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Excessive waiting times

Posted By giftnm37

"Excessive waiting times"

About: Downe Hospital / Urgent Care Centre The Ulster Hospital / Emergency Department

(as a parent/guardian),

I would like to put on record our experience of attending A&E department in the UHD.

While every effort from the staff was recognised and appreciated it was an experience that was both upsetting and unnecessary.

I need to express my profound disappointment regarding the excessive waiting times experienced at the Accident & Emergency (A&E) department.

Recently, I had the unfortunate necessity of visiting with my Daughter to the A&E department, and I was appalled by the length of time it took to receive medical attention. Patients, many of whom were in considerable discomfort, were left to endure prolonged waiting times that seemed wholly unnecessary and inhumane, specially, when there is a fantastic hospital in Downpatrick that I feel is not utilised efficiently.

It is deeply concerning that a facility designed for emergencies should be so overwhelmed and under-resourced that it cannot meet the basic needs of its patients in a timely manner. The prolonged waiting times not only exacerbate the suffering of those in distress but also undermine the trust and confidence that the public places in our healthcare system.

I understand that A&E departments can face high demand and unexpected surges in patient numbers; however, the delays encountered suggest a systemic issue that requires immediate attention. There should be mechanisms in place to ensure that patients receive prompt and efficient care, regardless of the day or hour of their visit.

In my view, our locality has suffered years of cost cutting and downgrading of services which quite frankly is disappointing and inequitable. I believe that the centralisation of services to UHD does not work, as the overcrowded A&E is a testament too!

I think that Urgent Care in the Downe could open its criteria to see more patients, which would reduce anxiety and pressures on A&E. The staff need more scope to see more patients. Assess and treatment if needed then the patients can be move on to UHD if required. Surely bloods, ECGs, x-rays and pain relief can be given in the local Downe Hospital.

This is outrageous and requires immediate attention. It is extremely unsafe to run an emergency department waiting room this way. 17 hours in A&E waiting room is completely unacceptable and a disgusting way to treat patients. I urge you to address this pressing issue with the urgency it demands.

Improved staffing levels, better resource allocation, and enhanced operational efficiency are critical to ensuring that the A&E department can be reopened to fulfil its vital role in our community.

Thank you for your attention to this matter. I look forward to your response and to seeing tangible improvements in the quality of care provided at the Downe Hospital and UHD A&E department.

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Responses

Response from Jennifer Nicholson, Lead Nurse - Emergency Care, Emergency Medicine - A&E, South Eastern Health and Social Care Trust 3 weeks ago
Jennifer Nicholson
Lead Nurse - Emergency Care, Emergency Medicine - A&E,
South Eastern Health and Social Care Trust

Submitted on 10/03/2025 at 16:33
Published on Care Opinion at 16:33

Hi giftnm37

Thank you for taking the time to tell us of your experience when attending the Emergency Department at the Ulster hospital with your daughter. It is disappointing to hear your experience was negative and you had a prolonged wait for your daughter to be seen, assessed and treated.

You have outlined a number of issues and suggestions that I will seek to address.

The Downe Urgent Care is staffed by medical staff who work across our sites and with the difficultly attracting staff into Emergency Medicine there are not additional staff to recruit and by opening with further hours you would have less staff on per shift and ultimately carry a significant unsafe risk with minimal staffing. We also have had significant number of nursing vacancies for a number of years and despite extensive efforts we were not able to recruit or fill those vacancies until more recently. Their isn't the resource or staff available to improve this is the near future.

The Urgent Care at the Downe is restricted in what services are available on site for review, follow up and what can be safely managed on site. It would be unsafe and could result in significant harm to a patient if there is not the speciality help available on site. While waiting to transfer someone acutely unwell can result in a prolonged wait for the help needed for that patient and a reliance on the ambulance service availability with on occasions nursing and medical staff having to transfer with the patient in the ambulance leaving the Urgent Care with minimal staffing and putting patients at risk. All of these are scenarios that we have experienced prior to the change to an Urgent Care with set safe criteria in the best interests of all. Unless there were surgical, intensive care, paediatric or cardiac services to support the Urgent Care it can not stand alone safely. Alongside the admin and support services such as cleaning, portering, radiography that would be required. There would not be the staffing available or financial resource to enable this. The aim is the right patient, right place, first time as this is proven to be the safest and most efficient management of patients. Moving patients twice is not timely or efficient.

You may be aware of the regional pressures across all our emergency services nation wide with many if not all of our first level ED's experiencing similar situations of increased numbers attending daily many with complex needs resulting in prolonged waiting times, this is not what we aspire to but unfortunately where all Emergency Departments find themselves. There are not infrequent surges as you imply but we are constantly day after day working above surge level. We continually escalate our concerns to senior management and avail of opportunities to meet with our local representatives including our Health Minister to highlight the issues and the need for further funding but with financial constraints in all areas of government there has been no available further funding released. Many times staff come in for extra shifts, stay late and go above and beyond to provide a high standard of care. The majority of our funded nursing and medical staffing positions are filled with a small number in process of being filled but undoubtedly there is the need for additional staffing especially to care for those who are waiting sometimes 3 or more days in ED for a bed in the ward. The wait for beds in the ward results in overcrowding and considerable nursing time is concentrated on caring for those patients rather than focused on the 400+ patients attending daily.

All patients have an initial assessment on arrival at triage but patients conditions can change quickly at anytime in their journey.

I hope this goes some way to provide the answers to your questions and explain the reasons for the criteria of the service of the Urgent Care Department.

I hope your daughter is improving.

Regards

Jenny

Lead Nurse Emergency Care

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