HEALTH Minister Stephen Donnelly will be asked by An Taoiseach Micheál Martin to set up an independent inquiry into chronic overcrowding in University Hospital Limerick (UHL) after two record-breaking days of trolley numbers, writes Dan Danaher.
Surging admissions, which resulted in 97 patients languishing on trolleys in UHL on Tuesday and 111 on Wednesday, have prompted calls for an independent inquiry into overcrowding.
Speaking in the Dáil on Wednesday, Deputy Michael McNamara said the new 96-bed unit will only deliver 48 additional beds as the remaining new beds will replace existing ones. (See Champion story here)
“I would accept that any amount of new beds isn’t going to meet the exponential growth in numbers on trolleys in UHL. I don’t know is there a problem with the way admission and discharge is done in the hospital, or one of the other hospitals in the group needs to be upgraded to a Model Three hospital.”
I have called for an independent investigation into ongoing overcrowding at University Hospital Limerick (UHL), where a record 111 patients were on trolleys this morning. pic.twitter.com/jNEE7kxCnW
— Michael McNamara TD (@MlMcNamaraTD) January 26, 2022
The Independent Deputy asked the Taoiseach to commission an official independent inquiry to establish “what is the problem with healthcare in the UHL Hospitals’ Group”.
The Taoiseach said there is capacity issues in the Saolta Group and, in particular, at UHL, which can’t be solved overnight, but there have been moves on that front.
“You (McNamara) have raised a wider issue that I think merits further examination. I will ask the minister and the HSE to pursue that.”
The Health Information and Quality Authority (HIQA) confirmed it has been in contact with UHL to seek further information on how they are managing the overcrowding situation.
The agency await a response from the hospital and will continue to monitor the situation closely.
Speaking in the Seanad, Senator Martin Conway called for an independent inquiry into overcrowding excluding any employee of the UL Hospitals’ Group.
Senator Conway described the presence of 97 people on trolleys in UHL on Tuesday as “indefensible” and an indictment of the health service and Government.
“In spite of tens of millions of euro being spent building modular units and additional accommodation, there is a situation in UHL where there are more people from the mid-west on trolleys than anywhere else in the country.
“Is it a lack of funding, resources, available nurses, beds or Covid? Is it due to a difficulty with management or is it down to incompetence? The people of the mid-west deserve answers at this stage. I am blue in the face standing up here year after year, month after month, highlighting this.”
The Irish Nurses and Midwives Organisation has called for direct intervention from the HSE and the Minister for Health as trolley numbers spiral out of control.
INMO General Secretary, Phil Ní Sheaghdha said the situation in UHL is now “out of control”.
“It is unacceptable to our members that this level of overcrowding is allowed to continue while Covid-19 is still a very real feature in our hospitals.
“Non-emergency care must be curtailed in our hospitals until the end of February to allow nurses and midwives to have some chance of doing their jobs safely.”
Mary Fogarty, INMO Assistant Director of Industrial Relations said UHL is regularly the most overcrowded hospital in Ireland.
“Despite major investment in capacity at the hospital, it is making no dent in the consistent overcrowding problem in the hospital. Overcrowding adds stress for staff and worsens patient care. It is high-risk in normal times, but even more so during a pandemic.
“Patients and nurses at UHL deserve better than these conditions. It has been an extremely difficult 22 months since Covid-19 first arrived but UHL was already overstretched before the pandemic.”
Councillor Cillian Murphy said UHL has been hit by the “perfect storm” of Covid-19, which had resulted in staff being off work and additional Covid-19 confirmed cases that have to be treated in the hospital.
However, Councillor Murphy wondered why Covid-19 and other factors have resulted in an estimated increase of 30% in patients on trolleys, which wasn’t being replicated in several other acute hospitals throughout the country.
The HSE Health Forum member called for the implementation of an action plan to reduce overcrowding in UHL as a matter of urgency.
Chief executive officer, Colette Cowan told a virtual media briefing on Monday said tenders for the new 96-bed block are due to be submitted in February.
“We have 199 beds in nightingale wards across the hospital group. It is very evident to us these are a risk for outbreaks. Our plan is to eliminate nightingale wards and provide new isolation facilities.
“We haven’t been able to use our new 60-bed block properly because it is effectively a Covid-19 block. When the 60-bed block is freed up after the pandemic we will be able to transfer more patients from the ED.”
She said there are plans to enhance community care with new community assessment hubs as an alternative pathway for patients to reduce the numbers of patients being funnelled into the ED in UHL.
She added the group was not ignoring the fact the emergency department is very busy and have several initiatives to ensure patients are discharged as quickly as possible.
The group apologised to all patients who are facing long wait times for a bed at UHL.
In line with their escalation plan, UHL has also opened surge capacity to manage extremely high activity levels.
It admitted UHL remains under severe pressure as a result of sustained high attendances of very sick people with a variety of complex illnesses, including Covid-19, and the public is being advised to consider all alternative care options before attending emergency department.
In the 24 hours to 8am on Wednesday morning, 251 people presented at ED. Since the start of the year, the average daily ED attendances at UHL has been 226. On all weekdays this month, attendances at the department have exceeded 200, with the highest attendances, 265, recorded this Monday and on January 18. This is far in excess of the 195 average daily presentation figure in 2019, and continues a trend experienced in the Mid-West over a number of months.
On Wednesday, there were 61 Covid-positive inpatients being treated in the hospital, of whom five are receiving critical care.
UHL also continue to manage a Covid-19 outbreak in the hospital that is affecting a number of inpatient wards, increasing demand for isolation beds and impacting on patient flow.
High incidence of Covid-19 in the community, including outbreaks in nursing homes, is affecting the group’s capacity to discharge/transfer patients whose acute episode of care has concluded.
Delayed transfers of care are above average.
There were 211 whole-time equivalent staff unavailable for work in the group on Tuesday due to Covid-19.