HIQA inspection highlights staff shortages and risk gaps at Tullamore Hospital

An unannounced inspection by HIQA of the Midland's Regional Hospital in Tullamore, revealed a high number of vacancies for key positions within the hospital.

Across the facility there were nine vacant consultant posts recognised as a risk on the hospital’s risk register. The pharmacy department had a number of vacant posts covered by agency staff and this risk was on the hospital’s risk register. Inspectors also found the peri-operative directorate had no clinical director.

In addition, the position of General Manager was also vacant during the inspection which was November 5 - 6 2024 and the director of nursing was filling the role.

The report published on June 24, noted that inspectors found the hospital to be compliant, partially compliant and substantially compliant, depending on the area reviewed.

A judgment of substantially compliant means that on the basis of the inspection, the service met most of the requirements of the relevant national standard, but some action is required to be fully compliant. A judgment of partially compliant means the service met some of the requirements of the relevant national standard while other requirements were not met. These deficiencies, while not currently presenting significant risks, may present moderate risks, which could lead to significant risks for people using the service over time if not addressed

One area of concern for the inspectors was that there were three patients over 75 in the emergency department greater than nine hours. This was not in line with national key performance indicators (KPI) where 99% of all attendees aged 75 years and over in the emergency department should be discharged or admitted within 9 hours of registration. There were no patients over the age of 75 years in the department greater than 24 hours of registration.

Inspectors reported that ''on the day of inspection more work was required to manage KPIs relating to patients over 75. In addition, further work is required to ensure that improvements relating to turn around times on reporting in radiology are followed up and closely monitored. Finally, improvements should be progressed to support a comprehensive medication safety programme in Midland Regional Hospital Tullamore.''

Inspectors spoke with patients during the inspection. Feedback from patients was positive and people stated they were happy with the care they received and were very complementary of staff

Overall, inspectors found that the hospital was planning, organising and managing their nursing, medical support staff to support the provision of high-quality, safe healthcare however improvements were required. There was room for improvement with regards to records on mandatory training and uptake of mandatory and essential training for staff.

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''More generally, management should progress full implementation of the HSE Enterprise Risk Management Policy 2023. In addition, further work is required to ensure that improvements relating to turn around times on reporting in radiology are followed up and closely monitored. Finally, improvements should be progressed to support a comprehensive medication safety programme in Midland Regional Hospital Tullamore,'' advised the inspectors.

The 232 bed hospital is the largest hospital in the midlands of Ireland and serves a population within Offaly Laois, Longford and Westmeath Kildare, West Wicklow and parts of South Dublin. It has 26 day beds.

Services provided by the hospital include: acute medical in-patient services, elective surgery, emergency care, critical care, diagnostics services and outpatient care

The hospital is a third in line referral site for Orthopaedics, ENT, Renal, Haematology/ Oncology and Rheumatology.