Ennis hospital has a ‘different future’

OVER 90% of accident and emergency cases in Clare will still be treated in the Mid-Western Regional Hospital, Ennis, despite a radical change in the delivery of acute services over the coming months.

 

That’s according to outgoing Ennis hospital manager, Frank Keane, who insists the introduction of a new Medical Assessment Unit and Local Injuries Unit is in line with current and previous Government policies and the best clinical advice.

The opening times for the Medical Assessment Unit still have to be finalised. The emergency department at the hospital has operated from 8am to 8pm since April 2009.

Mr Keane, who is the new directorate manager for child health and maternity services, confirmed that “blue light emergency calls” will continue to be transported directly to the Mid-Western Regional Hospital, Limerick.

It is expected that in two or three months time, patients entering Ennis hospital will be streamed into the Local Injuries Unit or the new Medical Assessment Unit.

The minor injuries clinic, which was flagged in the controversial Hanly Report, will be able to treat cuts, grazes, injuries requiring sutures and initial management of some fractures.

Minor fractures, such as broken fingers and even simple breaks of a person’s arm, will continue to be treated, x-rayed and provided with a plaster-of-paris before an appointment is given for a fracture clinic a few days later.

New medical emergency physicians, who have been recruited at the Mid-Western Regional Hospital, Limerick, will oversee the new Medical Assessment Unit where GPs can refer patients for a full medical assessment.

Once a patient is medically assessed in Ennis, a decision will be taken to discharge them as an out-patient with a referral to a clinic, admit them as an in-patient or send them by ambulance into Limerick if their condition is life-threatening.

Emergency services will continue to be delivered by non-consultant hospital doctors in Ennis.

Mr Keane believes the introduction of a new stewardship and governance for all hospitals in the Mid-West will provide a safe service.

“Under the new on-call structure, we will have three groups of consultants, where specialities will be split across the hospital group, being treated as one network,” he said.

Continuing, he explained, “We will have doctors migrating to Ennis, Nenagh and Limerick. This is currently happening but is not as joined up as it could be. When a doctor in Limerick is making a decision about a patient in Ennis under the new system, he will be cognisant of the fact he could be in Ennis treating the same patient a day or two later.

“I don’t see it as downgrading. I have been consistent in saying Ennis hospital has a bright future but a different future.

“I would love to be the manager of Ennis hospital with its own cardio-thoracic operating theatre doing treble bypasses. It is never going to happen. You can’t have every service in every hospital.

“This is current and previous Government policy and we are implementing what the Minister for Health wants. It is supported by the best and brightest clinical leadership and HIQA guidelines. It is the direction that acute health care is evolving,” he said.

The new model of care was previously criticised by Fianna Fáil Deputy Timmy Dooley as “downgrading”.

He also asked Fine Gael Deputies Pat Breen and Joe Carey to explain the rationale behind this significant change in Government policy in light of pre-election commitments made by Fine Gael leader Enda Kenny, that all existing services at Ennis would be maintained.

In an interview with The Clare Champion in February 2011, Deputy Kenny stated, “Fine Gael remain committed to retention of acute medical facilities and suspension of removal of cardiac facilities”.

Deputy Carey said Minister James Reilly had assured him the new template for smaller hospitals like Ennis would be provided in a new blueprint, which is expected to be published in the near future.

HSE West Forum member Councillor Brian Meaney queried the loss of services at Ennis hospital, such as the High Dependency Unit (HDU).

Councillor Meaney questioned if the acute medical programme is being rolled out in other small acute hospitals, such as Roscommon.

“I am concerned that Ennis hospital is taking the brunt of cost-cutting measures to compensate for over-runs in other hospitals throughout the west.”

Forum member Councillor Tom McNamara requested the HSE to publish the medical evidence supporting the changes in Ennis.