Battle for vital cystic fibrosis ward finally draws to a close

A charity that paid for an essential piece of infrastructure for cystic fibrosis patients at CUH has been battling for months to get it open. As RTÉ’s ‘Prime Time’ trains its sights on the story, could the epic saga be over, asks Catherine Shanahan

Tue, 20 Oct, 2015 - 01:00

Catherine Shanahan

THE saga of the 20-bed adult respiratory ward at Cork University Hospital (CUH), paid for by a charity, but still closed to the patients who helped fund it, is set to feature tonight in an RTÉ Prime Time examination of how nurse staffing shortages are affecting vital hospital services.

The story has featured repeatedly in these pages over the past few years, reaching a particular low last month when 27-year-old Cystic Fibrosis (CF) patient Kim Doheny, who travelled from Waterford to CUH for treatment, was sent home because there were no beds available.

Kim, who had a respiratory tract infection, was devastated, not so much by the inconvenience of a wasted trip, but because she, like many other CF patients, remained unable to access hospital treatment in the kind of safe and sterile environment her illness requires, despite the existence of a fully equipped ward designed to do so.

The hospital’s argument for its ongoing failure to open ward 5B centred on staffing shortages. It blamed its inability to set an opening date on the knock-effect the new beds would have elsewhere in the hospital system. It said the hospital would lose eight medical inpatient beds if it was to transfer CF patients to the new ward at this time.

Nobody was contesting this claim. Recruiting and retaining nurses in the current climate is like trying to push a rock uphill. But the excuse rang hollow in light of the documented history of the project. The need to address staffing has been on the agenda from the get-go, as minutes of the project group’s earliest meetings illustrate. As far back as February 2012, the minutes read that one member of hospital staff “is presently collating the nursing requirements which will be needed”.

As Joe Browne, founder of Build4Life, the charity that paid for the €2.3m ward, said, the hospital had over four years to plan to meet staffing requirements and actually tasked various individuals throughout the project’s lifetime with preparing to meet this need.

Despite flags being raised on a number of occasions, eg March 2013 the minutes read “that progress on identifying the staffing for the ward is not progressing due to overall staffing issues within the hospital”, we still arrived at a scenario where staffing issues remained unresolved more than two years later.

And when we talk about a ward being closed, we are not talking about a general ward, but a very specific piece of infrastructure designed to meet the needs of CF patients in a manner that offers the best shot of recovery from the kind of infections you or I can easily bat off but which to CF patients can prove fatal.

I went to visit Kim, with her blessing, when she got a hospital bed. It was not an isolation room, but a single room on a busy ward. Every time she stepped outside her room, you could argue she was potentially exposing herself to cross infection. If ward 5B was open, it would have been possible to isolate Kim.

The hospital’s own Statement of Need, drawn up in January 2012, which sets out the argument for the development of an adult CF and respiratory ward, refers to the “national and international consensus guidelines” which highlight “the absolute need for single side room accommodation during these patients’ inpatient stay to isolate CF patients from each other to minimise the risk of cross infection”.

It also refers to the fact that more than 90% of adult CF patients die from respiratory failure as a consequence of respiratory infection. “Recurrent respiratory tract infections result in patients being both very unwell themselves and a risk to cross infect other patients with CF as the infections are easily transmissible....with devastating consequences,” the statement said. This is grim reading for anyone with CF and it made failure to open ward 5B unforgivable.

No one is denying the difficulty of the challenge facing hospital managers where one cause is more worthy than the next. No one is saying one cohort of patients is more deserving than another. But it is fair to say, as the records show, that CUH could see this coming.

It is fair to say they had four years to plan for staff. What was not fair was expecting the charity that worked tirelessly to pay for the ward - or the patients who stand to benefit - to wait indefinitely.

According to the project timeline, it should have opened last March. It didn’t happen. In July, the charity was told they were looking at “a provisional opening date of October if not sooner” pending recruitment.

Just over a week ago, in response to a parliamentary question, hospital CEO Tony McNamara indicated the ward would open at the end of the month. And then finally, last night, the breakthrough.

When contacted by Prime Time, the hospital said the ward would open this weekend. Build4Life received an email announcing the same good news. Understandably delighted, Joe Browne nonetheless sounded a note of caution. “We of course welcome the news, but what we want to see now is the ward operating at full capacity.”

Original project timeline