Patients left to ‘wallow’ in pain in UHL, TD claims

PATIENTS are left to “wallow” in pain on trolleys in University Hospital Limerick for long periods after they are assessed, a local Dáil deputy has claimed.

Having attended the ED recently with a family member, Deputy Cathal Crowe told a recent Dáil Health Committee meeting there isn’t enough follow up with patients who are left waiting in corridors.

“Charts and extensive data can be seen by someone going to the toilet or the shop, people going into see their relatives can see patients with bedpans. There is no privacy there. There is very few people who come along with a cup of tea or a slice of toast to perk patients up.”

“There is enduring pain when you are sitting on a trolley. People feel from triage to trolley, you are left to wallow.”

Professor Brian Lenehan said UHL are focusing on providing privacy and dignity for patients following the HIQA report. He explained patients are triaged for care based on the critical nature of their illness, so if they are very critical there is no waiting time.

He said the best way to provide dignity and privacy was to eliminate trolleys from the ED where there are 40 individual assessment bays.

When HIQA completed its unannounced inspection last March, Professor Lenehan admitted they found nursing shortfall due to vacancies, short-term illness and last minute sickness, despite a
redeployment of other nurses.

Professor Lenehan said the number of patients on trolleys in UHL has reduced over the last few months following incremental changes.

“HIQA saw pictures none of us want to see, they saw a significant number of patients waiting in the waiting area for triage.

“Inspectors saw 49 or 50 trolleys, as well as the cubicles at capacity. It is not our aspiration to treat patients on trolleys. The inspectors also saw trolleys on our wards.

“We have not had a patient on a trolley on our wards for the past six weeks. We are in a better position than we were, and we will continue to work to improve that for the care of our patients and for the health and well-being of our staff.”

Deputy Crowe described the staff who provided care to his family member as “incredible”.

Two years ago, he recalled another family member was a so-called “bed blocker” because even though they were well enough to be discharged on a Friday at 4pm there was no consultant available to sign off on the discharge so they remained until the following Monday or Tuesday.

“How can you have oversight of what is happening in the hospital when you are based in an office block 1.5 kilometres away?

Professor Colette Cowan replied management were on site for three or four years when she first took up the CEO position eight years ago but moved out because clinical teams had no space to work out of.

As CEO, she stressed she runs six hospitals not just UHL.

“We are on site all of the time. All of my team go up and down to UHL three or four times a day. We hold our meetings there in the boardroom. All of the staff know me personally by name and we walk through the system.

Management teams at the most senior level run UHL. We also have a head of service in there now.”

Deputy Cathal Crowe asked why the UL Hospitals’ Group and not other hospital groups was the subject of a negative HIQA report and persistent overcrowding.

Professor Lenehan replied it comes down to demand and capacity where a population of almost 400,000 in the Mid-West has one 24-hour ED and only has 530 in-patient beds including 49 paediatric beds.

“There is a higher demand than we can service, without additional capacity that will persist, despite all the efforts of everyone working hard on the ground. We need to address this with short, medium and long term measures, which we are doing. Despite the lack of non-consultant hospital doctors, we are looking inward to see how we can perform better with what we have.”

Deputy Crowe asked why the group had a record number of ED attendances last year, despite repeated requests for patients to use other acute facilities.

Professor Lenehan said other hospital groups had Model Four and Model Three hospitals and private hospitals with Emergency facilities.

He said the group are looking at what primary, community and care at pharmacy level deliver as an alternative to the ED.