02 Jul 2022

UHL responds to report highlighting patient safety concerns at Emergency Department

Major overcrowding at Limerick emergency department

HIQA inspectors visited the Emergency Department at UHL on March 15

THE UL Hospitals Group has commissioned an external review of patient flows at University Hospital Limerick, following the publication of a highly critical report by the Health and Information and Quality Authority.

The 39-page report, relating to an unannounced inspection which was carried out at the emergency department at UHL on March 15, was published this Friday morning.

In it, inspectors raised serious and significant concerns about patient safety as a result of overcrowding.

The report states that conditions at the ED are insufficient to meet the needs of patients and that they compromise the delivery of safe care.

It details how the hospital is failing to comply with national standards governing patient dignity, patient care and staffing levels.

"HIQA was not fully satisfied that there were effective management arrangements to support and promote the delivery of high-quality, safe and reliable services in the emergency department in the short-term," it states.

Responding to the publication of the report, a spokesperson for the UL Hospitals Group said it plans have been developed to bring the service in the Emergency Department closer to compliance with the national standards.

"We have developed a detailed plan with actions to be taken within three months, six months and three years," said a spokesperson in a statement.

In addition, the CEO of UL Hospitals Group has commissioned Deloitte to conduct an external review of patient flow at University Hospital Limerick.

"This review is intended to provide an independent and comprehensive overview of patient flow through the ED at UHL while at the same time looking at the use of resources, processes in place and identifying any constraints. Our community and GP colleagues in the Mid West are also being consulted as part of this review and the final report from Deloitte is expected in the coming weeks," said the spokesperson.

Commenting on the report, Prof Brian Lenehan, Chief Clinical Director at UL Hospitals Group said The Mid West region and UHL have many unique challenges.

"We have fewer inpatient beds and fewer consultants and NCHDs to provide care than comparable hospitals. We serve a region with a higher frailty index and a city with a higher deprivation index. Over the course of the pandemic, our ED did not see the scale of reduction in presentations seen around the country and the growth in demand on our hospital since has also been disproportionate and exceptional. The volume of self-referrals to our ED as outlined in the HIQA report is higher than elsewhere. People of the Mid West have fewer alternatives than elsewhere when it comes to accessing emergency care".

Prof Lenehan says UHL remains committed to working with all stakeholders on improving its processes and how it works to meet this challenge.

"We acknowledge the significant investment we have received in recent years in improving our infrastructure. Lack of bed capacity remains our primary constraint and we hope that publication of this report today redoubles the efforts of all to ensure that the MidWest catches up with the rest of the country in terms of bed numbers and staffing resources,” he commented.

The Irish Nurses and Midwifes Organisation has  welcomed the publication of the HIQA report.

“The report is a fair analysis of the situation our members are facing on the ground. However, it needs to be noted that when things are this bad it becomes harder to keep nurses in their jobs, which makes it harder to ensure safe staffing numbers. The report shows that nursing staff are doing everything they can in a desperate situation, but that it’s not possible to keep patients safe in these conditions," commented INMO Assistant Director of Industrial Relations Mary Fogarty.

“Our members have been drawing attention to these issues for years and we requested that HIQA investigate the situation in UHL and they welcome the publication of the report as a first step, but it’s important that it leads to action," she added.

At a political level, Senator Martin Conway, Fine Gael's Seanad Health spokesperson, has written to the Chair of the Oireachtas Health Committee recommending that UL Hospitals Group management are invited before the Committee at the earliest possibly opportunity.

“The HIQA report raises some very serious concerns about patient safety at University Hospital Limerick. It is important that the Oireachtas Health Committee investigates this matter as soon as possible and so, I have asked the Chair of the Committee to invite UL Hospitals Group management to appear before the Committee at the earliest possibly opportunity," he said in a statement.

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