133 on trolleys at University Hospital Limerick as advice waited on second Mid West emergency department

Ambulances outside University Hospital Limerick.

THE IRISH Nurses and Midwives Organisation (INMO) reported that University Hospital Limerick (UHL) had 133 patients waiting on trolleys for an in-patient bed today (Monday), just over two weeks on from Health Minister Stephen Donnelly ordering a review into urgent and emergency care capacity at the hospital.

Minister Donnelly ordered the review on May 9 to determine whether a second emergency department (ED) is required in the Mid West region.

Last week it emerged that almost 240 patients had died on trolleys waiting for a bed at UHL between 2019 and 2023.

Inspections of the hospital conducted by the Health Information and Quality Authority (HIQA) found risks of harm to patients had not been managed properly as recently as November 2023.

The UHL ED has capacity for 49 patients divided into three zones and is routinely reported by INMO as being the most overcrowded in Ireland.

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The Mid West is the only region nationally without a Model 3 hospital to allow for 24-hour emergency care as a back-up support to UHL (a Model 4 hospital) for treatment of the most seriously ill patients.

Minister Donnelly told an Oireachtas Petitions Committee meeting last week that, in his opinion, the reconfiguration of emergency department services in the region in 2009 was not adequately resourced and not carried out properly, and he was trying to rectify this with extra bed capacity and additional services.

The meeting heard that the Mid West Hospital Campaign group (MWHC), which is made up of patient advocates and families of patents who have died in UHL, has repeatedly called for the reopening of emergency departments in Ennis, St John’s, and Nenagh hospitals – which were closed in 2009 and reconfigured to UHL.

The MWHC has repeatedly stated that the reconfiguration of emergency care in the region has significantly increased pressure on UHL’s emergency department as well as exacerbating patient overcrowding in the hospital, and is one of the root causes of a number of patient deaths at UHL.

There were 133 patients waiting on trolleys for beds at the hospital this Monday morning, according to INMO Trolley Watch figures, including 60 patients on trolleys in the emergency department and 73 on wards.

According to figures published by HSE TrolleyGAR (similar to the Trolley Watch count), there were 70 patients waiting on trolleys at UHL this Monday morning, including 36 patients (seven over 75 years) waiting more than 24 hours for a bed.

Last week it emerged that the HSE was conducting a review into the circumstances around the death of 76-year-old Limerick father of three, Michael Cuddihy, who spent 18 hours on a trolley at UHL in severe pain before being sent home and died from sepsis two days later at his home.

Last March an inquest into the 2019 death of UHL patient Martin Abbott (65), from Shannon County Clare, heard that the man had fallen off a trolley in the overcrowded emergency department at UHL and that he may have been dead for over an hour on the floor of the unit before staff discovered him.

An inquest held last month into the 2022 death of UHL patient Aoife Johnston (16), also of Shannon, County Clare, heard from UHL emergency medicine consultant Dr Jim Gray that the emergency department was then, and still is, a “death trap” for patients.

Cork University Hospital was the country’s second most overcrowded hospital with 47 patients on trolleys across the ED and wards, followed by the Mater University Hospital, in Dublin (43), Tallaght University Hospital, Dublin (39), and Galway University Hospital (28), according to INMO.

A 96-bed block is currently being built on the ground of the hospital and due for completion in 2025, and a second 96-bed block is proposed.