Hospital’s trolley use to end ‘in two years’

THE doctor tasked with overseeing the reconfiguration of hospitals in the Health Service Executive (HSE) South has pledged to end the use of trolleys within two years.

Director of Reconfiguration Professor John Higgins said he would regard it as “a mark of failure” if they did not eliminate the need to keep patients on trolleys in Cork University Hospital’s (CUH) A&E by the end of 2011.

CUH is set to be the only A&E in Cork city and county, if the reconfiguration plan is implemented in full. The plan proposes that A&Es in the Mercy University Hospital (MUH), South Infirmary Victoria University Hospital (SIVUH), Mallow General Hospital (MGH) and Bantry General Hospital (BGH) be replaced by medical assessment and admissions units (MAAU).

These units would be accessible 24-hours-a-day for medical emergencies and would cater for acutely medically ill patients with conditions such as heart failure, pneumonia, stroke and epilepsy. Patients in need of emergency surgery or trauma victims (eg car crash victims) would be treated at CUH, the only hospital in Cork to provide on-call out-of-hours emergency surgery.

However, management at MUH yesterday said they had “no intention” of closing its 24-hour A&E “or making any changes there at present”. “Our strategic plan does envisage a changed role, but any such changes will be in the context of the implementation of our strategy and in CUH addressing their challenges and problems.”

MUH unveiled a five-year plan in August which envisaged a reduced A&E service operating from 8am-10pm and a 24-hour admissions referral centre. MUH warned in its plan CUH was already operating beyond capacity.The Review of Emergency Departments [EDs] and Pre-Hospital Emergency Care in Cork and Kerry, launched by the HSE yesterday, listed crowding and staffing as top problems at CUH. Its A&E was designed with a capacity of 60,000 and “in a situation where there were to be two other 24-hour EDs working in the city,” the review said.

Prof Higgins said they would be “looking at what services can come off the [CUH] campus”.

Mallow and Bantry will continue to carry out surgery, but on a day-case basis only. Kerry General will retain its 24-hour A&E and an existing MAAU will be “re-invigorated” according to HSE South director of emergency medicine, Dr Stephen Cusack.

Mallow, MUH and SIVUH will also have urgent care centres, open 12 hours a day, seven days a week to care for patients with acute illnesses and minor injuries which are not life-threatening.

Mallow and Bantry will also have the support of an advanced paramedic team, trained to carry out a number of life support procedures; the Bantry team isalready in place and is the first model of its kind in the country.