HSE at odds with medical training body over treatment of emergency department patients

• Published date: 23 March 2023

Hospitals across the country have been instructed by the HSE to ensure specialist teams from outside emergency departments are available to review patents experiencing long delays in EDs

The letter from HSE chief clinical director Dr Colm Henry flatly contradicts an instruction by the Royal College of Physicians of Ireland, which last week said medical hospital trainees should not be reviewing patients in the ED until staff there have seen them.

At issue is whether it is better for the longest-waiting ED patients to at least be seen by a junior medical trainee rather than no one in the short term. Dr Henry says there are "significant concerns" over current levels of overcrowding and this is a safety risk for patients in hospitals nationally.

The RCPI's Institute of Medicine, which is responsible for training more than 500 medical doctors in hospitals, has threatened to remove accreditation from any hospital where senior house officers (SHOs) are evaluating patients before they are seen in the ED, The Irish Times reported on Wednesday.

The letter sent by the RCPI's Prof John McDermott prompted a swift riposte from the HSE, in a terse two-paragraph letter sent on Wednesday by Dr Henry to hospital group chief executives and clinical directors.

"Significant concerns remain regarding the degree of overcrowding in our emergency departments. Given the numbers of presentations, this remains a patient safety risk for patients in our hospitals nationally," Dr Henry says in the letter.

"Clinical directors should continue to take all the necessary actions to alleviate overcrowding by facilitating the flow of patients through hospitals by early review, diagnosis...