Minister for Health Stephen Donnelly has ordered a review of health services in the midwest region to determine whether a second emergency department (ED) is required.
Amid ongoing controversy over overcrowding at University Hospital Limerick (UHL), the announcement signals Government acceptance that the region lacks capacity to deal with emergency patients.
The provision of a second ED in addition to that at UHL would require the construction of a new model 3 or 4 hospital or the upgrading of one of the smaller model 2 hospitals in the region – Nenagh, Ennis and St John’s.
Model 3 and 4 hospitals are larger facilities with EDs, whereas model 2 hospitals do not have an ED. The midwest is the only region in the State with no model 3 hospital, and has just one model 4 hospital – UHL.
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According to Mr Donnelly, the review will consider the case for a second ED in the region “in light of a big increase in the population in recent years and ongoing pressures” on the emergency department in Limerick.
The EDs at Nenagh, Ennis and St John’s closed 15 years ago as part of a reconfiguration of services in the region, which has been much criticised by campaign groups who want to see these services restored.
The decision was based on “very clear clinical advice at the time, as there is a clear relationship between emergency teams providing high volume of service and better outcomes,” Mr Donnelly said in a statement on Thursday.
“The aim was to minimise the risk of a patient presenting at the ED whose time critical needs exceeded the capacity of the hospital, and specialities 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.”
UHL has received “record” increases in investment in recent years, the Minister pointed out, yet overcrowding has increased – trolley numbers are up 39 per cent so far this year when they are falling elsewhere.
Staffing has increased by almost 1,200 since the end of 2019, and the hospital’s budget by 44 per cent. An additional 150 new beds have been provided.
Significant changes are still required in how UHL is run and how patient flow is managed, the Minister added.
Terms of reference of the review, to be carried out by the Health Information and Quality Authority, will be published after former chief justice Frank Clarke publishes his report on the death of 16-year-old Aoife Johnston in the UHL emergency department in December 2022. Mr Justice Clarke’s report will also make recommendations on the governance of the hospital.
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