Hospital triggers ‘crisis’ 365 times
Permanent state of emergency at UHL – but it admits it never reviews reasons
UNIVERSITY Hospital Limerick activated an emergency plan – meant for use only in the most extreme circumstances – to relieve pressure at its emergency department every day last year.
Figures obtained by the Irish Patients’ Association (IPA), and seen by the Irish Mail on Sunday, show the hospital was so overcrowded for 365 days in 2023 that staff struggled to deal with the number of patients.
As a result, management triggered a Full Capacity Protocol in order to cope.
Under a deal brokered by the Workplace Relations Commission (WRC) eight years ago, hospitals are obliged to carry out a review each time they implement the plan to deal with overcrowding.
But because of persistent overcrowding at the hospital, University Hospital Limerick (UHL) authorities admitted to the MoS last night that if these inquiries were done ‘every time an escalation was initiated, the entire business of the hospital would be taken up with reviewing past events’.
However, according to IPA director Stephen McMahon , failure to review why the protocol is activated is putting lives at risk.
He said: ‘This Full Capacity Protocol is being used as a normal management tool when it should be used as an extraordinary, “near-never” measure.
‘Hospitals are obliged under the WRC agreement of 2016 to review every incident. That is so that there can be learning. The whole process is meant to identify the barriers to emergency departments so they can be rectified.
‘The IPA has looked for copies of these reviews and this was brought up with the Minister for Health. But the HSE has not provided us with copies.’
He said: ‘Reviews are there to protect patients, staff and maintain the fragile domain of trust in the system. If there were so many occurrences, who in HSE corporate approved UHL having a derogation? Did the board approve this change? Is UHL an outlier with discontinuance of the Full Capacity Protocol activation?’
He also questioned why Health Minister Stephen Donnelly has delayed an independent review into whether a second ED is needed in the region.
Two weeks ago, the minister announced the independent State agency HIQA (Health Information and Quality Authority) would carry out a review after former Chief Justice Frank Clarke delivers his report on the death of Aoife Johnston at UHL in December 2022.
The 16-year-old arrived at the hospital with a GP’s letter stating she had suspected sepsis. But instead of being attended to within 10-15 minutes of arrival, she had to wait almost 14 hours to get readily available antibiotics.
By the time she was given this medication it was already too late and the teenager from Shannon, Co. Clare, died from meningitis after contracting sepsis.
Now the IPA says that Mr Donnelly could have avoided ordering an independent review into whether a second emergency department is needed if UHL had done the reviews it is obliged to do.
And this weekend he urged Mr Clarke to also investigate in his review whether the Department of Health and the HSE have a governance role in how the midwest hospital is managed.
Mr McMahon added: ‘If these reviews were done in Limerick they would have uncovered important issues to fix. If they were doing these reviews then you would think they would have picked up on what was needed.
‘I would hope that former Chief Justice Frank Clarke looks at governance vertically from UHL to the Department of Health and the HSE.
‘Were we going through red lights when we should have been stopping?’ he asked.
A Department of Health spokesman did not answer our questions about UHL directly this weekend but told us the overall situation in EDs across the country was improving.
‘The Emergency Department Taskforce continues to positively contribute towards the ongoing development of sustainable long-term solutions to ED congestion. Nationally, in the first four months of this year there has been a 10% (4,600 patients) reduction in the number of people waiting on a trolley at 8am, compared to the same period last year.
‘This reduction in trolley numbers has been achieved despite the increased demand experienced across our emergency departments. Over 55,500 more people have presented in ED this January through April, representing a 12% increase versus last year.’
The Emergency Department Taskforce is independent of the Minister for Health and is cochaired by the Irish Nurses and Midwives Organisation’s general secretary, Phil Ní Sheaghdha, and the HSE Chief Operations Officer, and its meetings agreed by the co-chairs.
‘Were we going through red lights?’