Hopes rise that Taoiseach fully engaged with resolving calamitous Mid-West health situation

SENIOR medics in Ennis Hospital will conduct a review of what additional resources are required in the Ennis Medical Assessment Unit (MAU) after one week of the new trial transferring all non-critical Clare patients by ambulance to Ennis Hospital.

Non-critical patients can now be transferred directly by ambulance to the Ennis MAU from Monday to Friday as part of a new pilot project to ease chronic overcrowding at University Hospital Limerick.

Paramedics previously had no option but to transport all Clare patients directly to UHL via ambulance following the controversial removal of 24-hour casualty cover from Ennis and Nenagh Hospitals in April 2009.

The unexpected change by the National Ambulance Service (NAS) in the controversial protocol, which started in Clare on Monday, is seen as a boost for the Mid-West Hospitals Group campaign to secure the return of round-the-clock cover in Ennis and Nenagh Hospitals.

Pressure is growing on the UL Hospitals Group to provide additional resources to Ennis Hospital to cope with the extra patients being admitted following the implementation of the new protocol.

UL Hospitals Group chief executive officer, Colette Cowan told a meeting of Mid-West Oireachtas members on Wednesday there would be a review after a week in conjunction with Dr Pearse and Dr Hennessy who run the Ennis MAU to determine what resources are required.

Describing the meeting as constructive, Deputy Michael McNamara said it seems improving healthcare in the Mid-West will be a greater priority under Taoiseach Leo Varadkar compared with his predecessor Micheál Martin.

“Time will tell, the proof of the pudding will be in the eating. I was very disappointed with Micheál Martin’s failure to engage after raising over-crowding in UHL with him repeatedly. This is a car crash in slow motion. Every deputy in the Mid-West could see this calamity coming.

“I get the sense that Leo Varadkar understands the urgency of the situation and the under resourcing of the UL Hospitals Group compared to other parts of the country. He seems determined to try and resolve this issue,” he said.

Deputy McNamara asked what resources were put in place in Ennis Hospital and what were planned.

Dr Mike O’Connor National Clinical Advisor and Group Lead Acute Hospitals HSE acknowledged there has been a significant under-utilisation of Model 2 hospitals such as Ennis Hospital.

While construction has started on the development of a new 96-bed block at UHL, it emerged during the meeting two more 96 bed units will be fast-tracked for capital funding.

There was no discussion about any planned capital works in Ennis Hospital.

Surgical hubs were advanced as an idea that might help ease the pressure on UHL particularly by the Taoiseach Leo Varadkar.

Deputy Alan Kelly proposed a new employment order should be introduced to improve the pay and conditions for family carers to tackle the huge deficit in social care.

The meeting was held against the backdrop of the growing public unease about the impact of chronic overcrowding in UHL on elderly Clare patients.

Major reductions in scheduled care are to remain in force across the UL Hospitals’ Group this week as the major internal incident declared on January 2 was stood down on Wednesday.

Extraordinary measures taken across the group and in the community have helped reduced the extreme levels of overcrowding seen early last week at the Emergency Department at UHL.

However, all acute hospitals in the region are operating above capacity and staff remain on high alert amid a surge of respiratory infection in the community that has not yet reached its peak.

Led by Health Minister Stephen Donnelly, the newly-elected Taoiseach Leo Varadkar was also a very active participant.

It was also attended by UL Hospitals’ Group Chief Clinical Director, Professor Brian Lenehan, Chief Operations Officer, Noreen Spillane and Chief Officer HSE Mid West Community Healthcare.

There was a lot of discussion at the meeting about the possibility of extending the hours of the Ennis MAU and Local Injury Unit, making the new ambulance protocol permanent and considering a similar initiative for Nenagh Hospital without any definite commitments.

Noeleen Moran of the Mid-West Hospital Campaign described the change in the ambulance protocol as a “step in the right direction”.

She called on the UL Hospitals’ Group to put the adequate resources in place in Ennis Hospital to ensure medical staff can cope with the increased number of patients that will be referred from the ambulance service, GPs and Shannondoc to the MAU.

“There will be extra demands put on Ennis Hospital and the resources have to be put in place to ensure this change is successful. The only way this will work practically is the additional resources must be put in place to deal with additional patients.

“This would be a game changer if the resources were put in place and the hours were extended. Once extra resources are put in place in Ennis, there is no reason why the operating hours for the protocol can’t be extended. GPs and Shannondoc are also able to refer patients directly to the MAU in Ennis but sometimes these patients end up going directly to the ED in UHL because the capacity isn’t there in Ennis,” she said.

In a statement issued to The Clare Champion, the UL Hospitals’ Group welcomed the pilot initiative for the Medical Assessment Unit at Ennis Hospital.

The group will be reviewing progress in the coming days with the National Ambulance Service and with the senior clinicians and the management team at Ennis Hospital.

Any additional resource requirements identified in the context of the new NAS protocol will be escalated to the HSE nationally.

“It should be noted that the MAU in Ennis has seen an increase in staffing levels recently. This follows approval by the National Treatment Purchase Fund in late 2020 of a business plan to expand the service in Ennis. This has allowed for additional medical, nursing, allied health and support staff to be recruited for Ennis MAU in 2021 and 2022.

“These additional staff have supported increased activity at Ennis MAU, where GPs can refer patients seven days a week. Attendances at Ennis MAU increased from 4,766 in 2019 to 7,768 in 2022, an increase of 63%, In 2022, there was an annual increase of 14% in attendances to Ennis MAU,” the group stated.