UHL staff fearful of winter surges due to 'unacceptable' overcrowding

On August 1, 110 patients were waiting for a bed at UHL. And on two days in July, the hospital had 86 and 95 patients on trolleys. Stock picture

Frontline staff at University Hospital Limerick say they are increasingly fearful about what the winter will bring as the hospital struggles to cope with “unprecedented” August overcrowding.

More than a year since Health Minister Stephen Donnelly deployed a specialist HSE team to address chronic overcrowding, particularly in the emergency department, the hospital had 100 patients on trolleys on Wednesday. On August 1, 110 patients were waiting for a bed, while in July, the hospital had 86 and 95 patients on trolleys on two separate days.

Siptu industrial representative Ger Kennedy says the situation is “worrisome”, noting how “there is very little difference now between the summer figures and the winter. If that’s the case in July and August, what are they going to be like come October or November, if this is the trend?”

Fine Gael senator Martin Conway: 'If this is the case in August, I dread where we will be on the first of November or even worse on January 1.' File picture: Stephen Collins

Mr Kennedy said there is real concern among members, including paramedics and porters. The Midwest Hospital Campaign described the overcrowding as unacceptable and called for a reversal of the policy which saw emergency departments closed in regional hospitals in Ennis, Co Clare, Nenagh, Co Tipperary, and St John’s, Limerick.

“This time last year they deployed a team of experts from the HSE to sort things out,” said spokeswoman Noeleen Moran. “One year on and despite all the efforts and the rejigging of plans for bank holiday weekend rotas, there is no difference to the outcome for patients. There is no difference to the trolley figures.

“The only thing that can turn this situation around will be the acceptance that one emergency department is not adequate to serve a population of over 400,000 people,” she said.

Noeleen Moran said: 'One year on and despite all the efforts and the rejigging of plans for bank holiday weekend rotas, there is no difference to the outcome for patients.' Picture: Brendan Gleeson

Mr Donnelly has defended the reconfiguration process and the role of the smaller hospitals, while also acknowledging that significant work remains to be done. 

In a letter to the Regional Health Forum West several days ago, he said: “These hospitals play a pivotal role in the delivery of high-quality patient care within the region. The model 2 hospitals accept transfers of appropriate patients from UHL on a daily basis.”

He pointed to construction of a 96-bed unit, and said: “Pre-planning meetings on a second 96-bed ward block at UHL have been also held and it is anticipated that planning permission will be applied for this month.”

The letter was in response to a query from Nenagh-based Independent councillor Seamus Morris,

It concluded: “The minister recognises that while improvements in patient care have been achieved, as noted in HIQA’s most recent inspection report of UHL, there is still significant work to be done.”

However, Sinn Féin TD for Limerick City Maurice Quinlivan accused the minister of not doing enough.

“Minister Donnelly hasn’t taken a hands-on approach here. He’s come down for a few photo ops, but 2023 will be the worst year for trolleys at UHL,” he said.

Mr Quinlivan claims the 2009 amalgamation of emergency departments at UHL left the hospitalcovering too large an area.

“People might be sitting in beds for four or five days,” he said. 

There’s a lot of things that could be done quickly, but July was its highest number of all time and it’s clear that UHL has never gotten the priority it deserves.

Mr Quinlivan added that there is no concrete plan to fix overcrowding.

“It is a massive area to cover with no plan. There’s a 96-bed ward being developed which would be welcome and other plans, but they will take years.”

Fine Gael senator Martin Conway said: “If this is the case in August, I dread where we will be on the first of November or even worse on January 1.”

He urged the health minister to tell the HSE to send its specialist team back in.

A hospital spokesman said: “University Hospital Limerick has for a sustained period been managing significantly high numbers of patients presenting to our Emergency Department, including many frail, elderly and other patients with complex care needs.” 

A daily average of 220 people came to the ED in July, compared to 195 in 2019, he said.

“A shortfall in patient bed capacity at UHL has been repeatedly acknowledged by all parties and remains the fundamental driver of hospital overcrowding,” he said.

This month 11 nurses join the ED, and he said: “Staff at all levels across UL Hospitals Group are working hard to reduce these wait times.”