Minister for Health Jennifer Carroll MacNeill thanks staff for their work in reducing ED overcrowding over St Patrick’s weekend

The number of patients waiting on Emergency Department (ED) trolleys at 8am over the St Patrick’s bank holiday weekend (Saturday-Monday) was reduced by 70% when compared to the St Brigid’s bank holiday weekend this year.

This resulted in 63% less patients waiting on ED trolleys at 8am this morning (Tuesday), when compared with the same Tuesday after the St Brigid’s bank holiday weekend in February this year. Attendances at Emergency Departments in hospitals were 4% lower this weekend when compared to the St Brigid’s bank holiday weekend.

Minister Carroll MacNeill said:

This period also saw discharges from acute hospitals increase by 8%. This included an increase in discharges on Saturday and Sunday with 175 more patients discharged compared to the St Brigid’s bank holiday weekend.

Minister Carroll MacNeill added:

The number of patients waiting on ED trolleys at 8am over this St Patrick’s bank holiday weekend (Saturday-Monday) was down 54% compared to the St Patrick’s bank holiday weekend in 2024. This resulted in 51% less patients waiting on ED trolleys at 8am this morning, when compared with the same Tuesday after the St Patrick’s bank holiday in 2024. This was despite attendances at Emergency Departments being at the same level, when compared to the same bank holiday period in 2024.

This period also saw discharges from acute hospitals increase by 10%, of particular note was the increase in discharges on Saturday and Sunday with an increase of 179 patients discharged compared to the same period in 2024.

While these initial results, which are subject to further verification, are encouraging the HSE and the Minister for Health will be reflecting on the factors that influenced this turnaround in performance in the coming days.

Minister Carroll MacNeill added:

To drive sustainable improvements in the timely delivery of urgent and emergency care, an increased focus is being put on the delivery of integrated services on a seven-day basis.

Fundamental to this is ensuring sufficient Senior Decision Makers (SDMs) are rostered to discharge patients throughout the entire week, including evenings, weekends and public holidays.

To support to 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. A core objective of this contract is to enhance senior decision-making presence on-site. Over 60% of all consultants working in the public health system are now on the new POCC. Attention is focused on realising the benefits and increasing productivity by maximising the use of the hours in the contract to enhance patient care and increase access to services in the evenings and at weekends.

Urgent and emergency care report - Daily Trolley Count available online at: Urgent and emergency care report (daily) - HSE.ie.

The demand for emergency care in 2024 was 9% higher (127,000 patients) to that experienced in 2023, with nearly 1.58 million Emergency Department (ED) presentations.

Presentations to EDs and admissions to hospital of those aged 75 and older, increased by 11% (an increase of 23,300 patients) and 10% (10,600 patients) respectively when compared to 2023. To note, patients aged 75 and older are typically sicker when admitted to hospital and require more intensive and longer stays than the general population.

In spite of the increased demand, the number of patients waiting on a trolley at 8.00am decreased by 11% in 2024 when compared to 2023.

• Patient Experience Time (PET) is the time from registration to discharge from ED.

February 2025 was very challenging for EDs nationally. Trolleys numbers increased by 10% compared to the same period in 2024 and EDs experienced sustained, high levels of demand.

High levels of seasonal influenza infection activity occurred this winter, peaking during the first week of January, impacting on demand for urgent and emergency care services.

In addition, severe weather events also occurred in early 2025, with significant and long-lasting impacts on the delivery of urgent and emergency care. Disruption to power supplies in many areas negatively impacted the operation of local health care services and the ability for some patients to be discharged from hospital in a timely manner.

In addition to the key actions identified in Annex 1, the HSE Senior Management Team have an intensified focus on engagement on the totality of urgent and emergency care services at national, regional and local levels. The HSE is also highlighting alternative care pathways to assist in ED avoidance. This campaign is running across social media platforms over the winter months, to help everyone get the care they need, when they need it.

The HSE now publishes a daily report listing trolley numbers at each hospital and provides a breakdown of patients waiting on trolleys in the ED and those waiting on trolleys in wards. As part of this report, the HSE also identifies the number of surge beds in use. These are beds that are taken from elsewhere in the hospital to meet ED demand.

Annex 1: UEC Operational Plan 2024 - Key Actions

Vaccine: Preventable illness

Promote uptake of Influenza, Measles and COVID-19 vaccinations to improve compliance for all target groups including Healthcare Workers.

Specialist care in the community

Community Specialist Teams (CSTs) for Chronic Disease Management to deliver 19,000 patient contacts each month.

CSTs for Older Persons will deliver 11,750 patient contacts each month.

GP out of hours

Work with GP Out of Hours Services to maintain/increase GP OOH contacts and reduce the level of GP OOH referrals to EDs.

NAS care pathways

Maximise usage of existing NAS alternative care pathways.

Local injury units

Injury Units to provide a 7-day service, 8am to 8pm including Bank Holidays.

Patient streaming at ED

High levels of streaming in the emergency department, for example: to Medical Assessment Units, GEMs Units, Injury Units, ICPOP assessment and other appropriate services.

Senior decision makers in ED

Roster amendments for Senior Decision Makers developed on a 7/7 basis and implemented to meet the predictable increased weekend and public holiday demand.

Consultant rounding in ED

Consultant daily rounding of admitted patients each morning in EDs and in surge beds to expedite decisions and treatment.

Demand and capacity management

Each hospital/community service to have a centralised operational hub that provides visibility of all available bed capacity in hospitals, community and private facilities

Clinical and oversight, operational

Senior clinical and operational decision makers rosters to be developed on a 7/7 basis and implemented to meet the predictable increased weekend and public holiday demand.

Cohorting

All sites will have plans in place to support the transition to hospital wide cohorting of patients to specialty or dedicated wards, commencing with the cohorting of Older Adults (≥ 75 years) to specialist geriatric wards by year end.

Extended hours

Roster amendments and additional services should be developed on a 6/7 basis in the interim, ultimately working to a 7/7 basis and implemented to meet the predictable increased weekend and public holiday demand.

Senior clinical review

All admitted patients on wards to have senior clinical review every morning to expedite decisions and treatment.

Length of stay

Hospitals will implement protocols for inpatients with Length of Stay over 14 days transitioning to over 7 days.

Patient flow

All clinically appropriate patients in Model 3 and Model 4s to transfer to alternative care settings including Model 2s, Rehabilitation Beds and Transitional Care Beds (TCBs).

Discharge plan for every patient

All inpatients to have a comprehensive plan for discharge, developed in conjunction with community services. A predicted date of discharge is to be assigned at time of admission.

Discharge processes

Operational processes will be in place to support the discharge of patients prior to midday on a 7/7 basis, and to deliver a consistent level of discharges each day.

Managing delayed transfers of care

In anticipation of their final care plan being fulfilled, all available options are to be put to suitable patients who are experiencing a DTOC if they have already been approved for NHSS long term care. Patient choice to be prioritised, however in line with the discharge policy, patients will be safely transferred on the third offer provided to them.