Acute services should cease at hospital, warns report

IT is unsafe to continue with acute services at the Mid-Western Regional Hospital in Ennis, a damning report by the state’s health service watchdog reveals.

The Health Information and Quality Authority (HIQA) said it alerted the Health Service Executive (HSE) in January about patient safety issues at the hospital that needed to be addressed immediately.

It said acute, complex and specialist services were not sustainable at the hospital because not enough patients were presenting with serious conditions so medical specialists could maintain their clinical skills and expertise.

HIQA has asked the HSE to produce a plan for the implementation of 65 recommendations in their report and stressed that resources must be made available.

Some of the services are already in the process of being transferred by the health authority from Ennis to Limerick Regional Hospital.

The report also recommends a review of other hospitals that are providing a range of acute services similar to those provided by the Mid-Western Regional Hospital.

The authority said it was anxious that a transfer protocol was established at the hospital whereby critically ill patients requiring intensive care were transferred to Limerick.

The investigation was established last year after family members of two patients — the late Ann Moriarty and the late Edel Kelly, raised serious concerns about the care they received at the hospital.

“The investigation found that the hospital as it is currently configured is unsafe and will need to change the range and types of services it provides for its patients in order to build a thriving, appropriate and safer future for the community it serves,” said HIQA chief executive Dr Tracey Cooper.

The investigation did find examples of good non-acute care at the hospital and a committed ethos from hospital staff.

It also identified services which could be greatly expanded and enhanced at the hospital including diagnostic services, out-patients, day procedures, appropriate medical care, minor injuries and rehabilitation as part of the regional hospital network.

The report also stressed that the investigation did not set out to undertake a forensic investigation of the two women who died after their breast cancer was missed by the hospital.

Dr Cooper said the investigation took into account the experiences of a total of seven families at the start of the inquiry and spent many hours interviewing them.

HIQA also confirmed that it had not asked the HSE to cut the hospital’s accident and emergency opening hours in half.

Dr Cooper said the timing of the publication of the report had nothing to do with any HSE agenda. The report was ready to go before the board last Friday and the board decided on Monday that it should be published as soon as possible, she said.

Dr Cooper said HIQA was anxious that changes were made in governance procedures in the hospital so people could be held accountable in future.

She also criticised the way local HSE staff dealt with complaints from family members that left them feeling distrustful of them and the authority had made recommendations so that would not happen in the future.

The report found that complaints and claims process were not formally integrated at the hospitals and outcomes from such processes were not patient-focused.

Dr Cooper said it had to be made clear to patients that while some services could be satisfactorily delivered in the Ennis hospital, it was safer to receive other services in Limerick. And she said it was perfectly understandable that people wanted to maintain services in their local hospital.

“That does not necessarily mean that all services can be provided safely to the highest standards, with the best outcomes in those hospitals,” said Dr Cooper.


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