COVID-19 - Service Pressures

COVID-19 – Service Pressures

Health and Social Care (HSC) continues to respond to the unprecedented challenges presented by COVID-19 during the current surge of the pandemic in Northern Ireland.

These challenges are causing significant disruption across all health and care services, including lengthy delays in our Emergency Departments (EDs) and cancellations of some planned appointments and treatment.

The following update provides a regional overview of the current pressures and challenges across the HSC System in Northern Ireland.

Number of people in Emergency Departments

Snapshot at 12 noon on 17 September 2021

Trust	Hospital	0-4 hours	Over 4 – 8 hours	Over 8 to 12 hours	Over 12 hours	Total Waiting in Emergency Department	*Number of Patients Waiting for Admission to a Hospital Bed (DTA)*	*ED Attendances* *midnight on 15th to midnight on 16th*
Belfast	MATER	13	1	0	7	21	6	65
Belfast	RVH	29	5	2	18	54	21	204
Belfast	Belfast Total	42	6	2	25	75	27	269
Northern	ANTRIM	37	2	1	21	61	23	301
Northern	CAUSEWAY	18	1	1	14	34	15	114
Northern	Northern Total	55	3	2	35	95	38	415
South Eastern	ULSTER	52	6	2	25	85	32	318
South Eastern	South East Total	52	6	2	25	85	32	318
Southern	CRAIGAVON	35	3	1	17	56	18	213
Southern	DAISY HILL	36	1	3	7	47	10	151
Southern	Southern Total	71	4	4	24	103	28	364
Western	ALTNAGELVIN	35	5	2	22	64	27	190
Western	SWAH	18	0	1	10	29	9	102
Western	Western Total	53	5	3	32	93	36	292
Regional Position	Regional Total	273	24	13	141	451	161	1658

This information is updated Monday-Friday.
The information is taken from a live, operational dashboard and only provides a snapshot of Emergency Departments at a particular point in time. Therefore, as the situation in Emergency Departments is very dynamic, the information cannot and should not be taken as the definitive position.
The statistics do not include information from Urgent Care Centres or Phone First Data.
Information provided relates to Type 1 sites only. Type 1 departments are defined as those with a consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services on a round the clock basis.
In Emergency Departments, the sickest and most critically injured patients will be prioritised. People with less serious conditions unfortunately may have to wait longer to be seen, treated, and either discharged or admitted to a hospital bed. Please consider other services, including Urgent Care Centres (which are now running in RVH in Belfast and Downe Hospitals), Minor Injury Units, GP Out of Hours, or your own GP. Pharmacists now also have additional services in place and can also offer advice and treatment for common conditions and refer patients to other healthcare professionals as appropriate.

Emergency Department Figures

(Updated every Monday at approximately 4pm)
Weekly Position: 3 September – 9 September 2021

Trust	Hospital	ED Attendances	Number of Waits > 12hrs	% of Waits <4 hrs	Non-Elective Admissions
Belfast	MATER	470	58	51%	115
Belfast	RVH	1,700	402	28%	521
Belfast	BCH				34
Belfast	RBHSC	1,032	0	71%	117
Belfast	Belfast Total	3,202	460	45%	787
Northern	ANTRIM	1,884	229	56%	397
Northern	CAUSEWAY	889	97	55%	162
Northern	Northern Total	2,773	326	56%	559
South Eastern	ULSTER	2,093	379	48%	504
South Eastern	LAGAN VALLEY	567	2	66%	80
South Eastern	South East Total	2,660	381	52%	584
Southern	CRAIGAVON	1,534	343	38%	411
Southern	DAISY HILL	1,135	130	56%	241
Southern	Southern Total	2,669	473	46%	652
Western	ALTNAGELVIN	1,285	196	41%	339
Western	SWAH	735	104	51%	153
Western	OMAGH	332	0	98%	85
Western	Western Total	2,352	300	52%	577
Regional Position	Regional Total	13,656	1,940	50%	3,159

These figures do not include Urgent Care and Phone First attendances.¹To be seen, treated, and either discharged or admitted to a hospital bed.

Information provided relates to Type 1 and Type 2 ED sites. Type 1 departments are defined as those with a consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services on around the clock basis. Type 2 departments are consultant-led service with designated accommodation for the reception of emergency care patients, but do not provide both emergency medicine and emergency surgical services and/or has time-limited opening hours.

[Source: Health and Social Care Board]

Cancelled elective procedures

HSC Trusts continue to make extremely difficult decisions to cancel some elective procedures to free nursing and medical resources to support the Intensive Care Units and the increasing number of patients with COVID-19 admitted to medical wards.

Unfortunately, cancer services have been adversely affected. Trusts are working very hard to maintain cancer care in so far as that is possible during the current surge.

Cancer services are seeking to maintain chemotherapy, radiotherapy and other non-surgical treatments and alternative treatments will be provided in the absence of surgical options.

A regional approach has also been developed to ensure that any available theatre capacity across Northern Ireland is allocated for those patients most in need of surgery, both during the surge and as we come out of this surge.

HSC is working to ensure that any cancelled procedures are rescheduled as soon as possible.

Cancellations will be kept under review as the impact of COVID-19 is being felt in all areas of the system and it is anticipated that this pressure will continue over the next number of weeks.

HSC would like to apologise to those patients, their families and carers who have been affected by surgeries being postponed and for any anxiety and distress caused to them.

From 3 September to 9 Sept 2021

In total 5840 elective procedures (inpatient and daycase admission and regular attenders) were scheduled of which:

5316 elective procedures (inpatient and daycase admission and regular attenders) went ahead as planned.
There were 524 cancellations (9%).
Of the 524 cancellations, there were: – 188 Red Flag suspected cancer procedures or confirmed cancer procedures cancelled. Trusts are actively working to offer new dates as soon as possible.

From 27 August to 2 Sept 2021

In total 4485 elective procedures (inpatient and daycase admission and regular attenders) were scheduled of which:

4256 elective procedures (inpatient and daycase admission and regular attenders) went ahead as planned.
There were 229 cancellations (5%).
Of the 229 cancellations, there were: – 46 Red Flag suspected cancer procedures or confirmed cancer procedures cancelled. Trusts are actively working to offer new dates as soon as possible.

From 20 August to 26 August 2021

In total 5535 elective procedures (inpatient and daycase admission and regular attenders) were scheduled of which:

5268 elective procedures (inpatient and daycase admission and regular attenders) went ahead as planned.
There were 267 cancellations (5%).
Of the 267 cancellations, there were: – 56 Red Flag suspected cancer procedures or confirmed cancer procedures cancelled. Trusts are actively working to offer new dates as soon as possible.

Bed pressures

Visit the Department of Health’s COVID-19 Dashboard and click on the General Bed Occupancy link for all the latest bed information across hospitals in Northern Ireland.

Department of Health’s COVID-19 Dashboard

Covid Centre update

There are currently 10 primary care COVID-19 centres across Northern Ireland. They are located in Belfast, Ballymena, Coleraine, Newtownards, Downpatrick, Lisburn, Banbridge, Dungannon, Altnagelvin and South West Acute Hospital.

COVID-19 centres are a GP-led innovation that was an urgent and immediate response to the challenges posed by the COVID-19 pandemic. The centres ensure that primary care services can be maintained, by enabling patients who have COVID-19 symptoms to be treated separately from those patients who have other conditions which require assessment or treatment in primary care.

From 6 April 2020 to 5 September 2021

It is projected that there were 221,794 COVID-19 related queries in General Practice across Northern Ireland from 6 April 2020 to 5 September 2021. This figure is (as always) subject to ongoing validation efforts and changes made to the counting system to improve speed of returns by the HSCB.
55,248 Patients triaged and referred to Primary Care COVID-19 centres across Northern Ireland in that time period. 13% of patients assessed at these centres were then referred to secondary care.

From 30 August 2021 to 5 September 2021

481 referrals

From 12 August 2021 to 29 August 2021

407 referrals

From 16 August 2021 to 22 August 2021

421 referrals

[Source: Health and Social Care Board]

Further information

For enquiries about the information available on this page contact the Communications Office at the Health and Social Care Board Tel: 028 9536 3278