Cathal Crowe
Ceist:635. Deputy Cathal Crowe asked the Minister for Health if a report (details supplied) recommending a model 3 hospital in CHO3 will be considered. [10042/23]
Amharc ar fhreagraTuesday, 28 February 2023
Ceisteanna (635)
Freagraí scríofa
In 2013, the Smaller Hospitals Framework defined the role of smaller hospitals and outlined the need for both smaller and larger hospitals to operate within Hospital Groups. The Framework identified the activities that can be performed in smaller Model 2 hospitals, in a safe and sustainable manner. In developing our smaller hospitals, the first and overriding priority is the safety of patients.
This Framework provided a stronger role for smaller hospitals, like Ennis, Nenagh and St John’s Hospitals, in delivering a higher volume of less complex care in many cases closer to patients’ homes. It also ensures that patients who require true emergency or complex planned care are managed safely in a larger hospital environment.
Regarding hospitals in the University of Limerick Hospital Group, in April 2009, a process of reconfiguration commenced with the closure of the 24-7 emergency departments in Ennis and Nenagh. These emergency departments were replaced with Medical Assessment Units (MAUs) for GP referrals; and by local injury units/urgent care centres for self-referrals and operating 12 hours a day, seven days a week. These changes were supported by an Emergency Care Network, which had been set up in the region and led by Consultants in Emergency Medicine. These consultants, while based in UHL, have clinical responsibility for the Injury Units in Ennis, Nenagh and St John's. Additional Consultants in Emergency Medicine were recruited to support these changes in addition to Advanced Nurse Practitioners for the Injury Units in the smaller hospitals and for the ED in UHL.
Within the UL Hospitals Group, there are two Model 2 Hospitals, Ennis and Nenagh Hospitals. St John's Hospital is classified as a Model 2S Hospital, i.e. St. John's can carry out intermediate surgery, which requires in-patient stay and accommodation in addition to day case surgery. These hospitals play a pivotal role in the delivery of high-quality patient care within the region. The UL Group also includes Croom Orthopaedic Hospital, University Maternity Hospital Limerick and University Hospital Limerick.
The model 2 hospitals accept transfers of appropriate patients from UHL on a daily basis. These patients can either be stepped down from an inpatient ward in UHL or they may, where a clinician has decided it is appropriate, transfer to Ennis, Nenagh or St John's directly from the ED in UHL.
A recent development in Ennis Hospital from January 9th and Nenagh Hospital from February 7th has been the introduction of the Medical Assessment Unit (MAU) pathway for 112/999 patients. This allows patients that meet agreed clinical criteria to be transferred by ambulance and treated in a Model 2 hospital. This pathway will result in patients receiving medical treatment in a hospital closer to their home, will reduce patient presentations to Emergency Departments and will release ambulances more quickly to respond to other emergency calls. The MAUs in Ennis and Nenagh Hospitals treat patients referred by GPs, ShannonDoc, and now National Ambulance Service paramedics. 112/999 patients that do not meet these clinical criteria will continue to be transported to Emergency Departments for assessment and treatment.
There has also been significant investment in infrastructure in UHL in recent times. For example, in October 2022, I broke ground on the new 96-bed inpatient block project at University Hospital Limerick. This project represents a total capital investment of just over €90 million, and will deliver a 4-storey, 96 single bed acute inpatient ward block and will go some way toward addressing capacity issues in the region.
In 2021, a new 60-bed modular ward block opened. This follows the completion of two separate rapid-build projects, constructed in response to the Covid-19 emergency, which provided an additional 38 inpatient beds on site at UHL.
Complementary to the development of the new Elective Hospitals, the HSE also plans to work with Hospital Groups and forthcoming Regional Health Areas to progress proposals for a shorter-term measure by developing ‘Surgical Hubs’ in Cork, Galway, Limerick, Waterford and Dublin with a narrower scope of procedures. Regarding the Surgical Hub for Limerick, planning is at an early stage, and I have asked the HSE to expedite the development, so it is operational as soon as possible.
Following these and other investments in the ULHG, consideration is also being given to future capacity requirements. It is noted that ULHG has developed proposals in this regard. These proposals will be considered by the hospital group and the HSE in line with their governance processes.
I would like to assure the Deputy that my department continues to work closely with the HSE to ensure that the UL Hospitals Group is fully supported and that the necessary improvements to address capacity issues are actioned in a timely manner.