Strategic plan to deal with UHL overcrowding

Independent Clare TD Michael McNamara has received confirmation that HIQA is to undertake inspections of the Emergency Department at University Hospital Limerick (UHL) and work with hospital management to develop a strategic plan to address capacity issues at the Mid-West facility.

In response to Deputy McNamara’s call for an independent inquiry into ongoing overcrowding at the hospital, Health Minister Stephen Donnelly says HIQA has received an evaluation of the current factors influencing crowding in the emergency department from the Hospital Group CEO.

Deputy McNamara said he hopes the strategic approach to tackling the trolley crisis will have a wider scope than the approach taken up to now.

“UHL is the most consistently overcrowded hospital in the country with over 76,000 attendances in 2021, up 16% compared to 2020 and up 7% on 2019,” stated Deputy McNamara. “Hospital management and staff appear to be firefighting on the issue of overcrowding as opposed to identifying and rectifying the issues that are causing the problem.”

“The Minister informed me that a key part of the solution for Limerick is additional beds,” stated Deputy McNamara. “However, the problem of overcrowding in Limerick has worsened rather than improved since the delivery of the 60-bed modular ward block, the provision of an additional 38 inpatient beds and the anticipated delivery of a 96-bed replacement ward block, for which a works contract will be awarded in early Quarter 2 of this year subject to HSE Board approval and funding availability. A full review of operations within the UL Hospitals Group is required if we are to ultimately find lasting solutions to the overcrowding issues.”

Deputy McNamara said HIQA has a limited remit and would not be able to put forward such recommendations as the upgrading of Ennis, Nenagh or St. Johns to Model 3 Hospitals. He continued, “There also needs to be an assessment of admission and discharge policies at UHL, as well as the impact of population growth on the demand for services within the UL Hospitals Group. I would hope that some additional outside expertise and input can form part of the delivery of any future strategic plan for tackling the long-standing overcrowding problem.”

Responding to Deputy McNamara, Minister Donnelly said surge capacity had been opened to manage the “extremely high levels of activity” being experienced at UHL. He added that the UL Hospital Group have reported that they are continuing to deal with high volumes of patients attending the University Hospital Limerick ED, a pattern that has been sustained over a number of months and is being replicated around the country.

“University Hospital Limerick is working to ensure that care is prioritised for the sickest patients,” Minister Donnelly stated. “As part of their escalation plan, additional ward rounds, accelerated discharges, and identification of patients for transfer to UL Model 2 hospitals are all underway. Surge capacity has been opened to manage the extremely high levels of activity.”

The Minister added, “HIQA has also been in recent correspondence with the Hospital Group CEO to seek further information and assurances from them relating to their evaluation of the current factors influencing crowding in the emergency department. The resultant evaluation which HIQA received is very comprehensive and strongly highlights the Hospital Group’s view as to the factors at play, not least their opinion that they remain short on bed capacity at the hospital in the context of limited bed stock across both the public and private sector in the region.”