LAST UPDATE | 9 May

A REVIEW IS set to be launched to consider the case for a second emergency department in the Midwest region in light of ongoing pressures at the ED in University Hospital Limerick.

Trolley numbers at UHL have increased by 39% so far this year and the Department of Health said these figures are in “contrast” with trends elsewhere, with the average morning trolley count falling by 11% over the first quarter of the year.

The latest Trolley Watch figures from the INMO showed 95 people waiting for a bed this morning in UHL.

Emergency departments are part of larger hospitals and smaller ones in the region, such as in Nenagh and Ennis, closed around 15 years ago.

There are currently four injury units in the region, but only one ED at University Hospital Limerick.

In a statement today, a Department of Health spokesperson said this decision was based on “very clear clinical advice at the time”.

The spokesperson remarked that the “aim was to minimise the risk of a patient presenting at the ED whose time critical needs exceeded the capacity of the hospital, and specialties needed, to treat them”.

However, the Department spokesperson said the population of the Midwest has “grown considerably” since then and noted that the population is older than other regions, and therefore in “greater need for urgent and emergency care”.

The Department said “significant changes” are required at UHL, as highlighted in a recent HIQA report that found “significant risks” to patient safety remain at UHL’s ED.

Health Minister Stephen Donnelly has asked HIQA to lead the upcoming review considering the case for a second ED in the region, and the review will also consider future reforms that are needed.

Speaking to RTÉ’s News at One, Donnelly said he is ordering a review now “because of what’s happened in the hospital in recent months”. 

Donnelly said that what’s happened at UHL in recent months is “at odds” with other hospitals around the country.

“Around the country, there’s been a huge increase in capacity in beds, in workforce, in community capacity,” Donnelly said, adding that there has been a “very important reduction in the number of patients on trolleys”. 

“By contrast in UHL, it’s actually had the biggest level of investment, it’s had the biggest increase in staff, in spite of heroic efforts by many of those staff, not only are the trolley numbers in UHL not falling in the last few months, they’ve actually gone up very considerably on this time last year,” he said. 

“What I want is an answer for the people in the Midwest.”

The Irish Nurses and Midwives Association (INMO) has welcomed the decision for a HIQA review to be conducted of the acute hospital system in the Midwest.

The union’s assistant director of industrial relations for the region, Mary Fogerty said the issues that have “dogged” the emergency department of UHL have been well flagged by the INMO.

“So far this year, 8,798 patients have been admitted to University Hospital Limerick to be treated on a trolley, chair or in another inappropriate bed space,” she said.

“Any review into providing additional urgent care capacity will be welcomed by the INMO and we want to have input into the drafting of the terms of reference,” she added.

Clare TD Cathal Crowe has also welcomed the decision by Donnelly to request a HIQA review into the acute hospital system in the Midwest.

The terms of reference for the review will soon be drawn up, and Crowe described the upcoming review as a “huge day for healthcare in our region”.

“We have waited so long for this news, and it is inevitable that an additional accident and emergency department will be needed in the Midwest, as the region’s population continues to grow,” said Crowe.

While he remarked that there are “no foregone conclusions of the HIQA review”, he added that it is his “strong hope” that the “result of the review is that an additional A&E is recommended and then pursued”.

He added: “Half a million people through one A&E is simply untenable and not experienced anywhere else in the country.

“I eagerly await further detail on this and hope that this will result in a positive outcome for healthcare in Clare and the wider region.”

With reporting by Hayley Halpin and Muiris O’Cearbhaill