Press release
Statement on review into urgent and emergency care capacity in the mid-west region
From Department of Health
Published on
Last updated on
From Department of Health
Published on
Last updated on
The Minister for Health Stephen Donnelly is to initiate a review into urgent and emergency care capacity in the mid-west region to determine whether a second Emergency Department (ED) is required. EDs are part of larger hospitals (known as Model 3’s / Model 4’s).
The review will consider the case for a second Emergency Department for the region, in light of a big increase in the population in recent years and ongoing pressures at the Emergency Department at University Hospital Limerick (UHL).
Smaller Emergency Departments in the region closed 15 years ago. This was based on the very clear clinical advice at the time, as there is a clear relationship between emergency teams providing high volume of service and better outcomes. The aim was to minimise the risk of a patient presenting at the Emergency Department whose time critical needs exceeded the capacity of the hospital, and specialties needed, to treat them. We also know that important services, including intensive care units, require a certain throughput so that clinicians can maintain their skills.
Since those clinical decisions were made, the population in the Midwest has grown considerably. The population is also older than it is in most other regions. Older populations have a greater need for urgent and emergency care.
There have been record increases in investment in UHL during the lifetime of this government. However, overcrowding at UHL’s emergency department continues with trolley numbers increasing by 39% so far this year. This contrasts with the national trend, with the average morning trolley count falling by 11% during the first four months of the year. Some hospitals continually have no patients on trolleys.
Investment in additional capacity includes:
Investment has also included additional capacity at St. John’s, Croom Orthopaedic, Ennis and Nenagh hospitals.
While some reforms are underway at UHL, significant changes are still required in terms of how UHL is run and how patient flow is managed. This was highlighted in the recent report by the Health Information and Quality Authority (HIQA). HIQA noted evidence of improvements in operational efficiencies, but said greater operational grip was also needed.
The review will consider the additional capacity being added, as well as future reforms that are needed.
Terms of Reference will be finalised and published once the upcoming review by Mr Justice Frank Clarke (retired) has been considered, so that its findings and recommendations can be incorporated. The former Chief Justice is conducting a formal investigation into the death of Aoife Johnston. The Minister has asked HIQA to lead the review.