Extending ambulance protocols will not solve Limerick hospital overcrowding

Overcrowding at the emergency department in UHL

PROTOCOLS allowing National Ambulance service personnel to alleviate dangerously high levels of overcrowding at University Hospital Limerick (UHL) by transporting patients to Ennis Hospital are to be extended to Nenagh and St John’s Hospital in Limerick City.

The UL Hospitals Group, which operates six hospitals in the Mid West region, including four in Limerick, declared a “major internal incident” on January 2, when UHL’s emergency department could not sustain persistently high patient attendances.

Off-duty staff were summoned back to work; all outpatient appointments were cancelled and only urgent elective surgeries were being conducted to deal with the crisis.

Ennis, Nenagh, St Johns and Croom Orthopaedic Hospitals, along with nursing homes, have been providing surge capacity for UHL.

UHL, which provides the only 24-hour emergency department for a catchment of almost 400,000 was the most overcrowded hospital nationally today (Friday), with 70 patients on trolleys.

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This included 25 patients in the emergency department and 45 on wards, according to figures published by the Irish Nurses and Midwives Organisation.

On January 9, the National Ambulance Service began taking non-critical patients to a Medical Assessment Unit (MAU) at Ennis Hospital, instead of the emergency department in UHL.

A spokesman for the UL Hospitals Group said they were pleased with the progress of the initiative in Ennis and, following an evaluation, they expect to expand it to the Medical Assessment Unit at Nenagh Hospital and an update will be issued in the coming days”.

He added that the hospitals group also has “every expectation” the new protocol will be reintroduced at the MAU in St Johns Hospital.

However, a senior source working in the UL Hospital Group was skeptical about the new patient pathways having much of an impact on the overcrowded emergency department.

They raised concern that Nenagh does not have enough MAU beds to effectively alleviate UHL’s surge capacity.

“There are only six beds available at the Nenagh MAU at the weekends, which has traditionally been the busiest time of the week for UHL.

“Would six patients going into Nenagh at the weekend have much of an impact on the emergency department at UHL? Is that really taking away from the problem in Limerick?” the source asked

“Maybe it would make more sense to move Nenagh’s weekend MAU staff into UHL rather than move the patients out to Nenagh, because, after all, UHL needs all the staff it can get.

“If you’re going to reopen the emergency departments in Ennis, Nenagh and St John’s, yes – reopen them, but then you are going to have to staff them. They have to change from a Model 2 hospital to a Model 3, and if you are going to do that, you have to upgrade the facilities and the staff.”