A total of 1,121 admissions to Letterkenny General Hospital, Co Donegal, had to be cancelled in the first six months of last year due to pressure on the hospital's A&E unit, a report commissioned by the Health Service Executive has found.
The report, released to The Irish Times under the Freedom of Information Act, describes the hospital's A&E department as "not fit for delivering emergency care in the 21st century".
It said the unit was too small and while the hospital had been given approval to go to tender for the construction of a new emergency department, this would not come onstream for three to four years. Interim improvements such as the erection of a temporary building to expand the treatment space available in A&E should be considered, the report said.
"The physical space constraints mean that there can be serious issues around patient dignity and confidentiality within the department, particularly at busy periods . . . there have been occasions when the department has physically run out of all treatment space," it added.
The report was compiled by the UK healthcare consultancy Tribal Secta, which also completed reports on nine other hospitals for the HSE aimed at determining the causes of A&E overcrowding.
To date five of these reports, including those on Galway's University College Hospital, Wexford General Hospital, Cork University Hospital and Our Lady of Lourdes Hospital in Drogheda, have been released to this newspaper under the Freedom of Information Act. A decision is still being made by the HSE on whether or not to release the other five, which were carried out on the main Dublin hospitals.
The Tribal Secta report on Letterkenny General said its day case ward was regularly used as a holding area for A&E patients, resulting in the cancellation of elective patients. "Emergency and urgent admissions are given priority over elective work and cancellations are routine, due to rising numbers of patients requiring admission," it said.
It added that patients having their operations cancelled up to three and four times was "not uncommon". "The organisation reported 1,121 cancelled elective inpatient, day cases procedures in the first six months of 2005," it said.
There were, the report added, some 27,223 attendances at the hospital's A&E unit in 2004, a 5 per cent increase on the previous year. Some 37 per cent of these were referred by GPs and 43 per cent were of people who self referred.
The report also noted that the emergency consultants at the hospital have no admitting rights, and this can lead to delays for patients.