Elective surgery is to resume at all hospitals in the University of Limerick group from tomorrow morning -after two days of cancellations.
It follows a meeting of the UL hospital management team which gathered daily to review planned surgery lists and to decide on scheduled surgery cutbacks and deferrals to help manage high numbers of seriously ill patients attending at the regions only ED at UHL in recent days.
RTÉ News has learned that 450 patients who were due to attend at hospitals across the UHL group for elective procedures have had their surgery cancelled since the beginning of the year.
But the hospital group added that 1,499 scheduled procedures did go ahead over the same period and that they met all their targets for scheduled care under the National Waiting List Action Plan last year.
Emergency and time-critical surgeries continued at UHL and were not deferred.
The hospital group said they regret that any patient has their scheduled procedure deferred and these patients are rescheduled as soon as possible.
In an update this afternoon the group said: “At a meeting of the UL Hospitals Group Hospital Management Team (HMT) this morning, it was decided that elective surgical activity across all sites – University Hospital Limerick, St John’s, Ennis, Nenagh and Croom Orthopaedic Hospitals – will resume in full from tomorrow morning, Thursday March 7th, 2024.
“Postponement of scheduled elective activity is a decision of last resort that no hospital manager wishes to make, and UL Hospitals Group regrets the impact on any patients who have been impacted by deferrals this week. We will work to ensure these appointments are rescheduled at the earliest opportunity.”
An emergency medicine consultant at the hospital, Dr Alan Watts, said UHL is experiencing “significant capacity issues” and it was the busiest emergency department in the country.
Dr Watts, who is also a member of the committee of the Irish Association for Emergency Medicine, said it was a reflection that nationally, “bed capacity is significantly under capacity”.
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He told RTÉ’s Six One: “The elective surgery is now recommencing which is certainly encouraging but overcrowding does persist – not only here at University Hospital Limerick in our emergency department, but in busy emergency departments across the country.
“I think that these are problems that are replicated across the country, certainly Limerick would be in a position where it has significant capacity issues.
“We’re the busiest emergency department in the country and if you look to other emergency departments that are equally busy, Cork, Galway, the Mater, St Vincent’s, their bed capacities are far greater than our own.
“That is also a reflection of the fact that nationally, the bed capacity is significantly under capacity.
“The OECD average for bed capacity is 4.3 per thousand population, whereas in Ireland it’s 2.9 per thousand population, which reflects a significant deficit in acute beds.”
Dr Watts said a reconfiguration report for the Mid West region projected that the area needed around 640 beds. However, there are currently just 535 beds.
“You can see there’s a deficit there and yes it takes time, but it has to be the priority and acted on as an emergent solution in addition to providing for community services and increased access to primary care,” he added.
The ED at University Hospital Limerick has been dealing with large numbers of very sick patients in the past week, which has been its busiest since the start of the year.
The Irish Nurses and Midwives Organisation said that this morning there were 99 admitted patients waiting for a bed at UHL – with 37 waiting in the ED and 62 on wards elsewhere in the hospital.
The HSE’s TrolleyGar figures put the number waiting at 62, compared to 73 yesterday – with 21 people waiting in the hospital’s Emergency Department and 41 on wards.
‘A drop in the ocean’ – campaigner
Noleen Moran, from the Mid-West Hospital Campaign, said the only thing as consistent as the levels of overcrowding in UHL is the failure of politicians to do anything to address it.
She said the ambulance protocol that was introduced is not doing enough and most ambulances are still by-passing hospitals in Ennis and Nenagh and going directly to UHL.
She said this was because only three beds have been allocated in Ennis hospital to take certain patients who have certain clinical conditions.
Speaking on RTÉ’s News At One, she said: “So, that is a drop in the ocean and it’s not having any impact or any effect.”
She said more capacity in the local hospitals is needed.
She said in 2022 and 2023 HIQA carried out reports and there was a commitment from management at UHL in 2022 to explore the option of a Model 3 hospital for the region as a long-term measure to bring the hospital back into compliance.
“But for some reason in 2023, there was no follow-up commitment that was made and there has been no tracking of progress in relation to that and our politicians are failing us because they are not asking why, they are not following up on that.”
She said there is a major mismatch between capacity and demand in the ED.
“The UL Hospital Group is distinct from any other area because it is the only hospital group that doesn’t have a Model 3 hospital to support the work of the Model 4 .
“So, the Emergency Department is built for 70,000 patients but what we are seeing is that there are over 80,000 patients attending annually.”
Government downplaying crisis, Dáil hears
The Government is downplaying the severity of the crisis at University Hospital Limerick, the Dáil has heard.
Sinn Féin leader Mary Lou McDonald said: “Day after day people are being left without a hospital bed and nurses and doctors are having to treat people in appalling conditions.”
Responding, Minister for Enterprise Simon Coveney said the emergency department remains open in Limerick but many people arriving there will face a significant wait.
He pledged that the Government would increase capacity, focus on better management and provide more resources to the hospital.
“There is of course an acknowledgment that all is not well in University Hospital Limerick,” Minister Coveney said.
Understaffing is placing people in harm’s way, Labour leader Ivana Bacik told the Dáil.
She said the HSE recruitment freeze was having an effect and “recent HIQA reports had shown that not one hospital was compliant on staffing”.
Mr Coveney said there had been an unprecedented level of investment in the health service workforce since 2020, adding that there were now 26,172 more staff in the HSE since the beginning of the Government.
Ms Bacik said it was “patently clear that spending is not enough to meet demand”.
Limits on GP support for UHL
There are limits on the supports a GP service can provide to ease pressure on hospitals in the UHL group, especially given the significant pressure the area is already under, a GP in Lahinch, Co Clare has said.
Speaking on RTÉ’s Morning Ireland, Dr Michael Kelleher said GPs are actively involved in preventative care and chronic disease management, both of which ease pressures on hospitals.
Capacity must be increased along with the provision of extra community and step down services, he said.
“What used to be a winter surge in a demand on the hospital sector is now an all year round demand,” Dr Kelleher said.
“That’s not going to change because our population is rising and aging.
“We simply have to build up the capacity to cope with that. In the short term we’re going to have lots of issues like are occurring in Limerick currently.”
Additional reporting Mícheál Lehane and Sandra Hurley
