AS Limerick nurses prepare to stage industrial action next week, management at University Hospital Limerick have begun a recruitment drive to boost their numbers.
While it falls far short of the 70-100 positions the INMO says are required, the hospital has received 65 applications for the 23 full-time nursing posts for which it has funding.
And Prof Colette Cowan, CEO of the UL Hospitals Group, said she is also looking for an additional funding stream to staff the overflow ward next to the emergency department that has been set up to respond to overcrowding. That unit is currently being staffed through a combination of agency staff and redeployment.
“The funded vacancies we have are 23 WTE (whole-time equivalents) but alongside that we have an overflow ward open and if we were to staff that overflow ward of up to 30 beds, we would need another 20 WTE,” Prof Cowan explained in a media briefing that followed a public meeting of the board of UL Hospitals Group in Dooradoyle.
“At the moment the overflow ward is running as a 22-bed unit and it does need a funding stream to keep it open but my view is that it should not be open all year round.”
When the annual winter surge passes in April or May, it is the intention that the overflow ward will be used to “decant patients from other wards around the hospital” which need to be improved to comply with HIQA standards.
Money had been set aside to carry out these works, Prof Cowan said.
In the meantime, recruitment of nurses continues apace with interviews having commenced last week and a number already added to a panel from which UHL intends to fill vacant positions.
Ads had been placed locally “for all types - registered nurses, emergency department nurses, critical care nurses, theatre nurses”, Prof Cowan said.
And she wants to cast the net wider by encouraging nurses who have emigrated to the UK, to Australia and elsewhere to return home.
“A lot of people left during the fiscal crisis and we need to get our own people back on fixed term contracts and we are making inroads on that,” said Prof Cowan, whose own background is in nursing.
Much of last Thursday’s board meeting was taken up with the ongoing pressures on the emergency department on Dooradoyle and Prof Cowan said the solution was about more than hiring extra staff and opening extra beds.
“We have to look at process across the whole hospital. Over the years people have tended to focus on the emergency department but it is actually much broader than that. How do we get them moving through the system quicker? What are the pathways for them? And one of the big areas we have looked at is frail elderly. Unfortunately, a lot of the patients we have coming into the emergency department are older people who need to come into hospital and get treated.”
Overcrowding was “a hospital-wide organisational problem” and measures taken to alleviate it included better co-ordination with Ennis, Nenagh and St John’s Hospital in increasing the numbers attending medical assessment units and local injury units for less complex cases in the smaller hospitals.
Prof Cowan said co-operation with community care colleagues in the HSE had seen 40 elderly patients moved into community care under Fair Deal packages in the last three weeks.
Chief financial officer Hugh Brady told the meeting that the hospitals group had overrun its budget by €28 million in 2014 but a supplementary budget introduced by the HSE nationally at the end of the year had allowed it to break even.
A budget of €254 million has been allocated to the hospitals group for 2015, up from €238 million last year.
Mr Brady said that during 2014, the overtime bill had come down by €2 million but the bill for agency staff had increased by €10 million.
And Prof Cowan said that in order to bring down the agency bill, work remained to be done in bringing the group’s absenteeism rate of 6% into line with the national average in the health service of 3.5%.
Outside of pay, the drug bill at UL Hospitals increased by €1.5 million during 2014, much of this accounted for by costly cancer and HIV medication.
“There are areas we have to work at around pay, non-pay and income and there are areas where we have to look at cost improvement plans. Based on existing levels of service and looking at last year, we are looking at making around €5 million in cost improvements within our organisation,” Prof Cowan said.
The CEO also told board member Prof Don Barry that one of the reasons why the new emergency department could not be completed before the end of 2016 was enabling works around electricity substations to ensure continuity of supply to patients in the intensive care unit of the critical care block.
In tandem with the new A&E would be the construction of a new dialysis unit with 24 beds for acute and chronic patients. Once complete, this would spare long trips for many dialysis patients, some of whom have to travel as far as Dublin for treatment.
A new maternity hospital in Dooradoyle was some distance away and, with a price tag of €120 million, would be expensive.
Prof Cowan said she understood people in the region were “passionate about the project” but said there was currently no capital funding in place and the new National Children’s Hospital was the priority nationally.
But work on the design of the new maternity unit was ongoing and it is hoped plans could be brought to the HSE early next year.