Patients waiting for surgery are given warnings over cancellations

Public waiting-list patients who are scheduled for surgery in the coming months have been warned they risk having the operation cancelled as the trolley crisis worsens.

The warning from surgeon Kenneth Mealy, president of the Royal College of Surgeons of Ireland (RCSI), comes as patients in hospital emergency departments endured another day of intense overcrowding yesterday, with 525 waiting on trolleys for a bed across the country.

As the row over Taoiseach Leo Varadkar’s comments that hospital Christmas and new year leave be kept to a minimum to avert the worst of the crisis, it emerged that waiting-list patients will again be the hidden victims of the crisis due to bed shortages.

“There is no quick fix to this problem but, long term, we must separate acute and elective care in the hospital system so that elective surgeries are no longer vulnerable to cancellation during the winter months when the emergency system is under pressure,” Mr Mealy said.

Meanwhile, Professor Deborah McNamara, a general and colorectal surgeon in Beaumont Hospital, said: “I can already see the impact of our aging population in my own clinical practice in Beaumont Hospital. Half of emergency laparotomies (keyhole surgery) in the hospital last year were carried out on patients over 65 years of age, and 16pc were on patients over 80.”

Speaking in advance of her address to the RCSI Millin meeting today, she said: “The result of this is that comorbidity is the new norm and it is vital that we identify better ways of managing this increased complexity among surgical patients.”

One-third of patients undergoing hip fracture surgery have cognitive impairment, for example. At present, just 13pc of Irish patients undergo a risk assessment prior to undergoing an emergency laparotomy.

This compares to 94pc of patients in the UK. In order to improve quality and safety in emergency surgery, they must identify deteriorating and high-risk patients.

They must ensure patients have rapid access to theatre for their surgical care, and access to the input necessary from geriatric and rehabilitation services “that will enable them to make a full recovery to independent life”.

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