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Health Minister Stephen Donnelly Alamy Stock Photo
University Hospital Limerick

GPs at ED doors and fast build beds: The HSE and Donnelly's plan to tackle UHL's overcrowding

Health Minister Stephen Donnelly visited University Hospital Limerick today and met with management, consultants and the HSE CEO.

MINISTER FOR HEALTH Stephen Donnelly has announced a suite of measures aimed at tackling overcrowding at University Hospital Limerick (UHL) as he visited the hospital today. 

During his visit, Donnelly met with management, the HSE CEO Bernard Gloster, consultants and other clinical leaders. 

UHL’s Emergency Department has been consistently and chronically overcrowded for years and the hospital has frequently been in the news in recent months. 

RTÉ News reported last month that 450 patients who were due to attend hospitals across the UHL group for elective procedures had their surgeries cancelled since the start of this year. HSE chief Bernard Gloster said “it’s not acceptable”

In a statement today, the HSE said that so far this year, there has been a 11.5% (37,000) increase in the number of people presenting at Emergency Departments (EDs) in Ireland compared to the same period last year. 

UHL has consistently the highest number of people waiting on trollies for admittance to a hospital bed in the country, the HSE said. 

So, what are Minister for Health Stephen Donnelly and the HSE planning to do to tackle the overcrowding issue? 

The Minister today announced the following measures:

  • The opening hours of the region’s three Acute Medical Assessment Units at Nenagh, Ennis and St John’s are to be extended to 24/7 on a phased basis.
  • UHL is to provide GP and Advanced Nurse Practitioner-on-the-door services for the ED in an effort to alleviate overcrowding and allow the ED staff to treat urgent and emergency patients in a more timely manner.
  • A procurement process has been started for the operation of the new 50-bed Community Nursing Unit in Nenagh as a step down sub-acute and rehabilitation facility for UHL for one year until the first 96-bed block is opened.
  • The bed profile in this new block is being changed from 48 new beds to 71 new beds. Donnelly has asked that recruitment commence 2024 for immediate readiness in 2025.
  • He has mandated that all steps are taken to accelerate the second 96-bed block to be built at UHL, having sanctioned enabling works for that project last year. Those works have begun.
  • A further 20 permanent step down transition & rehab beds is to be procured in Clare.
  • 16 additional fast build beds are to be commissioned onsite with this capacity to be available in advance of next winter’s surge.
  • Safe staffing will be extended to all wards in UHL as per the national rollout.
  • UHL is to be one of two national test sites for Acute Virtual Wards. 

To date this year, 17% of those who waited on trollies did so at UHL, a hospital which has 6% of Emergency Department attendances, and 6% of attendances of those over 75 years.

In UHL so far this year, there has been a 14% increase in the number of people presenting at ED compared to the same period last year. The number of patients on trolleys has increased by 49%.

Of the five hospitals with the highest numbers of patients on trolleys, UHL is the only one showing an increase in trolley numbers for 2024, the HSE said. 

Staffing changes

Donnelly has said he has asked and expects to see at UHL that senior decision makers are rostered on site, both in the Emergency Department and throughout the hospital after hours and at weekends. 

He said he wants an all-of-hospital approach to treating ED patients, including presence of non-ED consultants to support ED colleagues when necessary. 

There should be weekend access to scheduled diagnostics for ED and a strong patient flow team in place seven days per week, Donnelly has requested. 

Among some other measures, he has also asked that there be community and health and social care professional support for weekend discharge, with seven-day rostering. 

“These measures have proved to be successful when deployed in Waterford, Mullingar, Beaumont and elsewhere and I expect that they will be successful when they are rolled out here in Limerick,” Donnelly said. 

“Reform and change are difficult, they challenge us all, but reform and change are required here in UHL if we are to provide the service the people of this region expect and deserve.”

The UHL Hospital Group launched an internal investigation into the death of a 16-year old girl who died in the hospital in January. This comes after another teenage girl, Aoife Johnston, diedafter developing meningitis and languishing on a trolley for 12 hours in the overcrowded Emergency Department in December 2022. There is to be an inquiry into her death.

The HSE has also launched a review into the death of a woman in her 30s who died soon after presenting as unwell at UHL and going through a miscarriage. 

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