The opening of an extension of the Mater hospital’s emergency department was delayed by more than a year due to nursing shortages, an independent inspection has found.
On Wednesday, the Health Information and Quality Authority (Hiqa) published an inspection report into a number of healthcare facilities, including the Mater hospital in Dublin.
According to the health and safety watchdog, some 19.7 per cent of nursing positions in the emergency department were unfilled when the facility was inspected in July 2024.
However, the inspector noted this was an improvement on the previous year when 29 per cent were unfilled. The ED was “reliant” on agency staff to manage the shortfall, it added.
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As a result, a purpose-built extension to the department with five treatment bays that had been due to open at the end of July 2023 had not yet been opened due to the vacant nursing positions. It opened in September 2024.
Inspectors found patients in the ED were experiencing “lengthy waiting times” to access an inpatient bed.
On the first day of inspection, there were 108 patients in the hospital’s emergency department, of whom 42 (39 per cent) were admitted and on a trolley, awaiting a bed in the main hospital.
Separately, Hiqa also published a report on the regional hospital Mullingar, which found at the time that 44 per cent of the hospital’s nine executive management positions were unfilled.
The inspection, which took place in October 2024, found the four unfilled positions were “important leadership positions with responsibilities and roles in ensuring the effective clinical governance and efficient delivery of healthcare services”.
“The shortfall in the executive management team resulted in a void that had the potential to affect the effective governance and efficient delivery of healthcare services,” the report said.
According to Hiqa, measures were put in place to mitigate the actual and potential risks arising from “the void, which included other staff members assuming the responsibilities.
“However, this arrangement, along with their own substantive roles and responsibilities was not sustainable in the medium and longer term,” the report added.
Hiqa also highlighted concerns around staffing, stating that at the time of inspection there was a “significant difference” in the funded and actual number of staff in managerial, nursing and midwifery positions.
“The 13 per cent shortfall in nursing staff, 20 per cent shortfall in midwifery staff and 13 per cent in healthcare assistant staff was managed in the short-term through staff redeployment and the use of agency staff,” the report said.
“But this was not a reliable and sustainable way to manage the issue. Staff resourcing issues in the quality and safety department also impacted on the delivery of healthcare services”
