Health Minister Stephen Donnelly has called for more on-site involvement from consultants at Limerick’s University Hospital (UHL) emergency department to address the ongoing trolley crisis. By implementing improvements under the Public Only Consultant Contract (POCC), overcrowding issues can be resolved, he stated during his crisis visit to UHL, a hospital known for its chronic overcrowding that has resulted in numerous patient fatalities.
Reflecting on his meetings with ‘exhausted’ frontline staff, Minister Donnelly said that additional troops in the form of beds and greater support from senior medical practitioners are needed on the ground in the hospital. He further disclosed plans to add 86 more beds to the hospital, comprising 16 rapid build beds at UHL, 50 step-down beds in Nenagh and 20 community healthcare beds in Clare, before a predicted increase in patient numbers during the winter period, in order to relieve some of the pressure on hospital staff and patients.
He announced the construction of a 96-bed block within the UHL grounds, anticipated to be operational by 2025, with plans for another of similar size. However, he insisted that changes in the workplace practices by UHL consultants are crucial. He highlighted that reform within the hospital is required for successful outcomes. He made note of Limerick’s relatively low uptake of the new public-only consultant contract and expressed concerns about the insufficient scale of weekend discharges.
The Health Minister commended those ‘many’ consultants tirelessly working around the clock to improve patient flow, but he insisted on having more consultants ‘scheduled on-site, throughout the hospital, post-normal working hours and at weekends.’ He concluded by saying that he had clearly communicated to the management team that strong leadership from senior clinical professionals is now crucial to reducing the number of trolleys in the hospital.
Colette Cowan, the CEO of the UL Hospitals Group, commented at a local health forum recently that only 28% of emergency medicine consultants in her group had agreed to the POCC, which may require them to extend their working hours by five on Saturdays and by two on weekdays.
HSE Chief Executive Bernard Gloster accompanied Mr Donnelly to UHL, where Mr Donnelly stated to the press that UHL was listed as the 9th hospital in the nation for weekend discharges, a factor that needed to be ameliorated. He also stressed that an all-encompassing hospital strategy was crucial for treating ED patients. This would involve the support of non-ED consultants in the Emergency Department when necessary.
Mr Donnelly pointed out that UHL was a “significant outlier” as there was a notable rise in trolley numbers despite a decrease in other hospitals, indicating a 50% upsurge in trolleys despite similar increases in presentations.
Members of the MWHC staged a protest outside the hospital, demanding the reopening of emergency departments in Nenagh, Ennis, and St Johns Hospital, all of which were closed and redirected to UHL in 2009.
Mr Donnelly conceded that the reconfiguration had been a failure due to inadequate resources, emphasising that investment should have been made initially in UHL to accommodate the inflow of extra patients. He also expressed concern over an unreleased internal report on the death of Martin Abbott, a patient at UHL whose body remained unnoticed on the ED floor for over an hour. Mr Donnelly commented that the report revealed a chain of “failures” in Mr Abbott’s care and criticised UHL for not yet implementing solutions to overcrowding that have been effective in other hospitals.
“It’s imperative to ensure that the medical staff in this hospital are equipped with the necessary support and a system for patient management is effectively orchestrated, to prevent a reoccurrence of such incidents.”