Special Report 70: Emergency Departments - Press Release

Office of the
Comptroller and Auditor General

Dublin Castle, 12 February 2010

Press Release: Emergency Departments in Hospitals

The Comptroller and Auditor General, John Buckley, has today published a report on emergency departments. Reviewing performance in 33 hospitals and building on the findings and recommendations of a range of reviews conducted during the period 2002 - 2007 the report examines

  • the extent to which measures to improve care within emergency departments have been implemented and the scope for further improvement
  • the impact of wider hospital organisation on the effectiveness of emergency departments
  • the scope for measures to divert cases currently handled by emergency departments to a more appropriate care setting.

The examination found that there were considerable differences in emergency department capacity and that cost per attendance also varied significantly across the service. Some of the pressure on emergency departments could be ameliorated by more streamlined hospital processes particularly in managing discharges and increasing the volume of work completed on a day case basis.

Community initiatives need to be evaluated to determine their relative cost effectiveness and, to the extent that they are found to be more economic and effective, integrated into the primary care team model.  This could also help reduce recourse to the emergency services.

As part of its Transformation Programme the HSE plans to reconfigure its acute services and concentrate emergency, urgent and complex acute care into regional centres with skilled clinicians.  The intention is that regional centres will be supported by a network of minor injury units in outlying facilities.  The report findings suggest that considerable work remains to be done to bring about change consistent with these objectives and align current service provision with the objectives of the desired reconfiguration.

The report identifies areas where improvements could be made to the systems, practices and procedures to enhance the service provided by emergency departments.  

The key findings and overall conclusions are set out in the attached Summary of Findings.

Notes for Editors

The Comptroller and Auditor General is an independent constitutional officer with responsibility for the audit of public funds.  He reports to Dáil ?reann.

The full text of the report is available at www.gov.ie/audgen/

For further information contact: Fergus Glavey at (01) 603 1021 or fergus_glavey @audgen.irlgov.ie