for whom these delays add discomfort and further distress. However, as Minister Reilly has stated regularly in recent weeks, these pressures are anticipated in the early part of the year and time and again the system has proved it can come through these peaks, stabilise and continue to improve.

One of the elements which assists in all areas of acute hospital practice, including emergency and acute medicine, is the introduction of medicinal product prescribing by trained and registered nurses and midwives, as the Senator correctly outlined. Nurse and midwife medicinal product prescribing has been in place in Ireland since 2007, underpinned by legislation and the Nursing and Midwifery Board of Ireland, NMBI, regulatory framework, whereby nurses and midwives must be registered as nurse prescribers. There are currently 650 registered nurse prescribers. Professional guidance is in place with regard to the scope of nursing and practice, and specifically on nurse and midwife medicinal product prescribing. There is, therefore, no barrier to advanced nurse practitioners who are registered as nurse or midwife prescribers with the NMBI prescribing to patients in the accident and emergency department at University Hospital Galway or in any other acute hospital.

No single trend or factor is wholly accountable for the peak pressure encountered at this time of year and no single action will address these pressures. However, University Hospital Galway has made steady improvement using a combination of actions, such as prioritising diagnostics of inpatients over outpatients to enhance patient flow; the transfer of patients to other hospitals within the west and north west hospital group; increased ward rounding; the use of a surgical day ward; the use of a medical assessment unit in tandem with the emergency department; and a focus on the use of nursing home and long-stay beds with colleagues in primary care.

These actions aid progress, with numbers awaiting admission reducing from 29 on Monday, 27 January to 22 on Monday, 3 February and 17 yesterday, Monday, 10 February. While these numbers are still unacceptably high, I am confident that with sustained effort, supported by senior management, Galway can achieve the type of reductions it has shown it is capable of, namely, a 34.1 % reduction, or 266 fewer patients on trolleys, between 2011 and the end of 2013.