Review to determine if second ED needed in Mid-West

Emergency facilities in Ennis and Nenagh closed 15 years ago

Health authorities will determine if a second emergency department is required in the Mid-West after the Minister for Health announced a review into emergency care capacity in the region.

The HIQA assessment will consider the case for a second ED for the region in light of ongoing pressures at University Hospital Limerick (UHL), which has consistently seen the worst overcrowding levels in the country.

The review comes 15 years after smaller EDs in the region – in Ennis, Nenagh, and St John’s Hospital in Limerick – were closed. The closures came amid advice that the smaller facilities did not have high enough levels of patient activity needed to ensure optimal outcomes.

“The aim was to minimise the risk of a patient presenting at the Emergency Department whose time critical needs exceeded the capacity of the hospital, and specialties needed, to treat them,” said a statement from the Department of Health.

“We also know that important services, including intensive care units, require a certain throughput so that clinicians can maintain their skills.”

The Irish Nurses and Midwives Organisation (INMO) has welcomed the review.

“There is huge pressure on our members working in University Hospital Limerick due to capacity issues and staffing deficits coupled with changes in demographics in the mid-west region,” said INMO mid-west representative Mary Fogarty.

“Any review into providing additional urgent care capacity will be welcomed by the INMO and we want to have input into the drafting of the terms of reference. It is clear that at this point we will need a Model 3 hospital in the Mid-West.”

While average trolley counts in hospitals around the country falling by 11 per cent in the first four months of this year, UHL has seen record overcrowding. So far this year trolley numbers in the Limerick ED has increased by 39 per cent, with 8,798 patients left waiting for care there.

The review announcement also comes one week after HIQA published an inspection report on UHL’s ED, which found that patient experience times were continuing to fall short of targets.

Despite these persistent challenges, the hospital has seen significant investment in recent years, including an extra 1,183 staff since late 2019 and a 44 per cent increase in its budget in the last five years.

Since January 2020, 98 new ward beds and 10 critical care bed have opened in UHL. The new review will consider the additional capacity being added, as well as future reforms that are needed.

Terms of reference will be finalised once the report commissioned into the death of Aoife Johnston has been considered, so that its findings can be incorporated. This report is being led by former Chief Justice Frank Clarke and comes after the inquest into the 16-year-old’s death returned a verdict of medical misadventure.

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