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University Hospital Limerick Alamy Stock Photo

Pilot project to ease overcrowding at Limerick hospital under way

Ambulances in the region will be able to bring patients directly to Ennis Hospital instead of them waiting on a trolley at University Hospital Limerick.

LAST UPDATE | 9 Jan 2023

A PILOT PROJECT to alleviate “inhumane” overcrowding at University Hospital Limerick (UHL) gets under way today. 

Patients in the midwest region will be brought directly to Ennis Hospital instead of them waiting on a trolley at University Hospital Limerick as part of plans to ease record-breaking overcrowding at UHL’s emergency department.

UL Hospitals Group (ULHG) management outlined in a note to staff last week that “patients can be transported directly to the Medical Assessment Unit in Ennis Hospital” from Monday.

The service will operate from 8am to 8pm but is not open to the public in general – a referral is required. Paramedics will transport patients to the unit until 6pm. 

Patients will need to meet criteria and any transfers will be done in consultation between the paramedic and a consultant at the hospital.

Emergency crowding

A “major internal incident” was declared at University Hospital Limerick last Monday due to increasing patient numbers.

It is hoped the use of the Ennis unit will help with the flow of patients from Limerick, providing patients in Co Clare and surrounds treatment closer to home. 

In a joint statement to The Journal today, ULHG and the National Ambulance Service (NAS) said that the “Medical Assessment Unit (MAU) pathway for 112/999 patients being introduced in Ennis Hospital and the Mid-West was successfully trialled in North Cork and Mallow General Hospital in 2022″.

“It allows stable medical patients that meet the agreed clinical criteria to be treated in a Model 2 hospital,” they explained, adding, “A key element is a telephone referral from the treating paramedic to the receiving MAU doctor, which ensures that the right patient is brought to the MAU. 

“This pathway will result in patients receiving medical treatment in a hospital closer to their home, will reduce patient presentations to Emergency Departments and will release ambulances more quickly to respond to other emergency calls. 112/999 patients that do not meet these clinical criteria will continue to be transported to Emergency Departments for assessment and treatment.” 

The groups also asked that unwell medical patients do not attend the MAU without a referral from either a GP, ShannonDoc or NAS paramedics. 

HSE response

Speaking on RTÉ’s Morning Ireland, the HSE’s chief clinical director Dr Colm Henry said that prioritising patients presenting to emergency departments may lead to the delay or cancellation of elective surgeries at Ennis Hospital.

“From a clinical and from a patient safety perspective, our absolute priority are those people with acute unscheduled care who are presenting to emergency departments as well as time critical care people,” he said.

These are our priorities. Unfortunately, in prioritising those patients, it does involve curtailment of non urgent care.

“It’s never a preferred option to cancel or curtail or delay a surgery for people who are awaiting surgery whether for pain or disability. But as I say, in any healthcare system, and we’re no different from other health care systems across Europe now in responding to what is a significant threat – an exceptional flu season coupled with Covid and RSV – is we must maximise the care of those people who have time critical care who are presenting in great numbers due to the surge of viral infection right across this country and right across Europe, prioritising the care of those with the greatest need.”

A similar project was implemented in north Co Cork with Mallow Hospital to ease overcrowding at Cork University Hospital, however that has also been hit with high numbers on trolleys in recent weeks.

The downgrading of Ennis Hospital, as well as other similarly sized hospitals in Limerick city and Nenagh, has been highlighted by doctors and health campaigners in the Midwest as the key factor behind the overcrowding.  

Reconfiguration of the region’s hospitals over a decade ago saw the A&E wards closed in Ennis, Nenagh and St John’s Hospital in Limerick City, partly due to safety concerns surrounding these smaller hospitals.

The pilot project has been welcomed by the region’s Midwest Hospital Campaign group.

It told The Journal last week that it was a small step in the right direction following its members’ campaigning over years for Ennis to be used more.

Similar calls have been made for Nenagh Hospital in north Tipperary to also be used to ease overcrowding at UHL, but the pilot is focused on Ennis for now.

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