Health watchdog to publish terms of review into overcrowding at UHL

Hiqa to consider whether a second emergency department is needed in University Hospital Limerick as part of its review into emergency services across Limerick, Clare and North Tipperary

Hiqa spokeswoman said on Tuesday it intended to 'publish the terms of reference for its independent review into urgent and emergency healthcare services in the Mid-West region shortly'. Picture: Sam Boal /RollingNews.ie

Hiqa will soon publish the terms of reference for its review into whether a second hospital emergency department is needed to support University Hospital Limerick.

The health watchdog was asked in May to review all emergency services across Limerick, Clare and North Tipperary. 

This followed outrage at findings from two inquests and a court case linked to tragic deaths in the busy department at UHL.

A spokeswoman said on Tuesday it intended to “publish the terms of reference for its independent review into urgent and emergency healthcare services in the Mid-West region shortly". 

A separate report into the death of Aoife Johnston, 16, at the hospital by former Justice Frank Clarke was submitted to the HSE chief executive last month. 

Hiqa has not yet received a copy of this from the HSE, but the spokeswoman said: “Hiqa will take account of its recommendations in this review."

Meanwhile, Health Minister Stephen Donnelly said UHL was “fire-fighting” against overcrowding. He said solutions applied in other hospitals are not working there.

This comes as patients in five hospitals across Limerick, Clare and Tipperary, see their operations and appointments cancelled for a second week as UHL struggles with overcrowding.

Described as a re-set, the aim is to reduce numbers and allow people in crisis to be treated. 

There were 56 people on trolleys on Tuesday compared to 103 last Tuesday, figures for UHL from the Irish Nurses and Midwives Organisation show.

Health Minister Stephen Donnelly: 'We have a major problem in UHL and five of the hospitals with the biggest number of patients on trolleys represent half the national figure.' Picture: Niall Carson/PA Wire

Solving overcrowding in all Irish hospitals “is something that takes years”, Mr Donnelly said during a launch for a report on pharmacies.

He admitted: “We have a major problem in UHL and five of the hospitals with the biggest number of patients on trolleys represent half the national figure.” 

A report by an external expert team is “pretty stark in terms of what is not yet happening in UHL, these bits are not about capacity”, he said.

He also pointed to a recent Hiqa report which criticised overcrowding at UHL, but acknowledged this also said the hospital did not have enough beds.

However, he said: “In UHL, not exclusively but in UHL most prominently, the kind of reforms that have worked in other hospitals are not fully rolled out.” 

He gave a number of reasons for this. 

“Partly they’ve been under so much pressure for so long that it is nearly more difficult to do reform when you are fire-fighting all the time,” he said, agreeing some staff are at burnout.

The crisis in trolley numbers last week was partly linked to delays in discharging patients from UHL who had finished treatment, he said.

“Unfortunately in UHL, while the discharge rate on the Saturday and Sunday was good, it fell off on the Monday and it fell off on the Tuesday”, he said. 

He added: “So there is a management issue, there is a clinical leadership issue. There is a capacity issue.” 

Nationally, he said 1,200 beds have been opened and 500 are “under active construction”, with plans for more as well as additional staff in place.