Doctors to change how they speak to grieving families, Limerick medical conference hears

NEW GUIDELINES aimed to help doctors explain post-mortem exams more clearly to families following the bereavement of a loved one have been announced at a medical conference in Limerick.

Chief state pathologist, Professor Linda Mulligan, addressed the NCHD Research Conference at University Hospital Limerick (UHL) as a keynote speaker.

The annual medical conference is a showcase of research activity, audit and quality improvement initiatives that are completed by Non-Consultant Hospital Doctors working and training in the Mid-West region.

Prof Mulligan, who completed her medicine degree in UCD in 2002, told attendees she was delighted to return to Limerick, where she spent six months as an intern in St John’s Hospital before going on to take higher specialist training in Histopathology and to ultimately specialise in Forensic Pathology.

She was appointed as the Chief State Pathologist in 2021.

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During her address, Prof Mulligan spoke of her own career path and highlighted a number of case studies, criminal investigations and suspicious deaths. Prof Mulligan also highlighted the importance of the HSE National Clinical Guidelines for Post-Mortem Examinations (2023), a set of standards for which she served as Chair of the Review Group.

“A significant amount of learning has emerged in recent years through audits, investigations and through the recent COVID-19 pandemic,” she said. 

“Bereaved families are more aware of how the post-mortem examination process can serve to answer questions they may have around the death of a person, especially where there are pathological conditions that may have implications for other family members. 

“There has also been key learning about what needs to happen to ensure that the post-mortem examination service is compassionate and centred on the needs of families and individuals using the service while also being reflective of international recommended practice.”

Now in its fifth year, the annual event was initiated by Lead NCHDs at UHL in partnership with the Postgraduate Medical Training Office, under the leadership of NDTP Training Lead, Prof John McManus.

A record 224 abstracts were received for this year’s conference, an increase of 60% from last year. 

Abstracts were received from various disciplines including anaesthetics, emergency medicine, medicine, surgery, paediatrics, psychiatry, obstetrics and gynaecology, radiology, the intern network, general practice and public health.

Among the speciality winners this year were research projects on the use of statins in primary care, childhood obesity, psychiatric conditions affected by gaming and the quality of health information on social media.

During a week in which the HSE Mid-West and Limerick City and County Council launched a new programme to address health inequality in Limerick city, two of the shortlisted papers focused on the social determinants of ill health, one of which actually went on to become the conference’s overall winner.

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Dr Emma Kearney, Specialist Registrar in Public Health and overall winner at this year’s conference, presented a landmark study examining the relationship between emergency department attendance at UHL and socioeconomic position.

Dr Kearney said: “This research shows a clear social gradient in emergency department attendance, with people living in disadvantaged areas in the Mid West significantly more likely to attend, even when distance from UHL is taken into account. 

“This kind of work helps to highlight the impact of health inequalities in our region, and I was very grateful for the opportunity to represent Public Health at the conference. The results provide us with an opportunity to focus on the challenges faced by our health service through a health equity lens and the use of data is a key element in terms of guiding service design and resource allocation.”

In opening this year’s conference, Ms Sandra Broderick, regional executive officer, HSE Mid-West, described NCHDs as “the lifeblood of our hospitals and each of you make such a tremendous contribution to the care of our patients”.  

“I am fully committed to supporting research and innovation across our region,” she said. 

“I am especially proud that the Mid-West opened the first HSE Regional Research Directorate earlier this year. Our research directorate continues to drive high-quality, reliable and impactful research that improves patient outcomes. I am delighted to see the remarkable increase in abstract submissions from NCHDs for this year’s conference, and I commend the outstanding quality of your entries.

“Through their engagement in research, NCHDs are not only developing professionally but also helping us translate evidence into real-world improvements in patient care, delivering lasting and meaningful change.

“I want to extend my sincere thanks to Dr John McManus and the team for their unwavering dedication to enriching the research experience for NCHDs and for creating opportunities to leverage this work in shaping the future strategic delivery of healthcare.”

Ms Broderick said that the number of NCHDs employed by acute hospitals in the Mid-West had increased from 387 to 626, or by over 60%, since 2020 and she had every expectation that this number would continue to increase significantly as the region prepared to open an additional 112 acute beds in UHL before the end of this year.