The health service watchdog, the Health Information and Quality Authority (Hiqa) will report to the Government next summer on whether emergency department (ED) services in the midwest should continue to be centralised at University Hospital Limerick (UHL).
In May Hiqa, as the independent health and social care regulator, was asked by Minister for Health Stephen Donnelly to conduct a review of urgent and emergency care in the midwest.
Hiqa was asked to consider the case for a second ED within the region given population changes and pressures on the existing ED at UHL, which has experienced wide-scale overcrowding over recent years.
Hiqa published the terms of reference for its new review on Wednesday.
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EDs in smaller hospitals in the midwest such as at Ennis and Nenagh were closed several years ago on foot of a Health Service Executive review and a previous Hiqa report, with services concentrated at UHL.
Hiqa said on Wednesday that at the time of the centralisation of emergency services at UHL, it was estimated 267 additional beds would be needed but such an investment did not occur before the reconfiguration took place, due to financial difficulties.
It said in 2020-2021 a new ED as well as a critical care block and 98 new beds were provided at UHL. A further 96 bed block was currently in advanced stages of construction, and a second 96-bed block was also at an early stage of development. Additional beds were earmarked for the hospital under a Government expansion plan announced earlier this year, it added.
Hiqa also said that since 2019 an additional 1,200 staff have been appointed.
“Accordingly, at the time of the initiation of this review, the full impact of the cumulative investment in capacity on overcrowding at UHL is still to be realised. This review will aim to identify what additional capacity, if any, above that which has been delivered or which is in train, would be required.”
Hiqa noted that between 2014 and 2023, the population grew by 13.7 per cent, while in the same period the number of people aged 65 and over increased by 37 per cent.
The new Hiqa review will consider the recommendations of the (as yet unpublished) report carried out by former chief justice Frank Clarke into the circumstances surrounding the death of Aoife Johnston from sepsis in the ED at UHL in December 2022.
“The review will determine current evidence-based best practice in the design and delivery of urgent and emergency care services, as applied on a population-wide basis within comparable health services.” Hiqa said.
An extensive stakeholder engagement plan would be developed and implemented, which would involve key interested parties, including patients and healthcare professionals in the region and nationally, it said.
Hiqa said an independent expert evaluation of current and projected population demand for urgent and emergency healthcare services in the midwest region would also be undertaken.
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