Nenagh councillor is told bed shortfall remains main driver of hospital overcrowding

Tipperary county councillor Seamus Morris has asked the Regional Health Forum if, due to the the worsening of conditions of the Emergency Department at U Hospital Limerick despite many investigations and interventions, was hospital management happy with the safety in ED for staff and patients.

In response, Prof Colette Cowan, CEO of University Limerick Hospital Group, said that patient safety in the ED and across the hospital group “is a constant area of focus for our staff”.

She said that examples of recent Quality and Patient Safety initiatives had been sepsis awareness events throughout September and World Patient Safety Day on September 17.

“UHL’s well documented shortfall in bed capacity remains the fundamental driver of overcrowding at UHL. Our teams must continually balance the needs of the most acutely ill emergency and urgent care patients against the needs of inpatients and those waiting for scheduled care,” she said.

Prof Cowan said that the group was following its hospital escalation plan to maximise patient flow and create additional capacity to manage the consistently high levels of activity in the hospital.

“Staff are focused on ensuring that emergency care is first received by the sickest patients. Measures taken on a daily basis include opening surge capacity across all sites; transferring patients on trolleys to our inpatient wards; additional ward rounds by medical teams to expedite discharges or identify patients suitable for transfer to Ennis, Nenagh and St John’s Hospitals; and working closely with our colleagues in HSE Mid West Community Healthcare in order to expedite discharges” said the CEO.

She said that the publication of the Hiqa report in June arising from its inspection at UHL in February 2023 provided some assurance that measures introduced to improve flow in the hospital and in the community were having a positive impact on patient care.

“The report reflects an overall increase in compliance with the national standards since the previous inspection,” she said.

Of the 15 standards assessed in the ED and across the hospital, UHL was found to be compliant in one instance, substantially compliant in seven, partially compliant in five and non-compliant in two. The areas of non-compliance related in the main to physical infrastructure in its older nightingale wards and to patient dignity and respect in its Emergency Department.

“It is important to acknowledge progress in the provision of care to the sickest patients in the region. For example, we have considerably increased our critical care capacity in recent years in one of the most modern ICU/HDU facilities in the country,” she said.

However, Cllr Morris said after the meeting that management were not doing themselves any favours by covering up Government policy on reconfiguration which promised 600 emergency health beds for a population of 350,000 in 2009.

"We now have 530 beds for a population of 425,000 with just 48 beds on the way in the 96-bed block being built (the other 48 are replacing old wards in the hospital) so it was doomed to failure from the start with 'corridor care' becoming the norm," said Cllr Morris.

He said that he had pointed out that the Hiqa report stated UHL was compliant on one point but on two points it was non-compliant

“It found demand for services exceeded the Emergency Department's capacity which was a major contributing factor to overcrowding. While the HSE keeps fooling themselves, they are not providing us with safe emergency care,” he said.

However, Cllr Morris said that, to be fair, management agreed with most of his points.

“I will be working on this long, long journey to seek safe emergency care in the Mid-West, he pledged.