About six people a day have been awaiting hospital admission on trolleys at University Hospital Limerick’s emergency department (ED) this week, according to Minister for Health Stephen Donnelly, a number wildly at odds with those reported by nurses.
A recent review found overcrowding to be “endemic” at UHL, a hospital Mr Donnelly said remained one of the most under pressure in the country.
“We watch the trolley figures every day, obviously, and what we are seeing in Limerick, for example, over the last few days is five or six patients on trolleys in the emergency department, another 35, 36 in the wards.”
However, the Irish Nurses and Midwives Organisation’s (INMO) daily “trolley watch” report from national hospitals found that on Friday morning there were 42 people awaiting admission in UHL’s emergency department and another 54 in wards.
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Waiting numbers at the hospital reported by the INMO this week were 81 on Thursday (including 29 in the ED), 69 on Wednesday (22 in ED), and 112 on Tuesday (61 in ED).
There is intense focus on overcrowding at UHL following the 2022 death of 16-year-old Aoife Johnston from sepsis, who had been left waiting for treatment in the ED for 12 hours.
The true picture of overcrowding and admission wait times depends on which data is referenced.
On Thursday morning, according to the Health Service Executive, there were eight people on trolleys in UHL’s ED as of 8am and 38 on trolleys elsewhere, a total of 46. Surge capacity beds, which officials say are fully staffed, accommodated a further 38 patients. Unlike the INMO, the HSE does not include “surge” beds as trolleys or inappropriate bed space.
On the same morning, INMO figures reported 81 people on its trolley-watch list at UHL, which can include trolleys, chairs and other bed space deemed inappropriate. The INMO counts all bed and other spaces used for patients not properly admitted on to wards, viewing such use as dangerous to overall patient care.
Nationally on Thursday, the HSE count was 376 people on trolleys as of 8am, while the INMO count was 510, a difference of 36 per cent.
Pressure on bed spaces is considerable at this time of year. In an interview on RTÉ’s Morning Ireland programme on Friday, Mr Donnelly said about seven public hospitals currently account for half of patients left waiting for admission on trolleys.
The Minister said that while some hospitals were improving, some “are still struggling” with the problem, which could be met through both capacity improvement and general reform.
“We know that in too many of our hospitals there are too many patients waiting on trolleys, particularly those waiting in the emergency department who are most at risk,” he said.
“When I was appointed Minister for Health I went to Limerick and the team in Limerick quite rightly put it up to me and put it up to Government. They said we need more beds, we need more staff, we need more funding, we need more discharge options.”
Since then, he said, they have added 130 more beds to the hospital group, 100 of which are in Limerick. They are also building capacity for 200 more beds on-site and staff has been increased by more than 1,000.
“But the second thing is you have to have reform. One of the most important reforms is seven-day-a-week discharge,” he said.
“You see in the hospitals that are doing the best, their discharge rates on a Saturday and a Sunday are very high. Limerick, in contrast to that, has the second-lowest weekend discharge rate of any hospital in the country.”
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