A NUMBER of hospitals are continuing to provide care to acutely ill patients where the volume of patients is too low or staffing is insufficient for this to be done reliably and safely, the Health Information and Quality Authority (Hiqa) warned yesterday.
Hiqa did not list the hospitals which were providing such unsafe services but pointed to Mallow hospital as being among them.
It said that following a review of the quality and safety of services at Ennis hospital in April 2009, it had made a number of national recommendations aimed at kick-starting a review by the Health Service Executive (HSE) of clinical services in hospitals of a similar size.
It had urged the HSE in particular to review the configuration of emergency care services at other smaller hospitals with a similar activity profile to Ennis with a view to consolidating emergency services in regional centres, leaving smaller hospitals to deal with minor injuries only.
The HSE was also to look at similar sized hospitals providing acute surgery and critical care services to ensure they were being provided within safe practice guidelines. Hiqa said it recently sought assurances from the executive that these national recommendations have been implemented but was “not sufficiently assured by the response”.
It added: “It is of concern to the authority that there are hospitals that are continuing to provide care to acutely ill patients where the volume of patients is too low or the depth of clinical staffing cover is insufficient for this to be done reliably and safely.”
Its report into Ennis hospital, initiated after a number of cancer misdiagnoses, ultimately found it was unsafe to provide acute surgery, intensive care, round-the-clock emergency care, paediatric and maternity care at the 88-bed Co Clare hospital. Since then, round-the-clock emergency services have been removed from the hospital.
Hospitals of’ a similar size to Ennis would include Mallow hospital with 76 beds – where there is now to be an investigation into the quality and safety of care – and Roscommon County Hospital with 84 beds. Both have emergency departments which are open 24 hours a day.
Other small hospitals with fewer than 200 beds would include Louth County Hospital in Dundalk with 137 beds; Bantry Hospital with 118 beds; St Columcille’s Hospital, Loughlinstown, Dublin, with 150 beds; Navan Hospital with 172 beds; and Portiuncula Hospital, Ballinasloe, with 196 beds. Round-the-clock emergency services were removed from Dundalk hospital at the end of June but the other four hospitals continue to operate 24-hour emergency departments.
Hiqa’s comments are likely to speed up the reconfiguration of acute hospital services across the State, resulting in what many would consider to be the downgrading of smaller local facilities.
Meanwhile, correspondence between Hiqa chief executive Dr Tracey Cooper and HSE outgoing chief executive Prof Brendan Drumm, which has been seen by The Irish Times, shows Hiqa has had difficulty obtaining information from the HSE on the implementation of the recommendations contained in the Ennis report.
Dr Cooper’s letter dated June 15th last said: “There have been repeated requests from the authority to your staff requiring updates on the implementation of these recommendations which have not been forthcoming.”