Record emergency department patient numbers at Royal Victoria Hospital

More than 430 people attended the emergency department (ED) at the Royal Victoria Hospital in Belfast in just over 24 hours, BBC News NI can reveal.

It is the highest ever number of patients recorded at the hospital's ED.

The BBC understands clinicians in the hospital discussed the need for a major incident to be declared, but were able to cope when staff answered the call to return to work.

The Belfast Health Trust said the situation was managed.

The numbers were recorded between Sunday and Monday.

Dr Eoghan Ferrie, an emergency medicine consultant at the Royal Victoria Hospital (RVH) said: "The clinicians and staff on the ground very quickly identified that the demand was starting to exceed what would be normally expected.

"They did escalate that with the senior leadership team on the ground, who worked through the usual escalation measures to try to cope with that demand.

"We managed to manage through the escalation measures. Staff were re-deployed from other parts of the hospital to come and help at the front door and I want to thank those staff - it was very much appreciated."

EDs in a number of different health trusts have used social media in recent weeks to highlight how busy they are and to appeal for members of the public to only attend if absolutely necessary.

Waiting time targets have been breached in several areas with some patients have had to wait 24 hours or more.

In the past day there were also 300 12-hour breaches across the system.

Calling a major incident is often seen as a sign of weakness but according to staff it recognises that the system is broken and needs vital support.

The numbers treated in a 24-hour period at the RVH are a record

Dr Ferrie added: "There's no doubt that yesterday was extremely challenging and from what I hear the whole region has been under pressure over the past 24 hours in particular.

"The numbers through the door of the ED and urgent care centre - was higher than we have experienced ever before in RVH so there is do doubt it was a challenging day."

The following figures, provided by the Health and Social Care Board, reflect the number of people who attended EDs in 24 hours between Monday and Tuesady.

• Southern Trust - 505

• Northern Trust - 460

• Belfast Trust - 432

• South Eastern Trust - 389

• Western Trust - 340

Dr Ferrie added: "It is hard to know why Monday in particular was so busy - we do know that the start of the week does tend to be busy but from looking at the attendances and the types of attendances yesterday they were all patients who did need to be seen at some part of the system.

"Capacity is always an issue and a challenge and has been for a long time - not just in Northern Ireland but across the UK as well.

"Last year the health minister announced the reform and the early principles from the regional review of emergency care and each of the trusts is trying to working against principles to try and improve capacity both in hospitals and in the community to make sure patients get to the right place at the right time.

"There is a limit on capacity and we know that.

"We are just trying to manage that capacity in the most efficient way possible."

While covid figures are under control the health service is beginning to see old problems creeping back into the system again.

Challenges including a lack of hospital beds and too few nurses still haven't been resolved and the fact they are rearing their heads at the start of summer and not winter is particularly concerning.