This renewed focus comes just over a year since an inquest into the death of Patrick Rowland heard he spent upwards of 42 hours on a trolley there.
A verdict of accidental death was returned after he was found drowned in Castlebar river having left the hospital in his pyjamas on a night in January 2023.
Dr Lisa Cunningham, consultant in emergency medicine at Mayo University Hospital, said overcrowding is at “unheard of” levels now.
“We absolutely have patients who are multiple hours in the back of an ambulance, getting treatment — getting their IV antibiotic, having had bloods already drawn,” she said.
“We’re having now to assign doctors to the ambulances because it’s a space to treat a patient. There is physically no space in the emergency department.”
Various barriers are behind the overcrowding, she suggested.
“Everybody has to come to the emergency department in Mayo to access hospital care,” she said.
Almost a third of ED patients could be treated at injury units
She estimated up to 30% of their ED patients could be treated by injury units.
However unlike Limerick for example, Mayo does not have this.
It does not operate a Pathfinder ambulance service. In Cork, for example, older patients who call 999 can be treated at home by paramedics if appropriate.
“So this is a gap even before they reach into the emergency department,” she said.
Irish College of GP data shows 79 GPs per 100,000 of population in Mayo when 100 is recommended.
Dr Cunningham said this and other shortages mean: “We don’t have a lot of the care in the community to help keep people out (of hospital).”
She called for solutions to the whole jigsaw not just the “one little part” in the ED.
Dr Cunningham said the “complexities” they are facing can be “just for us” as she said solutions might not transfer between regions.
“So when you have somebody that comes along with a bit of a sledgehammer and says ‘this is what’s happening in Mayo’ you instead need to take us and every other ED based on the population demographics we actually treat,” she said.
‘Dangerous staffing shortfalls’ in Mayo
The Irish Nurses and Midwives Organisation (INMO) is balloting emergency care nurses in response to “dangerous staffing shortfalls” in Mayo.
Assistant director of industrial relations for the area, Colm Porter said long talks did not bring adequate answers.
He said nurses now feel risks being posed to patients due to ongoing understaffing problems “have become too significant and that their concerns are not being taken seriously”.
Nurse have regularly reported a chronic staffing shortfall for two years, he added, without getting “an adequate response”.
The union called for the safe staffing framework to be applied, saying nurse numbers do not match patient numbers.
Mr Lawless described the hospital as being in a crisis situation.
His understanding is an additional 30 nurses are “desperately needed” now.
In relation to beds, HSE West and Northwest said the average occupancy rate in Mayo is “currently 113%”.
Hospital ‘routinely operated at about 120% capacity’
The inquest into Mr Rowland’s death heard the hospital “routinely operated at about 120% capacity” then. The safe recommended level is 85% in any hospital.
CSO census data shows Mayo’s population has the highest average age, followed by Kerry.
The ED has seen a 6% increase in patients aged over 75 since last year, the HSE said.
This meant 296 more patients by August.
The gap is even bigger compared to 2023 with 1,064 more older patients already seen.
Overall 124 patients were seen daily in August compared to 117 last August.
The HSE has funding for four geriatricians but only one permanent consultant in place. Locums fill the other roles while recruitment continues.
Injury unit at Ballina District Hospital
It is planning an injury unit at Ballina District Hospital. Phase 1 is expected to open by June 2026. Talks continue on how this will work including who will staff it.
The overcrowding was raised in the Dáil in recent days in an exchange between health minister Jennifer Carroll MacNeill and local Aontu TD Paul Lawless. He described a patient waiting 13 hours in an ambulance outside the hospital.
Ms Carroll MacNeill described visiting Mayo hospital on a Saturday last month.
She said there were “practically no diagnostics going on”.
Asked about this, the HSE said: “Additional diagnostics appointments are being facilitated by extending hours in the unit — an earlier start, later finish, and keeping scanners all through lunch in radiology.”
The hospital is also operating a Saturday and Sunday list.
The minister said the hospital has had a 30% staffing increase over five years, saying: “Mayo hospital is not understaffed. However, Mayo hospital is imbalanced.”
The HSE said: “Like other hospitals, there are certain pockets of resources required to meet current demand.”
It referred to physiotherapy, dietitians, occupational therapists, and social workers. They are working on business cases “where gaps in clinical specialties have been identified”.
In the meantime, Dr Cunningham called on people to come to the ED if they are unwell, saying “like clockwork” they see numbers drop every time the crisis is highlighted.
“People are afraid,” she warned. “Then when they do come a week or two later, they are quite unwell. That happens in every ED.”
Original source: ie