SWAH facing pressure as hundreds attend ED in one week

In addition, 16 people are in the Covid-19 ward, two are in the Covid ICU, while 29 patients are medically fit to be discharged but cannot be safely released without care packages.

On Monday night alone this week, 53 people presented to the ED, while on Tuesday morning, 29 patients were waiting in the ED, with 15 being identified as in need for a bed, and on a trolley

Moreover, one day last week, the hospital had to enter full capacity protocol to prioritise the ED, such is the scale of the pressure being experienced at the hospital, with all this marking just the beginning of the winter pressures according to a leading SWAH consultant.

Dr. Monica Monaghan, Consultant Cardiologist and Divisional Clinical Director (DCD), spoke to The Impartial Reporter this week about the current pressures within the busy hospital.

While highlighting and praising the resilience of staff at the busy hospital – and while emphasising that the hospital is open for business, despite current challenges – she also outlined three ttpes of pressure particularly affecting the hospital at present.

“We’ve got the pressure at the front door [of the ED], and then the pressure of discharging safely, and then – in the middle – we have got acutely unwell patients, including our Covid-19 patients,” she said.

As outlined above, front door attendance for the past week have been very high at the SWAH, with nearly 700 people presenting to the ED.

Dr. Monaghan said: “From November 23-29, there were 673 walk-in or ambulatory patients attending the ED.” In addition, there are also those who are treated via the same-day emergency care service.

Speaking about the pressure from safely discharging patients who are medically fit to come home, but are unable to for a variety of reasons, Dr. Monaghan said: “29 beds are occupied by patients who are deemed medically fit to go home.

“If we had the capacity in the community, for those patients to be safe [in a care home or with a care package in place], then they wouldn’t be in our beds.

“That’s why we’re so pleased to see that the Minister [for Health Robin Swann] is really putting carers and the staffing of care homes as a priority going forward because none of us work in isolation.”

Dr. Monaghan praised the innovation of the Hospital at Home project in working with patients who have been discharged, which was introduced during the pandemic.

A sign of pressures mounting on the hospital came last week when on November 23, the SWAH implemented its full capacity protocol in response to the numbers of people present and attending.

Dr. Monaghan said: “This was the first time the SWAH has done that, and we’re not even in December [when a seasonal winter increase may be expected], because we had 25 patients who had been designated as requiring a bed.”

Explaining what happens when this protocol is in place, Dr. Monaghan said: “We immediately went into escalation mood.

“The acute medical team attended the ED; as a cardiologist and a DCD, I attended the ED; the manager of surgery attended the ED; the manager of medicine also attended, and there were two emergency department consultants on the floor.”

She continued: “We escalated within the hospital to try take the pressures of the ED to make everything as safe as possible for the patients.”

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Dr. Monaghan wished to make it clear that the hospital is still open for business.

She emphasised: “The hospital is open. You will be seen, but remember that we are under significant challenges.

“Everybody that comes through the door of the ED will be triaged according to their symptoms, and will be seen according to the severity of them, or if they are deemed to have time-critical illness.

“We are open for business.”

She added: “We don’t want patients staying away who are unwell because they feel that might be the right thing to do – we are open, but they may have longer to wait, and I know that is frustrating.”