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26/07/2023
ED Dept At Royal Victoria Hospital Is 'Operating Beyond Its Core Purpose And Capacity'
The Royal Victoria Hospital’s emergency department (ED) is "operating beyond its core purpose and capacity', according to a report published by the Regulation and Quality Improvement Authority (RQIA).
Inspectors found the service did not meet the quality standards established by the Department of Health for health and social care services in Northern Ireland.
According to the report, the ED was operating beyond its intended purpose and capacity. This was caused by a significant rise in the number of patients seeking care. Additionally, some patients were staying in the department longer than necessary for emergency acute care, as they required ongoing care.
Briege Donaghy, Chief Executive of the RQIA said: "During this inspection, RQIA found a dedicated workforce, who were struggling to deliver care above the ED's capacity and outside of the core purpose of an emergency department.
"We have heard the powerful testaments of patients and their families who have accessed ED services and while commending the staff for their compassion and care, have at times been concerned and anxious.
"Clinical Staff and their professional bodies have told us of their severe concerns, frustrations, and distress at the persistence of the situation.
"This RQIA inspection report concurs with these experiences. It describes a service under stress and the inspection findings provide specific evidence of quality and safety at risk.
"The inspection report sets out a Quality Improvement Plan (QIP) that the Belfast Trust has agreed to implement. This will help alleviate some of the immediate safety issues identified, but we must caution that these steps will not resolve the underlying problems.
"Without service reform, the ED will continue to be pressed to operate beyond its capacity and outside its core purpose with resulting increased risks to patient safety and to its staff.
"RQIA recognise that many of the pressures observed during the inspection are occurring at Emergency Departments across Northern Ireland. We have shared our findings with the Department of Health (DoH).
"We will liaise with the Healthcare Policy Group to inform the Service Transformation Programme. We will also liaise with the Strategic Planning and Performance Group (SPPG) of the DoH, to inform a regional response to the findings of this inspection report. This report comes ahead of a predictable increase in demand this coming winter."
SDLP South Down MLA Mr McGrath said: "I wish I could say that the findings in this report are shocking, but the reality is that we are all aware of the problems within our health service, what’s needed to address them and the reasons that we have failed to make any significant progress so far. This report shows just how broken our system is and if we don’t act now things are only going to get worse.
"The pressures in RVH and our other hospitals are having a terrible impact on patients and their families, with people in acute need of medical care being left in emergency department corridors waiting for beds to become free. Having to work in that environment every single day is also taking a tremendous toll on staff who are surely coming to the end of their reserves after years of having to make do in extremely difficult situations, with little recognition in the way of fair pay and working conditions.
"These problems will not be solved overnight, but it’s been clear for many years that the transformation of our health service is the only way we will be able to put things right. While this will involve difficult decisions, we must also ensure that no community disproportionately loses out, while working to create a modern health service that treats patients in a timely and efficient manner.
"To implement the necessary transformation we need to see the Stormont institutions back up and running. Every day we delay this move the situation is only getting worse resulting in worse outcomes for patients and more pressure for staff. This situation cannot continue indefinitely, we are rapidly approaching the edge of the cliff and I cannot bear to think what situation will be facing our hospitals and emergency departments this winter if we don't start to implement change."
Inspectors found the service did not meet the quality standards established by the Department of Health for health and social care services in Northern Ireland.
According to the report, the ED was operating beyond its intended purpose and capacity. This was caused by a significant rise in the number of patients seeking care. Additionally, some patients were staying in the department longer than necessary for emergency acute care, as they required ongoing care.
Briege Donaghy, Chief Executive of the RQIA said: "During this inspection, RQIA found a dedicated workforce, who were struggling to deliver care above the ED's capacity and outside of the core purpose of an emergency department.
"We have heard the powerful testaments of patients and their families who have accessed ED services and while commending the staff for their compassion and care, have at times been concerned and anxious.
"Clinical Staff and their professional bodies have told us of their severe concerns, frustrations, and distress at the persistence of the situation.
"This RQIA inspection report concurs with these experiences. It describes a service under stress and the inspection findings provide specific evidence of quality and safety at risk.
"The inspection report sets out a Quality Improvement Plan (QIP) that the Belfast Trust has agreed to implement. This will help alleviate some of the immediate safety issues identified, but we must caution that these steps will not resolve the underlying problems.
"Without service reform, the ED will continue to be pressed to operate beyond its capacity and outside its core purpose with resulting increased risks to patient safety and to its staff.
"RQIA recognise that many of the pressures observed during the inspection are occurring at Emergency Departments across Northern Ireland. We have shared our findings with the Department of Health (DoH).
"We will liaise with the Healthcare Policy Group to inform the Service Transformation Programme. We will also liaise with the Strategic Planning and Performance Group (SPPG) of the DoH, to inform a regional response to the findings of this inspection report. This report comes ahead of a predictable increase in demand this coming winter."
SDLP South Down MLA Mr McGrath said: "I wish I could say that the findings in this report are shocking, but the reality is that we are all aware of the problems within our health service, what’s needed to address them and the reasons that we have failed to make any significant progress so far. This report shows just how broken our system is and if we don’t act now things are only going to get worse.
"The pressures in RVH and our other hospitals are having a terrible impact on patients and their families, with people in acute need of medical care being left in emergency department corridors waiting for beds to become free. Having to work in that environment every single day is also taking a tremendous toll on staff who are surely coming to the end of their reserves after years of having to make do in extremely difficult situations, with little recognition in the way of fair pay and working conditions.
"These problems will not be solved overnight, but it’s been clear for many years that the transformation of our health service is the only way we will be able to put things right. While this will involve difficult decisions, we must also ensure that no community disproportionately loses out, while working to create a modern health service that treats patients in a timely and efficient manner.
"To implement the necessary transformation we need to see the Stormont institutions back up and running. Every day we delay this move the situation is only getting worse resulting in worse outcomes for patients and more pressure for staff. This situation cannot continue indefinitely, we are rapidly approaching the edge of the cliff and I cannot bear to think what situation will be facing our hospitals and emergency departments this winter if we don't start to implement change."
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