UHL chief apologises for excessive waiting times at hospital ED

UL Hospitals Group, Chief Executive Officer, Professor Colette Cowan has apologised to every patient that has experienced excessive wait times or a poor care environment in UHL.

Professor Cowan made the apology during a three-hour discussion between senior officials in the UL Hospitals Group, national HSE officials and Mid-West Oireachtas representatives during a joint Health Committee meeting in Dublin on Wednesday.

Responding to Deputy Maurice Quinlivan’s question about what management was doing to relieve chronic waiting times in the UHL emergency department, shr said, “We don’t feel comfortable about patients waiting for treatment in the ED, but it is a capacity issue.

“We have looked at developments in our community and are developing the Enhanced Community Care Programme, which will create alternatives for elderly people, apart from the ED.

“UHL is a very busy hospital. All our patients tell us the care is good, the difficulty is getting through the ED door. We need another second 96-bed block, which would be five to ten years away.”

Senator Martin Conway acknowledged no one in management or the hard working staff wanted to see the situation that has existed in UHL over the last few years.

The Fine Gael Senator asked if management should have engaged with the Performance Management Unit (PMI) before HIQA’s unannounced inspection of UHL last March and why a more proactive approach wasn’t undertaken a few years ago.

He asked why did it take ministerial action to send down an expert group to prompt change in the patient flows and structures.

Professor Cowan acknowledged HIQA didn’t visit the ED in UHL because of the overcrowding problems highlighted in the media.

“We have been proactive for years raising issues on the growing demand in the region. There has been extensive work done and funding for the development of community health care. In my eight years, a lot of new health developments and new staff have been hired.”

PMI manager, Dr Mike O’Connor, said the health service has experienced an unprecedented challenge due to Covid-19 over the last few years.

Dr O’Connor said when members of the Performance Management and Improvement Unit arrived in UHL for a four-week stint in July, there was an improvement programme in place.

Senator Conway pointed out UHL has recorded some of the highest levels of overcrowding with patients on trolleys for a few years.

Asked whether Ennis should be upgraded to a Model Three acute facility, Professor Brian Lenehan said he didn’t believe Ennis and Nenagh are in a position to be upgraded to Model Thee status as this would require significant infrastructure and staffing resources.

He said the group needed to continue developing Ennis and Nenagh hospitals and provide more capacity in UHL.

“Trolleys will not disappear overnight,” he said.

A series of questions and proposals were also tabled by Deputy Cathal Crowe, Deputy Michael McNamara and Deputy Joe Carey.

Professor Cowan confirmed the group would do everything in its power to address the deficiencies outlined in the recent HIQA report and will welcome the support of the National Support Team as part of a recognition that significant resources are required to meet exceptional health demands in the Mid-West.

“We hope the publication of the HIQA report will be the catalyst to address the fundamental mismatch between demand and resources that is particular to the Mid-West.

“We have communicated this in parliamentary replies to committee members over the years and this mismatch is underlined in an external review of UHL by Deloitte, which was commissioned prior to the recent ministerial intervention.

“Nothing in this review alters the view we are short in-patient beds to meet demand.”

Next month, Professor Cowan confirmed the construction of a new 96-bed block will start in UHL, which will go some way towards alleviating existing bed capacity pressures.

This will include 48 new and 48 replacement beds and will take two years to build. However, UHL will continue to have a shortfall of 87 beds even when this new bed block is built.

The group also requires at least 68 extra non consultant hospital doctors.

She recalled the decision to reconfiguration public acute hospitals was taken in line with national policy and in response to another HIQA report, which raised questions about patient safety.

Since 2019, there has been a 63% in attendances at Ennis Medical Assessment Unit.

Almost 10,000 radiology tests have been completed up to the end of August 2022 under the direct access Community GP Diagnostics Programme.

Professor Cowan told the meeting there has been an extraordinary demand and response to the Covid-19 pandemic by staff in the UL Hospitals’ Group.

In 2021, UHL saw a record 76,473 attendances, which increased by 7% and 25% in the ED for the first eight months of this year.

The number of people who are 75 and older has also increased by an even greater percentage.

While other hospitals are seeing an increase in demand for unscheduled care, Professor Cowan described the UHL figures as “exceptional”, with an increase of 20% in in-patient admission and 15% in bed nights in UHL between 2019 and 2021.

In 2021, more than 1,200 new staff were recruited across the group, increasing their head count by 12%, while 900 additional staff have been hired in 2022.

Since the pandemic, 96 new in-patient and ten new critical care beds have been opened in UHL. New theatres and a 24-bed block has been opened in Croom Orthopaedic Hospital, three Covid-19 Vaccination Centres and the country’s only new field hospital in the University of Limerick.

Meanwhile, the Mid West Hospital Campaign was pleased to note that the petition with over 15,000 signatures demanding decent Emergency services for the people of Clare, Limerick and North Tipperary was accepted by the Petitions’ Committee in the Dáil on Thursday, September 14.

The JCPP has written to the campaign since and included the response from UL management that they received. The group are now considering its response to that communication, which it must submit before the committee next meets on September 29.