An unannounced inspection of University Hospital Limerick has found the hospital “non-compliant” with three of the four national standards assessed in the inspection and “substantially compliant” with the forth standard.
The inspection, which was conducted by HIQA on November 21 last, found that since the previous inspection, the hospital had made improvements in resourcing, supports and alternate pathways.
It had established an Urgent and Emergency Care Directorate to coordinate the strategic and operational function of the emergency and urgent care services across the six hospital sites of the UL Hospitals Group.
The report, which was published earlier today, found that the ongoing mismatch between the number of people attending the Emergency Department (ED) and the hospital’s capacity resulted in an overcrowded ED, with patients admitted to the hospital continuing to be accommodated in the ED.
At 10am on the day of inspection, 32 of the 82 patients in the ED were admitted and awaiting an inpatient bed. This overcrowding, albeit reduced since the previous inspection, impacted on meaningful promotion of dignity and privacy for patients.
The planned addition of extra inpatient bed capacity is to be welcomed, but HIQA notes that the intended gains may be limited if a significant proportion of this new stock is used as replacement stock. This should be further considered in the context of the risks posed by overcrowding in the ED.
HIQA found that many of the new initiatives and improvements introduced by the hospital will take time to be fully established to impact positively on hospital attendance, PETs and admission rates. The underlying issue of ineffective patient flow has yet to be fully addressed but ongoing focus should be targeted at hospital avoidance measures and alternate pathways alongside the planned additional capacity.
Sinn Féin spokesperson on Health David Cullinane TD has called on the Government to end the dangerous recruitment embargo and fast-track 288 additional beds for University Hospital Limerick to get ahead of the constant crisis in the emergency department.
Mr Cullinane was responding to the publication of a HIQA, having also separately raised the issue with the Minister for Health in the Dáil earlier this morning.
“The latest HIQA inspection of University Hospital Limerick has again demonstrated that the hospital is severely constrained by a lack of bed capacity both in the hospital and in the community,” he said.
“The hospital is routinely overcrowded, which is degrading, not compliant with a human-rights approach to care, and strips patients of their dignity. The report clearly identifies significant and severe patient safety risks, which are not being effectively managed.
“The HIQA report is yet another clarion call for urgent action to expand capacity and improve management of safety risks at the hospital. The hospital is also severely challenged by a lack of alternative care options and step-down facilities in local communities, which would decrease pressure on the hospital if made available.
“Tomorrow morning, Sinn Féin will be launching our plan to fix Midwest health services. Maurice Quinlivan TD and I will launch that plan, which will outline our commitments to end the recruitment embargo, invest in 288 additional inpatient beds, review the closure of Ennis and Nenagh emergency departments, establish the full need for additional ED capacity in the region, and determine the safest configuration of emergency services on the basis of best practice and clinical evidence.”
The Irish Nurses and Midwives Organisation has called on the Government to fast-track the Patient Safety (Licensing) Bill in order to give HIQA more powers.
“The State has received ample reviews and inspections by HIQA that are all welcome. The reviews by HIQA compound what is being reported by our members on a daily basis,” said INMO General Secretary, Phil Ní Sheaghdha.
“The powers of HIQA need to go further than inspection and comment. Government must now publish and prioritise the passing of the Patient Safety (Licensing) Bill which would give HIQA the powers to ensure its recommendations are being enacted by individual hospitals and healthcare settings it inspects.
“Today’s reports by HIQA confirm that patients receive kind and compassionate care from the healthcare workers they interact with. It is clear that the conditions that they are working in are out of their control.”
Andrew Hamilton is a journalist, investigative reporter and blogger who has been working in the media in Ireland for the past 20 years. His areas of special interest include the environment, mental health and politics.