Daily Mirror (Northern Ireland)
FRONTLINE
More younger people feeling pain of stress
ELDERLY people are arriving at A&E in “pain” and “desperation” thanks to growing waiting lists, a senior doctor has told the Mirror.
And the influx of patients who are facing lengthy delays ahead of routine operations are piling pressure on the emergency ward at the Ulster Hospital.
Consultant Alister Mcilwee, who has worked in emergency medicine for 12 years, issued the stark warning weeks after the facility on the outskirts of East Belfast saw 332 patients enter its A&E on October 23 – its busiest ever day.
The projected numbers for patients arriving in 2017/2018 is 96,000, up on 92,931 the previous year.
Mr Mcilwee said: “The reason why our department is busy at the moment is because the entire system is busy.
“There aren’t that many patients who come to our department inappropriately. But what we are finding is an increase in patients attending because of pressures on elective care.
“Patients who are waiting to have their gall bladder removed, a hernia repaired, to see a specialist – their condition is getting worse and it’s beyond the scope of their GP to sort this out.
“They’re not getting seen to have their outpatient appointment, so, in desperation, they’re coming to us. Because they need to be seen, they need an additional bit of help.”
Mr Mcilwee added older people coming to his department often tell how their GP has informed them they need a specific procedure within months but the patient is facing a much longer wait or sometimes “not told at all” when they can expect treatment.
He said “waiting times seem to be accelerating away from us rather than being reduced” and routine procedures on gall bladder, hernia, joint replacement if carried out in a “timely fashion” are much less likely to end up in ED.
In damning indictment of the system, Mr Mcilwee said when patients are asked what the problem is, “they’re mentioning much more frequently, their hernia, their hip.”
He added: “I’m seeing the same patients coming back in a great deal of pain and distress and we’re trying to patch them up.”
In the long run this problem costs more in terms of nurse time, beds and theatre time.
A gall bladder that becomes infected while a patients waits for its removal will require emergency surgery and result in them spending more time in hospital than if they had had a planned A&E consultant Alister Mcilwee is increasingly worried at the number of young people with stress-related symptoms.
He said patients in their 20s, 30s and 40s with chest pains, headaches and breathlessness, was “not on my radar” in previous years.
Mr Mcilwee added: “I’ve seen that more and more frequently than I have before. There’s a lot of anxiety, stress, depression out there. It’s very worrying to see.”
He said patients tell medical staff about the stress they’re under, which is “manifesting itself in physical symptoms, neurological symptoms, chest pains, sleeplesness, nausea, mental health.
Mr Mcilwee added: “It’s very, very common now to see one or two patients per shift. After doing all the tests, I can confirm stress is the most likely cause.”
He has seen an increase over the last two to three years “but particularly this year”.
The senior doctor added: “People work very hard, sometimes for themselves, sometimes for employers. They push themselves really hard.”
He believes part of the reason they are arriving at A&E may be down to “pressure on GPS” who “are overwhelmed as well”. procedure. Mr Mcilwee added the crisis in the system is that at the “other end” where patients need to be discharged, they are often “stuck” thanks to a lack of specialist care packages on the “outside”. The often talked about “demographic timebomb” is also an issue, more so at the Ulster thanks to an older population in the Ards and North Down council areas.
Mr Mcilwee said there is a “growth of patients attending and they are older and sicker”. He added the number of patients over 75 and even over