The Irish Nurses and Midwives Organisation has met with the HSE and the Department of Health in a bid to avert the threat of nationwide industrial action by nurses over under-staffing, recruitment and retention difficulties.

Last month, 90% of INMO members backed industrial action - including one-day strikes - in protest at the failure of the HSE to recruit sufficient nurses.

The union argues that an additional 3,500 nurses are required, but that incentives - including financial incentives - will be required to attract staff to the health service.

The INMO has given the HSE until next Tuesday, 17 January, to present appropriate proposals to address the staffing crisis.

Asked what would happen if the row was not resolved by then, General Secretary Liam Doran said the INMO executive, which will be meeting on that date, would make an informed, mature decision.

He said the INMO was not a rash organisation, but the members had spoken and the union had heard them.

The union had previously indicated that if the dispute were still continuing by 17 January it could serve 21 days notice of industrial action. 

Arriving for this evening's meeting, INMO General Secretary Liam Doran said his members were "broken to the bone" and they would be asking the HSE and the Department what they were going to do about it.

He said no one liked industrial action but the ball was in the management's court to demonstrate that they were going to take "real, substantial and meaningful" steps to address the staffing issues.

He said offering posts and hoping nurses would appear would not solve the problem, as they were going to have to offer incentives to address it.

Today's meeting was delayed for two hours because the INMO refused to attend the meeting until it received assurances restoration of time-and-a-sixth premium payments due to all nurses would actually be paid.

However, once those assurances were received, the meeting proceeded.

Speaking after it concluded, Mr Doran described discussions as comprehensive.

Management is to produce a set of further proposals for discussion by Friday 20 January - and the two sides will meet again on Monday 23 January.

Asked whether this removed the possibility that the union would serve formal notice of industrial action following Tuesday's Executive Council meeting, Mr Doran said he would be presenting tonight's proposal to the executive and they would decide whether to allow further time for discussion. 

A HSE spokesperson said both sides had a meaningful engagement and a number of proposals are under consideration.

Trolley figures still 'unacceptably high': Harris

Meanwhile, Minister for Health Simon Harris says that despite a "significant reduction" since last week, the number of people on hospital trolleys remains "unacceptably high".

Mr Harris said he expected figures to be driven down by the seven 'extraordinary measures'  over and above the Winter Initiative that are being put in place from today, including additional transitional care beds, and more acute beds.

He pointed to the fact that the situation has been compounded by a significant outbreak of flu and appealed again for older people to get vaccinated.

There are 387 patients on trolleys today, according to the Health Service Executive’s TrolleyGar figures, representing a 10% increase on the figure this day last year.

Of the 387 patients, 34 have been waiting more than 24 hours for admission to a bed.

The figures show that 201 have been waiting nine hours or more for admission to a bed.

The HSE target is that there should never be more than 236 patients on trolleys on any given day.

The worst affected hospitals this morning were the Mater in Dublin, Galway University Hospital, Cork University Hospital and University Hospital Waterford.

Figures from the INMO however, which include patients on wards awaiting admission to a bed, say there are 509 patients awaiting admission.

The HSE TrolleyGar figures are taken and updated at 8am, 2pm and 8pm and can be viewed online.

Full capacity protocol at Portiuncula

Overcrowding and lengthy waiting times have led to the introduction of a full capacity protocol at Portuincula Hospital in Ballinasloe.

The Saolta Hospital Group, which manages the facility, says the Emergency Department has been extremely busy all week and that patients are experiencing significant delays in being admitted.

It has advised people that they can expect long delays before receiving treatment.

Those in need of medical assistance are being asked to consider travelling to Roscommon Hospital's Urgent Care centre which opens from 8am to 8pm.

However, the injury unit is not equipped to treat serious head, back or neck injuries and does not have the medical expertise to cater for abdominal pain, medical illnesses or mental health problems.

The unit does not treat children under the age of five either.