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A new HIQA report has found the Emergency Department at UHL was "grossly overcrowded on February 21, 2023.

‘Dangerous conditions’ for staff and patients in UHL ED

SIGNIFICANT reductions in elective surgery and outpatient diagnostics will continue in University Hospital Limerick (UHL) over the next month after record high Emergency Department attendances resulted in “dangerous conditions” for patient and staff safety.

The UL Hospitals’ Group has admitted planned reductions in scheduled care will continue over the Christmas and New Year period as the group concentrate on inpatients as well as emergency and time-critical care after the busiest weekend ever recorded in the hospital.

Responding to Clare Champion queries about the impact of the unprecedented demand on public hospital services, the group outlined work in their operating theatres will be focused on emergency and trauma patients until January 16.

It also warned anyone attending the ED with a less than urgent condition is going to face an “exceptionally long wait for treatment” as UHL struggled to cope with 92 patients on trolleys on Monday, 94 on Tuesday and 88 on Wednesday.

The INMO has confirmed UHL is the most overcrowded hospital with a total of 17,640 on trolleys from January 4 until December 21 more than double the 7,406 patients waiting for a bed in
St. Vincent’s University Hospital, Dublin.

This compares with 12,133 patients on trolleys at Cork University Hospital, 10, 012 at Galway University Hospital and 7,977 in Sligo University Hospital.

Describing the figure of 77,000 patients now waiting for hospital care across the Mid-West as “frightening” Noeleen Moran of the Mid-West Hospital Campaign said people were becoming immune to these figures as every month UHL seemed to be breaking records for all the wrong reasons.

“It is shocking what is happening and illustrates the need for much more government intervention. This situation can’t be allowed to continue.

“The HSE announced the Winter Plan in the middle of winter. That is not planning. There needs to be a plan put in place to deal with the cancellation of elective surgery, which will increase waiting lists even further.

“Talking about hiring doctors in 2023 isn’t going to deal with the situation now. There will have to be much more focus from the government resolving health issues in the Mid-West.

“Ennis and Nenagh Hospitals should be utilised a lot more. More investment needs to be spent on improving facilities in Ennis and Nenagh to take the pressure off UHL, which simply can’t cope,” she said.

The Irish Nurses and Midwives Organisation has called on management in University Hospital Limerick to abide by public statements and cancel all non-urgent elective care in the hospital and to prioritise the clinical needs of the emergency department patients.

This appeal came after the hospital was exceptionally busy over the weekend.

INMO Assistant Director of Industrial Relations, Mary Fogarty said it is clear that UHL cannot cope with providing emergency and elective care at the same time.

“Hospital management must abide by their public statements and actually curtail non-urgent elective care immediately.

“INMO members are reporting serious delays in triage and assessment of patients by doctors in the emergency department. Further delays on top of high patients without a bed is compromising care and outcomes for patients.

“At a time when everyone else in the country is winding down, it is only getting worse for INMO members and other healthcare workers in UHL. Management must take the extraordinary steps they have publicly promised.”

The group outlined the “unprecedented level” of ED attendance is driven by a surge in patients with respiratory infections, including Covid-19, flu and RSV, and significant numbers of people with trauma injuries resulting from slips and trips on the ice over recent days.

Sunday saw 221 people attending the ED, and 251 on Saturday: the busiest weekend ever recorded at the hospital.

The cancellation of surgery in line with their Escalation Plan, includes the redeployment of medical staff to the ED, and the transfer of appropriate trauma patients to Croom Orthopaedic Hospital for treatment.

The hospital has been directly contacting all patients with surgery or diagnostics appointments scheduled for today, and these appointments will be rescheduled at the earliest opportunity.

A spokesperson said, “The group apologises to everyone impacted by the decision, which was taken in the interests of patient safety and to help healthcare teams focus on inpatients, emergency patients, and the most time-critical elective patients.

“The Department of Radiology has scheduled limited outpatient diagnostics this week as staff prioritise the high volume of inpatients to facilitate discharges from hospital and reduce pressure on the UHL site. Outpatient diagnostics on Monday and Tuesday has been focused on time-critical oncology only.

“The group regrets that 14 patients due to come in for CT scans on Monday were rescheduled as all available CT scanners were is use to facilitate patient flow.

“Elective surgery this Monday and Tuesday has also prioritised time-critical patients. Emergency and trauma surgery is ongoing in addition to limited elective cases for time-critical cancer, vascular and ophthalmology patients.

“The group regrets that 10 patients coming in for elective surgery on Monday and Tuesday, including dental and urology patients, have been rescheduled.

“On Tuesday, all elective procedures in Croom Orthopaedic Hospital were cancelled to facilitate suitable trauma patients from UHL.

“As a model 4 hospital, UHL is a centre for complex surgery and the significant demand for unscheduled care through their ED must be balanced against the clinical need of patients who urgently require surgery.

“Their escalation plan does provide for reductions in elective activity and the decision taken to do so this week was not taken lightly.”

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