Age NI: A&E review ‘a bit late’ to help elderly this winter

Age NI says the review of elderly services should have begun 'months ago' while a nursing representative says they are 'fearful' of what winter holds
Age NI says the review of elderly services should have begun 'months ago' while a nursing representative says they are 'fearful' of what winter holds

Age NI says a recently launched Department of Health review of emergency health care – with a particular focus on pensioners – is “a bit late in the day” for this winter and “should have started months ago”.

The charity was speaking to the News Letter after it was revealed that there were 50,100 excess winter deaths in England and Wales last winter, the highest since 1975-76.

Most occurred in women and the over-85s, caused by flu, the failure of the flu vaccine for the elderly and periods of very cold weather.

In NI there were 640 excess winter deaths in 2015/16, again, the most vulnerable group being those over 85, making up 59% of the deaths. Last winter’s figures for NI will be released on Wednesday.

The comments from Age NI come three weeks after the Department of Health (DoH) announced a ‘review of urgent and emergency care’ with a particular focus on the elderly in light of emergency departments experiencing “intensifying pressures over recent years”. DoH acknowledged growing waiting times for hospital admissions and that “another difficult winter period” is anticipated.

Age NI welcomed the review – but expressed concern about the timing. “It is good news but it seems late in the day to start this process if we want to see any benefits this winter,” a spokeswoman said.

“it seems late in the day ,,, this process should have started months ago”

Age NI

“We all know that our healthcare system, particularly our hospitals, come under extreme pressure during these winter months and this process should have started months ago.”

She noted the “added impact” a long wait in A&E can have on the elderly and pressed for “safe and effective” alternatives that will be “just as beneficial or more so than an admission to hospital”.

Rita Devlin, deputy director of the RCN in NI, said nurses are worried. “Our members are fearful that there will be a repeat of the problems experienced last year in emergency departments over the holiday period,” she said.

“Staff would hope that trusts will have contingency plans in place to ensure that services will be maintained at normal levels.”

Dr Grainne Doran, chair of the Royal College of General Practitioners NI, said GPs have “serious concerns about the increase in workload that will come this winter”.

She added: “With services already struggling, doctors have voiced their concern about being able to manage with the additional workload during the winter season.

“A review of emergency and urgent care, and the implementation of necessary changes, cannot come quickly enough.”

Dr Tom Black, BMA Northern Ireland Chair of Council, said a “long-term and meaningful plan” is needed to address winter pressures. While each trust will have a winter contingency plan, he said, staff face “additional workload and work-related stress” during the winter period which may see “the whole system begin to wobble”.

Properly funded home care packages for discharged patients are needed, he said, along with “meaningful long-term workforce planning” to have enough doctors in place to meet the needs.

Last winter saw Antrim Area Hospital call in St John Ambulance volunteers for basic ward cover on New Year’s Eve, while SDLP MLA Dolores Kelly said 250 people waited at Craigavon Area Hospital over two nights for assessment on January 2 and 3.

In the first week of January, staff reported that Belfast’s Royal Victoria Hospital was “at breaking point” and a ‘major incident’ was declared because of the excessive backlog of patients.

Londonderry’s Altnagelvin Hospital had to implement an emergency plan for its emergency department, and on Boxing Day the Southern Health Trust said patients were having to wait for up to 34 hours to speak to an out-of-hours GP.

From December 24 to January 1 last year, some 928 NI patients waited more than 12 hours for admission, transfer or discharge, the BBC reported.

However, the Department of Health said that its newly launched review of emergency care is not intended to address problems this winter.

A spokeswoman said: “The review of urgent and emergency care is a long-term project and should not be conflated with initiatives to counter winter pressures in hospitals this year.”

The review will aim to establish a new regional care model for the Province, with particular focus on the elderly, she said.

“A range of measures have been put in place by trusts for this winter in expectation of another challenging period for health services across these islands.”

The department has funded these initiatives, recognising the need for immediate mitigations and longer term review, she added.

Age NI advises that by taking some simple steps, older people can stay warm, well and safe in the winter months;-

1. By setting your heating to the right temperature (18-21°C or 64-70°F), you can keep your home warm and your bills as low as possible.

2. Food is a vital source of energy, which helps to keep your body warm. Keep basic food items in the cupboard or freezer, and try to have hot meals and drinks throughout the day.

3. Try to avoid going outside on extremely cold days. If you do need to, wrap up warm and remember that several thin layers will keep you warmer than one thick layer.

4. Keeping active generates heat and helps to keep you warm, so when you’re indoors, try not to sit still for more than an hour. Get up and walk around, make yourself a warm drink, and spread any chores throughout the day.

5. If you’re over 65, be sure to have a seasonal flu jab. Seasonal flu viruses are always changing, so you need to have a jab every year, using the latest vaccine.

6. It’s not unusual to feel a bit down in winter. Try to keep to your usual routines and, if you can’t visit friends, make sure you phone them regularly for a chat.

7. Call Age NI’s Advice Service on 0808 808 7575 for a free benefits check.