HSE Mid-West pledge to rid A&E of trolleys by end of 2013

Mike Dwane

Reporter:

Mike Dwane

AS SENIOR hospital managers admitted the emergency department at the Mid Western Regional Hospital was “no longer fit for purpose”, a leading consultant has pledged the days of patients waiting on trolleys in A&E will soon end.

AS SENIOR hospital managers admitted the emergency department at the Mid Western Regional Hospital was “no longer fit for purpose”, a leading consultant has pledged the days of patients waiting on trolleys in A&E will soon end.

Dr Con Cronin, clinical director of medicine with the Mid-Western Acute Hospitals Group, said “we are working towards a target of no trolleys” in the emergency department by the end of 2013 and that senior medics and managers would be “very upset” if this target was not met.

As the HSE Mid-West announced details of its service plan for 2013, hospitals group boss Anne Doherty said the target was that by the end of the year nobody would be waiting longer than six hours in A&E to be either admitted or discharged.

Limerick has one of the country’s busiest emergency departments and, according to the INMO, one of the most seriously overcrowded. The eye-catching pledge to rid Ireland’s casualty units of trolleys has been made before - famously by former minister Mary Harney in 2005 - and at a briefing on the plan this Tuesday, Fine Gael’s Deputy Kieran O’Donnell asked whether he had heard the commitment correctly.

“You expect to see significant improvement shortly and your target would be that by the end of this year, you would not have people waiting on trolleys at the emergency department?” he asked Dr Cronin.

“Absolutely, we would feel we have failed ourselves if we have not achieved that target,” Dr Cronin replied.

“We would be very upset if there are any trolleys by the end of the year. We are working towards a target of no trolleys.”

He explained that services at medical assessment units across the region were being developed in such a way that would reduce the number of referrals to the emergency department by GPs across the region.

Three new physicians had been appointed to the acute medical assessment unit in Dooradoyle in January, meaning the unit was now staffed by five “senior clinical decision-makers” at consultant and registrar level who were making decisions on where patients would be best treated across the region. These senior medics would also hold sessions and be involved in organising services at the medical assessment units at St John’s, Ennis and Nenagh hospitals, Dr Cronin said.

Hospitals group CEO Anne Doherty, meanwhile, candidly admitted that the emergency department at the Regional Hospital was “no longer fit for purpose” but said the new A&E unit could take as long as two years to construct.

“Our current emergency department was a ward that was refurbished. It was seen at the time as a huge step forward as we had come from an area that was even smaller. In emergency departments, you need a flow of patients through them: to triage and take those with lesser injuries into one stream; those who are really really sick into a recess environment; and you need children to be cared for in a separate area for everybody’s safety. None of those things are in our current department in the way we would like,” she said.

“In our new department we will design it, and the design is nearly finished, in a way that children can wait and be treated in a separate area to adults.”

Work, she said, would shortly commence on the new emergency department, which would be accommodated not only on the ground floor of the €35 million critical care block already developed but also on an adjacent site which she said would be as big again. Above would be four floors of 20-bed wards on which the HSE Mid-West was only beginning capital funding discussions with the national body.

The HSE anticipates that the first and second floors of the critical care block - which will house intensive care and high dependency units - should be commissioned and equipped by the middle of April and an extra €3 million in funding had been provided to run the new units to year end.

Ms Doherty said the number of intensive care beds at the Regional would be increasing from seven to 10 and high dependency beds from six to eight as a result. It could take “a number of months” before specialist staff, including intensive care nurses, are recruited in order for the new units to operate at full capacity.

The coronary care unit had been “fully functional and operational” since January, Ms Doherty said.