Concerns raised about dialysis in UHL as opening of new unit is delayed

DELAYS for a new dialysis unit in Ennis could see the return of night time dialysis to University Hospital Limerick (UHL).

Patients receiving haemodialysis are in the end stages of kidney disease experiencing kidney failure and would often need to attend the dialysis unit for four hours, three times a week.

The practice of night time dialysis was stopped around 2015 when a new renal dialysis unit opened in UHL and now with a satellite unit on the Dock Road in Limerick as well, the services are at capacity.

While the tenders have been completed for the Ennis site and HSE Mid-West say that a supplier has been chosen, no timeline is given for the completion of this project.

They said funding has been identified and the steps to get this site on stream as soon as possible are ongoing.

A HSE Mid-West spokesperson told the Limerick Leader/Limerick Live: “Due to the growing number of patients who require this treatment, we have reached maximum capacity in the dialysis unit at UHL. We continue to support patients who are suitable for home dialysis therapies and we are also proposing to establish a second satellite haemodialysis centre in Ennis, County Clare.

“In view of the current capacity constraints, we are considering the extension of the out-of-hours service to ensure patients who require dialysis continue to have access in the region. We are currently engaging with staff on this proposal. Among the determinants for offering this extended out-of-hours service would be that the patient is able-bodied and preferably living in close proximity to the hospital.”

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A spokesperson for the Irish Nurses and Midwives Organisation told the Limerick Leader that it is “inappropriate” for patients to get dialysis at night.

“We do not have a date for the new unit but nurses are concerned that this service will again be provided at night time and impacting on safety and wellbeing of their patients.

“When receiving dialysis at night the patient must remain awake most of the night, which has a profound impact on younger patients who are trying to hold down jobs and family carers.”

A source close to the hospital, who did not wish to be named, told the Limerick Leader/Limerick Live that there would be no “proper nursing management and medical cover in the evenings and during the proposed nights.”

They added: “Many of the patients who will be dialysed at night in these slots will be elderly and frail. They will have to leave their homes at approximately 10pm and will not return until around 6am after four hours of dialysis and travel time due to the catchment area of the unit.

“Night dialysis is not a safe solution to this problem in our view and we fear it will become a permanent measure, given previous trends. Patient safety and wellbeing will suffer greatly from this.”

According to the most recent HSE figures, there were 129 people on dialysis within the UHL catchment. A spokesperson for the Irish Kidney Association said: “Night time dialysis is not clinically favourable for many patients. This highlights the urgent need for a national model of care for patients with end-stage kidney disease requiring dialysis which all treatment facilities must adhere to.”

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They added that any plans for night time dialysis should be temporary.

“It should be treated as the exception rather than the norm and it should only be offered on a patient choice basis. The reality is that day-time dialysis is more humane, and it is also cheaper because rather than using night-shift nurses, patients can be treated during the day, making it a win-win situation - more convenient for patients and less expensive for the hospital.

“We believe a far better option, in this case, for both patients and the overburdened health care professionals working in the area is to open a new dialysis unit, which would relieve pressure on the existing unit. Indeed, tenders for a new dialysis unit to be located in Ennis issued on September 12, 2023. Eight months later we understand no decision has been made on the awarding of this tender,” the IKA spokesperson told the Limerick Leader/Limerick Live.

They added that dialysis is very demanding and can impact people's ability to go to work, provide childcare, go on holidays or engage in other daily activities.