More beds in UHL and extension of hospital campus needed in short term to address current risks to patient safety, HIQA report finds
The opening of a Model 3 hospital in the Mid West is among three options recommended as part of a review of emergency services in the region.
A report by the Health Information and Quality Authority (HIQA) identified a severe shortage of acute beds in the Mid West and advised that, while a Model 3 hospital would be beneficial in the long term, short-term measures would be needed to address the current crisis impacting patients.
The review comes 16 years after smaller EDs in the region – in Ennis, Nenagh, and St John’s Hospital in Limerick – were closed, downgrading them to Model 3 sites.
The closures came amid advice that the smaller facilities did not have high enough levels of patient activity needed to ensure optimal outcomes.
As a result, there is currently just one ED – in the Model 4 University Hospital Limerick – for the entire region.
HIQA has today presented the Minister for Health with three options for addressing the region’s capacity issues:
- Additional beds at UHL on its Dooradoyle site;
- The extension of the UHL hospital campus to include a second site in close proximity under a shared governance and resourcing model; and
- Thee development of a Model 3 hospital in HSE Mid West, providing a second emergency department (ED) for the region.
HIQA advised that the first two options would have greater impact in addressing current patient safety issues, given they would take less time to be implemented.
However, they add that a Model 3 hospital will contribute to future needs. It refers to research from the Economic and Social Research Institute (ESRI) which found that, compared to 2023 bed numbers, between 299 and 593 additional inpatient beds and between 38 and 73 day beds will be required to meet future healthcare demand for the Mid West up to 2040.
However, the report makes no determination on where in the Midwest the new ED should be located.
“HIQA found that the core issue impacting urgent and emergency healthcare delivery in HSE Mid West is the significant inpatient bed capacity deficit relative to demand from patients presenting with more serious or complex care needs,” said the organisation’s deputy CEO Dr Máirín Ryan.
“This is intensified by an ever-growing demand for services, which will continue into the future as highlighted by the ESRI projections for the period up to 2040. The current situation caused by the demand-capacity gap at University Hospital Limerick (UHL) and across HSE Mid West, presents a risk to patient safety.”
Given that the ESRI projections span a wide range in terms of additional beds required, HIQA advised that the delivery of new emergency services should be flexible, with an ongoing monitoring of public demand needed to ensure the right decision are made.
“In working to progress any of these options, HIQA recommends the development of a comprehensive strategic plan,” said its director of healthcare regulation Sean Egan.
“This should remain focused on addressing the safety concerns which prompted this Review, while having regard to the future demographic and policy considerations. Ongoing communication and engagement with the people of the Mid West will also be crucial to its delivery.”
President of the Irish Medical Organisation Dr Anne Dee welcomed the report. “The serious deficit of beds is at the root of the problem in the mid-west, and a quality, safe service for patients cannot be delivered without these beds as well as the right number of staff,” she said.
“Patients in the mid-west have lost trust in the system, and if that trust is to be rebuilt we need to see a clear, resourced plan with targeted supports. In addition to a longer term decision, short term measures to increase capacity must be initiated with supports both in terms of beds and services within the community – we need an immediate short term plan to run alongside a longer term ambition.”
