The Irish Nurses and Midwives Organisation said it has serious concerns about overcrowding in hospitals over winter because of the high numbers of patients on trolleys in Emergency Departments this month.

The HSE warned that it is expecting a difficult winter in the health service and it is appealing to patients to consult with a GP and consider all other options before they attend an Emergency Department.

Over the past 30 days, 10,515 people have spent time on a trolley in a hospital Emergency Department.

The INMO said the figure is extremely high, in particular for September, and that it is worried about the winter ahead.

INMO General Secretary Phil Ní Sheaghdha said that the conditions in Emergency Departments she visited in recent weeks are not safe, with trolleys so close people cannot walk by and patients are able to touch each other.

She said infection control was impossible because of the situation.

"The Emergency Departments are overcrowded to an extent that it's not possible to deliver safe care."

She called on the HSE to make an immediate plan to deal with the overcrowding.

The INMO also said that in the past week alone in one Dublin hospital, 12 nurses in the Emergency Department handed in their notice as have six in ICU.

It said it is a signal of the pressures that staff are under on a daily basis.

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Sinn Féin's Health Spokesman David Cullinane said the Government needed a plan and extra funding to tackle the problem.

"What we need is a plan from the minister. Unfortunately, what we are getting is crisis management and winter plans that come too late. If you look at the most recent budget, not one single additional inpatient bed was promised above previous commitments."

The HSE said it expects the winter to be difficult and that it in finalising its plan for the months ahead.

HSE Director of Operations Damien McCallion said: "We do anticipate that this winter will be difficult. We see the risks in terms of Covid and flu together.

"We don't know whether that will materialise in the way it did in other jurisdictions. But what we're planning for and have, we have planned right throughout the year, is trying to increase the capacity in the system to respond and then have additional measures throughout the winter, which are hospital and community care areas."

The HSE has also appealed to patients to consult with a GP and consider all other options before attending an Emergency Department unless their situation is an emergency.

One hospital sees 12 ED nurses hand in their notice in one week

Regarding the 12 nurses who handed in their notice, Ms Ní Sheaghdha said the INMO immediately contacted hospital management and asked 'what are you doing about this?'.

Speaking to RTÉ News, she said: "My understanding is that they have handed in their notice, but what we're trying to do is say 'is there anything you can do to make them change their minds?'"

A process of engagement with management on the issue is ongoing, according to the INMO.

She added: "Really what management must be doing is saying 'look we have plans for this winter, you won't be under the same pressure that you've been under since the beginning of 2020', because that's when it started for a lot of these hospitals."

The HSE must focus on staff retention as well as recruitment, Ms Ní Sheaghdha said.

"Retention, we've constantly said, is as important as recruitment, because there's no point spending thousands and thousands to go off and recruit people, if that only lasts and the benefit of that only lasts for a month or two."

In a statement, the Ireland East Hospitals Group said it "cannot comment on individual staff members, this includes their employment status".

But it said that the hospital in question is "actively recruiting across all disciplines, including nursing staff for their Emergency Department".

"Following recent successful overseas recruitment campaigns, the hospital hopes to appoint a number of nurses throughout the organisation including their ED in the coming weeks and months."

Additional reporting Saoirse McGarrigle