Simon Harris seeks A&E overcrowding answers from University Hospital Limerick

Health Minister Simon Harris has written to management at University Hospital Limerick asking how overcrowding seemed to be getting worse even after a new €24m A&E had been opened there.

The new emergency facility opened in May amid promises of three times more space and far better conditions for patients.

However, no sooner had it opened than the chronic overcrowding that had plagued the previous A&E reared its head once again. Documents obtained under freedom of information reveal how the patience of Health Minister Simon Harris finally ran out in July when promised improvements had not taken place.

In an email, he wrote: “I see that UHL has worsened this afternoon rather than improved as per their expectation [and] undertaking. 27 on trollies on a summer day … is far too high and a cause of significant concern.

“We have invested heavily in a new emergency department and additional staffing for Limerick. I would be grateful if you could convey my concerns and the need for actions [and] improvement.” The records also show how the hospital was hit with an outbreak of the highly drug resistant superbug KPC (klebsiella pneumoniae carbapenemase), which has been an ongoing problem in Limerick.

This latest outbreak temporarily shut the orthopaedic/ trauma ward of the hospital, causing further chaos in accident and emergency as they tried to deal with surging patient numbers.

The hospital later responded to Mr Harris saying the opening of the new €24m A&E was never going to solve all its problems.

Chief executive Colette Cowan told the minister that the emergency department had seen a spike in use of over 5% in its first weeks of operation.

She wrote: “Literature suggests a 10% growth in activity when new infrastructure is opened that normally peaks and reduces after four to eight weeks. A similar rise occurred when the Mater Hospital’s Emergency Department opened.”

Ms Cowan said the hospital had consistently said the new unit would not “resolve our capacity issues” but said it had greatly improved the “privacy and dignity for our patients”.

She wrote: “[A] study in recent weeks … indicated that UHL at 89% occupancy would require 50 additional beds immediately. We continue to operate at 110% to 115% occupancy.”

The hospital said it had a long list of measures in place to manage its A&E but that it faced a “challenged environment with high activity and low bed stock”.

The documents also reveal how within days of the €24m facility opening, Limerick was cropping up in daily reports with a surge in patient numbers.

Repeatedly, throughout the summer the hospital was mentioned in daily briefing reports as one of the “sites of most concern”.

One report described how there were 36 extra beds/trolleys in use on July 5 with “no prospect of reducing same, given steady demand”.

A week later, a separate briefing for the Department of Health described how the hospital was now dealing with an outbreak of the superbug klebsiella pneumoniae carbapenemase (KPC).

It said: “One of the biggest risks to flow is that KPC is now in the orthopaedic/ trauma ward therefore closed to admissions and transfers out which is impacting very significantly on other wards as this is the main trauma season. Site remains severely congested.”

In a statement, the hospital said a range of measures were in place to “relieve pressure” on the emergency department with a separate plan already in place for this winter.

The statement said: “While patients still face delays in the new emergency department, it provides for a much improved patient experience compared to the old department.”