A&E wait times on the rise

595 people waited over 12 hours in 2021

The number of people waiting more than 12 hours to be seen in the Emergency Department at Noble's Hospital is increasing year on year.

The figure has increased tenfold in the past five years according to data released in a written answer to a Tynwald question.

Douglas North MHK John Wannenburgh asked the minister for Health and Social Care how many people went through the department each year since 2017 and how long they had to wait.

Over the past five years 150,109 people have been through the Emergency Department.

While the number of people waiting under four hours in 2021 has improved from the year before, the number waiting over 12 hours increased by over 50 per cent to 595.

In 2017 there were just 51 people waiting that length of time.

Manx Radio put these figures to Manx Care, which said:

“This is a multifactorial issue – firstly, the Emergency Department (ED) was designed in 1998, and built in 2003 to cater for approximately 18,000 patients per year. The actual numbers per year are currently 38,000 – 40,000. We have secured some funding to make improvements to the infrastructure, and these are in the planning stages at present.

In addition, data regarding time spent in the department is sometimes skewed, as some patients are actively managed in the ED instead of being admitted to the hospital for short periods of time (less than 24 hours). Often, we can treat patients in ED over a number of hours and then safely discharge them, rather than admitting them to a hospital bed. Elsewhere, this is sometimes done in a Clinical Decision Unit (CDU) for patients with an expected length of stay below 24 hours. The Isle of Man ED does not have a CDU (this forms part of our potential infrastructure improvement), therefore the need arises to manage them in the department. This means that the data regarding time spent in the department is distorted by these instances of care.

The ED is often subject to delays in transfer of patients to in-patient wards due to a lack of available beds in the hospital. This means that patients who would normally be admitted to a ward are cared for in ED until a bed becomes available.

It should be noted that safe staffing levels in ED are maintained, however, due to staff shortages at times we have to limit the number of patients who can be treated and cared for in ED. We are addressing these shortfalls, and have recently recruited a number of newly qualified and experienced nurses to the team.

We can fairly accurately predict many of our periods of intense activity, due to the data we collect, which helps us to identify trends and improve performance. During these periods, we ensure that ‘in-reach’ takes place (Consultants who would not normally work within the ED, but who are employed in Medical or Surgical specialties, ‘reach in’ to the ED to provide additional expertise and support to other Consultants and specialist Doctors). This ensures that a Senior Consultant reviews all patients who may require admission, helping to confirm diagnosis and speeding up the process, meaning that those requiring admission are admitted more quickly, and those that can be treated and discharged safely following treatment are identified earlier and treated more quickly."

The written answer in relation to A&E wait times is available in full HERE.