Press Release: Tuesday 18 February 2025
Minister Carroll MacNeill focuses on further reducing Emergency Department overcrowding and enhancing urgent care services nationwide
Minister for Health, Jennifer Carroll MacNeill TD, has today brought a Memo to Government regarding the situation report for urgent and emergency care in February 2025, specifically the spike in trolley numbers over the February bank holiday weekend. The Minister briefed Cabinet on recent trends over weekends, including the recent Bank Holiday weekend, the impact of those trends on patients and the next steps needed to ensure that such weekend spikes do not occur in the future.
Minister Carroll MacNeill said:
“There are two problems – the first is the underlying question of continuing to extend our hospital and care capacity. We are committed to ensuring there are more beds for our hospitals and to removing some elective procedures from acute hospitals into new surgical hubs, and then Elective Hospitals. There is a clear capital programme already identified and commitment in the Programme for Government for further funding for this. A good step was taken this week as our first patients were treated in the new HSE surgical hub at Mount Carmel.
“However, there is a second problem which is specifically the increased numbers of patients on trolleys, especially the spikes after weekends, most notably after the St. Brigid’s Day bank holiday weekend. I was quite alarmed by the growth in the number of patients waiting on trolleys after this bank holiday which went from 253 to over 617 trolleys in a three-day period from Saturday morning to Tuesday morning.”
On Tuesday, 4 February 2025, 617 patients were waiting on trolleys at 8.00am for a hospital bed. This very high level of hospital congestion has not been seen since January 2023. The impact on patients and their families is too great for this to remain unresolved.
This congestion is directly linked to the very high numbers of patients on trolleys the following Tuesday and is a function of low weekend discharge rates. During the three-day period of the bank holiday weekend, it was noted that a total of 2,560 patients were admitted, and only 1,535 patients were discharged. This created a negative capacity variance of 1,025 patients.
Patient-flow must be carefully managed by each hospital seven days a week. The number of patients admitted and discharged must be kept balanced to avoid congestion, which results in patients waiting on a trolley for a bed. We can already see that consistently low, or zero, trolley numbers are possible. Hospitals including Waterford, Tullamore, and Connolly are evidence of this and the benefits of a whole-of-hospital culture, focussed on efficient and effective patient-flow.
Fundamental to maintaining proper patient-flow is ensuring sufficient senior decision makers are rostered to discharge patients throughout the entire week, including evenings, weekends and public holidays.
Minister Carroll MacNeill said:
“Accordingly, I requested detailed information on the number of admissions and discharges per hospital to identify where the issues may be particularly pronounced. I brought this hospital-by-hospital level data to Cabinet today which showed that over 1,000 more patients were admitted than discharged.
“Recognising that this is in large part connected to the presence of senior decision makers on site, I requested an analysis of the consultants rostered over the same period. It is clear in the hospitals for which we obtained initial data that approximately 10% of consultants were rostered – either on-call or on-site. This is not enough. Of course, other senior decision makers to support consultants are needed but clearly consultants are the clinical lead and indeed the cultural lead of every hospital.”
To support the provision of 7/7 services, the Public Only Consultant Contract, introduced in March 2023 provides for evening, extended out-of-hours and Saturday rostering. Attention must now focus on realising the benefits of that contract, which 61% of consultants have now signed up to , and increasing productivity by maximising the use of hours in the contract to enhance patient care and increase access to services in the evenings and at weekends.”
The number of consultants employed by the health service has increased from 3,226 Whole Time Equivalents (WTE) in 2020 to 4,578 at the end of December 2024 – a 42% increase.
There has been a substantial increase in the healthcare workforce, with 25,200 more WTE working in the health service since 2020. This includes 9,249 nurses and midwives, 3,751 health and social care professionals, and 2,323 doctors and dentists.
Minister Carroll MacNeill concluded:
“I will ensure every measure is being taken to help the smooth running of our hospitals. This information is a first step in shining a light on the situation and I have now requested the HSE to provide a deeper analysis of hospital consultant rostering in all acute hospitals, to cover a focused analysis of future periods’ rostering of senior decision makers in the evenings, on weekends and public holidays.
“I will update Government after St. Patrick’s weekend, the Easter weekend and the May and June bank holiday weekends.
“Along with my Government colleagues, I am committed to delivering sustained improvements in the provision of safe and timely access to emergency and urgent care for the people of Ireland.”