The Health Service Executive (HSE) has confirmed it is to proceed with plans to end round-the-clock A&E services at Ennis and Nenagh hospitals from Monday.
The moves follows the breakdown of talks with unions under the auspices of the Labour Relations Commission (LRC) in Limerick last night.
Health service unions have expressed concern over the changes, claiming the HSE has failed to produce written proposals and finalise protocols on the changes.
In a joint statement issued after the talks collapsed last night, The Irish Nurses Organisation (INO) and trade union Siptu said the HSE had failed to allow for time to comprehensively address patient safety issues and staffing levels raised.
The INO is also seeking compensation for the loss of income that nurses in both hospitals will lose from their night duty allowances once the changes are introduced.
Health service unions are due to meet in Limerick again tonight to discuss their response to the plans following the collapse of the talks.
The HSE has said that continuing to offer round-the-clock services in the midwest is unviable.
Under the changes the A&E units in Ennis and Nenagh will cease to provide 24-hour services from Monday.
Instead they will be open from 8am to 8pm and emergencies outside those hours will be dealt with at the Mid Western Regional Hospital in Limerick.
Over 3,000 people demonstrated over the HSE's plans in Ennis on Saturday.
