Ten years after the reconfiguration of acute hospitals in the region, University Hospital Limerick is still trying to cope with the increased number of patients attending accident and emergency.
A long-awaited new Emergency Department in University Hospital Limerick had been expected to alleviate overcrowding, in reality, it has led to significantly increased attendances.
Both staff and patients at the regional hospital have endured very stressful times since the HSE’s reconfiguration plan caused the closure of 24-hour emergency services at Ennis, Nenagh and St John’s back in 2007.
Following the general election of 2002, the health minister, Mary Harney, set about creating centres of excellence. The Hanly Report provided the political cover for a range of austerity measures leading to a decline in rural health services.
There was much local opposition to the forced changes as it became obvious to many that the closure of acute services in the three smaller hospitals would lead to problems in Limerick.
Ten years later, in May this year, University Hospital Limerick’s new Emergency Department (ED) finally opened at a cost of €24 million. However, nursing unions have consistently pointed out that the hospital remains inadequately resourced to cope with increasing numbers presenting.
Last week the UL Hospitals Group issued a statement saying that Limerick has become the busiest hospital in the country with over 64,000 attendances in 2016.
Average daily attendances were once around the 150 mark but inside a 24-hour period on 22nd August, 210 people attended the new ED which has designated spaces for 49 patients.
In addition, UL Hospitals Group says that the number of patients attending the ED and requiring admissions has increased by 9.3% in the year to date, including a 3.6% increase in over-75s.
“Overcrowding,” it said, “is a whole-hospital issue and not an issue strictly for the ED. A multi-faceted approach is required in this regard encompassing additional bed capacity, improved patient flow, the development of integrated care programmes with community services – all of which are being addressed by the Group – and other measures.”
Ironically, when you think back to the Hanly Report, measures being taken by the group to relieve pressure on the ED include transferring patients from University Hospital Limerick to Ennis, Nenagh, St John’s and Croom.
Management acknowledges that University Hospital Limerick’s 400 inpatient beds are insufficient for the region’s needs and say that a bid to build an additional 96-bed block on the site was submitted to the Dept. of Health. Approval has been granted to fund the design stage.
During the first seven months of this year, almost 5,000 patients spent time on trolleys in University Hospital Limerick. The figures were confirmed by the Irish Nurses and Midwives Organisation (INMO) as part of their Trolley Watch campaign. In all 57,674 patients were admitted for care at Irish hospitals during that period.
UHL tops the overcrowding list with 4,782 patients on trolleys; Cork University Hospital is in second place with 3,949 while UH Galway is third with 3,688.
There does appear to be a silver lining as INMO has also confirmed a 6% reduction in the month of July compared to the same period last year.
According to the nurses’ organisation, these statistics confirm the lack of capacity, leading to lack of access, within the public health system.
Commenting on the situation, INMO general secretary Liam Doran said, “The record levels of patients on trolleys, in the first seven months, is most alarming as we prepare for the autumn/winter period.
“These figures are further confirmation that our health service continues to be too small and, regardless of the initiatives that have been taken, demand continues to outstrip the capacity of the health service to provide timely, appropriate and dignified care.
“The situation must be the subject of immediate action by Government, the Department of Health and the HSE. Additional funding is needed to provide for incentivised staff recruitment so that additional beds can be opened and properly staffed to meet ever growing demand”.
Mr Doran concluded: “If our health service is to respond, appropriately, to both the emergency and planned admissions, additional bed capacity and community nursing services must be introduced.
“This will only be done when we solve the recruitment/retention crisis facing nursing and midwifery in Ireland. If we do not have additional nurses and midwives then we cannot expand our capacity and overcrowding levels will continue to grow”.