Rehab hospital resumes services after three months without consultant cover

Children in need of complex specialised rehabilitation were unable to access inpatient beds at the National Rehabilitation Hospital (NRH) over a three-month period because there was no consultant cover.

While the service resumed yesterday, the hospital acknowledged it needs to secure a second consultant paediatrician in order to safeguard its inpatient service going forward.

The service was suspended in August when a consultant paediatrician, whose time is divided between the NRH and Our Lady’s Children’s Hospital Crumlin, had to take extended unplanned leave. The consultant’s primary medical position is with Crumlin.

The NRH said Crumlin hospital was “not in a position to provide alternative consultant paediatrician cover to the service at that time”.

During the three-month suspension of the service, the waiting list increased from 17 to 29. Children on the waiting list have conditions such as acquired brain injury, or have suffered spinal cord injury, or have lost a limb and require training in use of a prosthetic.

The hospital said in a statement that it will prioritise patients on the waiting list for admission as well as those who are “newly referred to the services or have been affected by the disruption”.

The hospital said it is working on securing its eight-bed inpatient service into the future by extending the working hours of its existing consultant (which is currently described as “limited”), but also by hiring a second paediatrician.

An NRH spokesperson said yesterday that all parties — including the HSE, relevant agencies, and itself — had worked to restore the “much-needed” consultant cover in order to allow it resume its inpatient service, which consists of six beds that provide 24-hour, five-day-a-week, rehabilitation and nursing care, and two day-case beds.

The spokesperson acknowledged that the service remains exposed in the absence of a second consultant but said the HSE was in agreement that another appointment was needed “to bring it up to a half-time post”.

She said the hospital is “just awaiting formal approval of funding for the post” from the HSE.

During the suspension, the hospital said it had continued treating children who were medically stable and who had previously been assessed by the consultant paediatrician as being safe for engagement with NRH outpatient therapy services.

As an interim arrangement, the paediatric programme changed from an inpatient programme to an outpatient and outreach programme during that period,” said the hospital.

The NRH said the paediatric programme “continued to carry out review assessments, therapy and outpatient services to known and existing patients”.

However, without consultant paediatrician input, “it was not possible to appropriately assess and triage new referrals, and medically manage patients at that time”.