Patient transfers to ease pressure on University Hospital Limerick to become long-term arrangement

Some non-urgent patients at the hospital are currently transferred by ambulance to be treated at Ennis Hospital

Arrangements to relieve pressure on University Hospital Limerick by treating some non-urgent patients transferred by ambulance at Ennis Hospital are to be retained in the long term.

A similar arrangement may be put in place for Nenagh Hospital in order to ease the pressure on UHL, local representatives were told on Wednesday.

From this week, ambulances in the midwest have begun transporting non-urgent cases to the medical assessment unit in Ennis, under a pilot protocol approved by the University of Limerick Hospital Group.

Three patients a day were taken by ambulance to Ennis on Monday and Tuesday, and two of them were treated onsite, according to independent Clare TD Violet-Anne Wynne.

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The arrangement will continue after the pilot period is over, ULHG management told representatives at a virtual meeting that was also attended by Taoiseach Leo Varadkar and Minister for Health Stephen Donnelly.

Since 2009, the model four UHL has provided the only 24-hour emergency department service for a population of about 400,000 after accident and emergency services were closed in Ennis, Nenagh and St John’s Hospital, Limerick – all model two hospitals.

The next step beyond a 24-hour MAU must be the addition of a full emergency department

Ms Wynne said this week’s changes to protocols at Ennis were hugely significant but just “a first step”.

“It is vital now that pressure is kept on the Minister and Taoiseach to see the increase of the MAU hour to 18 or 24 hours a day opening, not merely eight,” she said. “The next step beyond a 24-hour MAU must be the addition of a full emergency department.”

A statement from the UL Hospitals Group said an evaluation of the arrangement “will be necessary before a decision is made on any expansion of the service.

However, the group said it had “every expectation of success for this new pathway, with a view to continuing the service in Ennis MAU and, with the agreement of NAS and the HSE, expanding it to our medical assessment units in Nenagh and St John’s hospitals”.

Meanwhile, the HSE has defended the number of beds closed due to the need for infection control, saying it is “remarkably low” given the level of diseases currently circulating.

The health service has been grappling with overcrowding in emergency departments with record numbers of patients on trolleys in recent weeks, due to a surge in hospital attendances caused by respiratory viruses including flu, Covid-19 and RSV.

An average of 95 beds per day were unavailable for use or closed over the first nine days of the year, with roughly 61 per day closed due to the need for infection prevention and control. Smaller numbers of beds were closed due to Covid-19, staffing issues or refurbishment.

Some 152 beds out of around about 11,800 across the system were unavailable on January 1st. This fell to 71 closed beds on Monday, with some 45 of these unavailable due to the need for infection prevention and control.

The HSE’s chief clinical officer, Dr Colm Henry, said: “Given the level of infectious diseases currently within our hospitals and presenting to our hospitals every day, and the efforts required by hospital teams to protect against the spread of such diseases, the number of beds closed for infection prevention and control reasons at any one time during this period is remarkably low.”

A HSE statement said that preventing infection of any kind in a hospital “can lead to beds being unavailable for a time” due to patients needing to be “cohorted or isolated”.

In addition, an area of a hospital may be closed to new admissions to prevent the spread of infection or to be cleaned, and beds can also be unavailable due to staffing needs connected to infection prevention and control.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times

Cormac McQuinn

Cormac McQuinn

Cormac McQuinn is a Political Correspondent at The Irish Times