Alan Kelly
Question:399. Deputy Alan Kelly asked the Minister for Health what measures he is taking to address the overcrowding situation in the UHL hospital group. [11369/24]
View answerThursday, 7 March 2024
Questions (399)
Written answers
The Emergency Department (ED) at University Hospital Limerick (UHL) continues to manage high volumes of presentations for unscheduled and emergency care. The latest available data shows that up to the 18th of February 2024, ED presentations at UHL increased by 19% on last year and emergency admissions by 13%. This trend is more pronounced among the over-75s with ED presentations having increased by 26% in the first seven weeks of the year and emergency admissions by 24% compared to the same period last year (2023).
This winter is the first winter we are using an all-year approach to urgent and emergency care, since the switch last year from annual winter plans recognising that the required investment, changes and supports go beyond winter.
Over the past year, ED staffing has been increased and enhanced alternative care pathways have been introduced to reduce demand on the department and better facilitate patient flow. These have included but are not limited to the following:
ED admission-avoidance for over-75s - The Geriatric Emergency Medicine (GEM) unit at UHL recently expanded to 9 treatment bays and to 24-hour operations during weekdays. This unit assesses elderly patients in ED with a view to avoiding unnecessary admission to hospital. This unit is funded to open 7 days a week until the end of March. The establishment of the GEM unit has ensured that less than one in three older adults seen there has required admission to UHL. Data for 2023 shows that of the 2,007 patients seen in the GEM unit, 59% patients were discharged to their home, 12% were transferred to a model 2 hospital, for example St John’s Hospital, and 28% were admitted to UHL.
Pathfinder - A collaborative ED-avoidance programme run by allied health staff and the National Ambulance Service (NAS). Pathfinder aims to deliver safe alternative care at home for over-65s in the HSE Mid-West region and expanded into Clare and Tipperary during 2023. Up to the end of December 2023, 49% of patients assessed by the Regional Pathfinder Team were supported at home without the need to go to the ED.
Alternative Pre-Hospital Pathway - A new collaboration between HSE Mid-West and the National Ambulance Service sees definitive care provided in the community by emergency medicine doctors and paramedics to patients who call 999/112. This reduces the number of ambulances bringing patients directly to the ED. Up to the end of December 2023, 52% of the patients reviewed by this service were seen via an alternative care pathway and 48% were conveyed to the ED at UHL.
Additional Medical Resources - In the past year, an additional two consultants in emergency medicine have been recruited for the Emergency Department.
Medical Assessment Units - The expanded Medical Assessment Unit services across the region are making a significant and positive impact on delivering timely care to patients referred by their GPs to hospital for urgent medical attention. The MAUs at Ennis, Nenagh and St John’s operate a seven-day service. In 2023, 15,006 patients were referred to the MAUs in Ennis, Nenagh and St John’s.
MAUs provide diagnosis and treatment for patients referred with a wide variety of medical conditions. Patients are reviewed by a senior clinician and may require x-rays, blood tests, scans or further diagnostic imaging.
Injury Units - Injury Units in St John’s Hospital, Ennis Hospital and Nenagh Hospital are open every day for injuries in adults and children aged 5 and upwards. In 2023, 46,702 patients attended Injury Units in Ennis, Nenagh and St John’s, representing a 6% increase on 2022 and since 2019 attendances have grown by 40%.
96-bed block - Work commenced on the first 96-bed ward block at UHL in September 2022. The construction phase will take at least two years to complete. It is currently envisaged that the construction phase will be complete by Q1 2025. Once handed over by the contractors, this first block will need to be equipped and commissioned and staff trained following the completion of a recruitment campaign. It is anticipated that this much-needed additional bed capacity for the HSE Mid-West region will become operational in mid-2025.
The Department is committed to the delivery of the second 96-bed block at UHL. This next phase of additional works has commenced. The construction phase will be completed in two stages and will be carried out directly adjacent to the 96-bed block currently under construction at UHL
Elective Hubs Stephen Donnelly, the Minister for Health has also announced plans to include Limerick as one of six new surgical hubs to speed up access to care.