Accident and Emergency: Nurses

Oral Answers to Questions – in the Northern Ireland Assembly at 2:30 pm on 11th September 2012.

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Photo of Michaela Boyle Michaela Boyle Sinn Féin 2:30 pm, 11th September 2012

2. asked the Minister of Health, Social Services and Public Safety for an update on the proposal to upskill nurses to allow them to discharge patients following the recent problems with accident and emergency departments. (AQO 2399/11-15)

Photo of Edwin Poots Edwin Poots DUP

In my announcement in March this year about tackling emergency department waiting times, I said that improvement could only be achieved through a broad approach involving all areas of the health service.  I listed a range of areas to be explored.  These included allowing senior nurses to discharge patients over weekends and public holidays, and exploring options to deal with patients who turn up inappropriately at emergency departments, by, for example, having triage nurses discharge individuals. 

Nurse-led or nurse-facilitated discharge by skilled and experienced nursing staff is and has been in place in many of our hospitals for some time.  Nurse-led or nurse-facilitated discharge is one part of the process that could improve the patient journey and make a substantial contribution to the efficient management of patients' stays and timely discharge.  Health and social care trusts have been working with the multidisciplinary teams at ward level to improve this process, which includes training, support and reviewing local policies and procedures.

Photo of Michaela Boyle Michaela Boyle Sinn Féin

I thank the Minister for his answer.  Some nurses may not feel comfortable doing that.  Will nurses need to be regraded as part of this retraining and reskilling?

Photo of Edwin Poots Edwin Poots DUP

That is a matter for the trusts to deal with.  It is important that the trusts have nurses with the necessary skills to take on that responsibility.  I am sure that discussions will be had between the trusts and the nurses' representative bodies to ensure that they are appropriately paid for the responsible job that they carry out.

Photo of Pat Ramsey Pat Ramsey Social Democratic and Labour Party

I thank the Minister for his response.  Will the Minister assure the House that there are sufficient beds and staff in accident and emergency departments to cater for any potential winter outbreaks?

Photo of Edwin Poots Edwin Poots DUP

One problem that accident and emergency departments can have is the entire hospital being full.  We could have a situation where, on one hand, we want our hospitals operating as efficiently as possible; therefore, we do not want lots of empty beds in a hospital on a regular basis.  On the other hand, if we have a significant flu outbreak or increase in ill health over a period, that would put incredible pressure on our hospitals.  I want to ensure that our hospitals can operate as efficiently as possible.  We have introduced a series of steps whereby we can have faster, better discharges from hospital, and that certainly is one of the things that can help us.  Pharmacy is another area where we can do more.  So, there are areas in hospitals where we can improve efficiencies.

Photo of Samuel Gardiner Samuel Gardiner UUP

Minister, how much time is set aside for the task of discharge — planning the work programme of discharge, whether by a doctor or nurse?

Photo of Edwin Poots Edwin Poots DUP

Obviously, we have more nurses than consultants on the wards, so it would make sense to have nurses discharging, where it is safe and appropriate to do so.  That is because the task of discharge can be time-consuming on occasions, particularly when it involves social services and other bodies, which can lead to further delays.  All of that takes time, and it is appropriate to use the right people to deliver for us.