THE HSE has issued a protocol to the UL Hospitals Group that if a patient is waiting on a trolley for more than nine hours at the University Hospital Limerick emergency department, they could apply a €10,000 budget deduction.
As part of a national protocol, Minister for Health Leo Varadkar, HSE director general Tony O’Brien and HSE acute services national director Liam Woods informed the UL Hospitals Group that the Dooradoyle A&E must enforce its escalation plans, should any patient be waiting on a trolley for nine hours or more.
The protocol — the Emergency Department Congestion Escalation Directive — also requires the Limerick hospital to activate its winter plans to assist the relief in A&E overcrowding.
A UL Hospitals Group spokesperson stated that if any more than eight patients are left on trolleys — or one patient waiting on a trolley for more than nine hours — UHL staff will roll out its overcrowding measures immediately.
When the Group was asked if the hospital is confident in fully-complying with the directive, the spokesperson replied:
“UL Hospitals would hope to keep any breaches of this ED Congestion Escalation Directive to a minimum.”
The directive’s financial penalties are active, from December 1 to March 1, 2016, and all proceeds will be re-allocated to “best performing hospitals” that are most compliant with the directive.
The new directive, which was launched last Friday, includes the “home by 11pm” policy, cross-team discharging, and the national ambulance service must be active in inter-hospital transfers to manage group-wide capacity.
According to the correspondence to management, the UL Hospitals Group liaison officer will be notified of any breaches, and that the designated officer will determine if a breach has been made. The spokesperson stated that staff at UHL “work hard to ensure that the number of people waiting on trolleys in the emergency department is kept to a minimum”.
Some of the measures to reduce times include the transfer of patients from UHL to Ennis, Nenagh or St John’s; the transfer of patients to community care; communication with GPs to ensure patients are appropriately referred to A&E treatment; extra beds put on wards as a last resort, and many more.
UHL emergency department staff are due to undergo strike action between December and the New Year, after nationwide INMO members voted “overwhelmingly” in favour of nationwide industrial action, on November 24.
However, the UL Hospitals Group spokesperson said that it will “do everything to avert any possible industrial action” by working with INMO and SIPTU throughout the emergency department forum meetings.
Between Monday and Wednesday, there were 10 people on trolleys in the emergency department at University Hospital Limerick. On Monday morning, UHL had its one of its lowest ever overcrowding rate, with zero people on trolleys in the A&E and just one person on an additional bed or trolley in a ward.
Despite the low figures, an INMO spokesperson said that strike action will still take place at UHL.