Care at Louth hospitals praised but overcrowding and staffing pressures persist

Patients attending Our Lady of Lourdes Hospital in Drogheda continue to receive kind and professional care, according to a new inspection report from the Health Information and Quality Authority (HIQA), but longstanding issues around overcrowding, bed capacity and staffing remain a serious concern.

The announced inspection, carried out on June 4 and 5, 2025, examined Our Lady of Lourdes Hospital along with Louth County Hospital in Dundalk and the Cottage Hospital in Drogheda. 

HIQA inspectors reported consistently positive feedback from patients across all three sites. Those attending the emergency department in Drogheda described staff as “very kind”, “lovely” and doing “the best they can” under pressure. Patients in Louth County Hospital’s Medical 1 ward in Dundalk described care as “exceptional”, while patients in the Cottage Hospital also praised staff and food quality.

Inspectors observed staff interacting with patients in a respectful, caring and compassionate manner, and HIQA found the hospital compliant with standards relating to kindness, dignity and respect.

Despite positive feedback on care, the report highlights ongoing overcrowding at Our Lady of Lourdes Hospital’s emergency department, now the fifth busiest in the country.

In 2024, the emergency department recorded more than 72,000 attendances – an average of around 200 patients per day, with peak days reaching as high as 270. Although a new 15-bed modular ward opened earlier this year, HIQA found that the additional capacity has had only a limited impact on reducing pressure.

On the day of inspection, 85 patients were registered in the emergency department, with 28 admitted and waiting for inpatient beds. Many patients continued to receive care on trolleys, either in the emergency department or in inpatient wards.

HIQA noted that average patient waiting times remain among the highest of any Model 3 hospital, with admitted patients spending almost 9 hours on average in the emergency department.

The inspection found that bed shortages continue to disrupt scheduled care. Units intended for assessment and day procedures, such as the Acute Medical Assessment Unit and the day ward, were frequently used as surge wards for admitted patients. This has contributed to delays and cancellations for elective procedures, increasing waiting lists.

While hospital management has introduced escalation plans and admission avoidance pathways, inspectors said the mismatch between demand and available beds remains unresolved.

Louth County Hospital in Dundalk was found to be operating at very high occupancy, with beds almost fully utilised. However, HIQA noted challenges in transferring suitable patients due to shortages in health and social care professionals.

By contrast, the Cottage Hospital was operating at lower occupancy levels. Senior hospital management reported that this was due to the type of service the Cottage Hospital provides and therefore there was a very limited and defined profile of patients that could be transferred to the Cottage Hospital.reflecting its highly specialised step-down role and limited patient profile.

While nursing numbers overall met approved levels, the report identified staffing pressures in specific areas, including the emergency department and the new short-stay ward, where reliance on overtime and agency staff was noted.

Absenteeism rates were also highlighted, particularly at Louth County Hospital, where levels exceeded national targets.

HIQA raised concerns about gaps in mandatory training, including hand hygiene compliance among doctors and nurses, and limited availability of clinical pharmacists across the hospital group.

Inspectors identified shortcomings in parts of the physical environment, particularly in surge areas and the emergency department. Issues included limited storage, insufficient isolation rooms, and infrastructure that does not fully support infection prevention and control.

Read Next: Much-loved mid-Louth deli to close its doors this Christmas

HIQA also criticised the failure to involve infection control specialists early in the design of the new modular ward, a gap senior management acknowledged during the inspection.

Overall HIQA found the hospital group to be substantially compliant with governance, quality monitoring and patient safety oversight and partially compliant in areas including emergency department management, workforce planning, physical environment and patient privacy.

The authority acknowledged progress since its last inspection in 2024 but warned that improvements have been modest and that sustained action is urgently needed.