Necessary and woeful: Mixed reaction in Tipperary to new UHL measures

Nenagh councillor Seamus Morris has said measures announced to alleviate over-crowding at UHL are "woeful and dangerous."

The measures were announced yesterday following a visit to the hospital by the Minister for Health Stephen Donnelly. 

Cllr Morris said they are not a replacement for a local A&E service. 

"The new measures recently announced with much fanfare by Health Minister Stephen Donnelly are a woeful and dangerous attempt to paper over the massive cracks in our acute healthcare provision in the mid-west region. 

"I must remind people that we were promised a world-class healthcare facility at UHL when they closed the acute services at Nenagh, St Johns and Ennis. 

"Still, we didn't get the promised replacement beds to provide that world-class facility and didn't even put in a review of the consequences of that scandalous decision. I have called for an investigation into who and why that decision was made," said Cllr Morris. 

Cllr Morris slammed to the repurposing of the 50-bed Community Nursing Home announced recently. 

The unit was supposed to be a much-needed replacement for the St Conlon's Nursing Home.

However, it was announced in recent weeks that the unit would be used to support UHL instead. 

"So the answer to our loss of a 24-hour A&E in Nenagh, Fianna Fail, Fine Gael and Michael Lowry decide to take out our replacement Community Nursing Home.

"If anyone gives one of their candidates a vote in the local and European Elections more shame you. The answer to our dangerous acute medicine healthcare situation is a model three hospital in the midwest now," said Cllr Morris. 

Measures Welcomed

Meanwhile, Tipperary TD Jackie Cahill has welcomed the measures. 

He said he hopes they will be a step in the right direction for the hospital. 

“I was glad to receive confirmation of these additional measures from Minister Donnelly yesterday. These measures will hopefully be a step towards addressing the trolley crisis at University Hospital Limerick.

"Urgent action is needed to tackle trolley numbers in UHL, and I have continuously raised this with Minister Donnelly and relevant officials," said Mr Cahill. 

He said the repurposing of the nursing unit was "necessary," but would be temporary. 

"I have looked for assurance that the use of the 50-bed Community Nursing Unit in Nenagh as a step-down facility for UHL on a temporary basis, and that once the first 96-bed block is opened in UHL next year, that the Community Nursing Unit be returned to the people of Nenagh and the surrounding areas

“Hopefully, these actions taken by Minister Donnelly will help alleviate the trolley crisis,” said Mr Cahill. 

Measures

Following a meeting with Management and the HSE on Thursday, Minister Stephen Donnelly said while some progress had been made the situation was still unacceptable. 

“This continued problem is not acceptable to me as Minister, and it most certainly is not acceptable to the people of this region.

“In an effort to alleviate the problem, I have agreed with the HSE a number of measures which will, I hope, help."

Minister Donnelly announced a "procurement process" to use the 50-bed Community Nursing Unit as a step-down sub-acute and rehabilitation facility until next year. 

After that, it is hoped the planned 96-bed unit will be open and available.

"We have decided to change the bed profile in this new block from 48 new beds to 71 new beds. I have also asked that recruitment commence in 2024 for immediate readiness in 2025.

"I have mandated that all steps are taken to accelerate the second 96-bed block to be built here at UHL, having sanctioned enabling works for that project last year. Those works have begun, said Minister Donnelly. 

The Minister also announced the following measures: 

A further 20 permanent step-down transition and rehab beds are to be procured in Clare, and 16 additional fast-build beds in Limerick. 

The Acute Medical Assessment Units at Nenagh, Ennis and St John’s are to be extended to 24/7 on a phased basis.

Safe staffing is to be extended to all wards in UHL as per the national rollout.

UHL is to be one of two national test sites for Acute Virtual Wards.

UHL will provide GP and Advanced Nurse Practitioner-on-the-door services for the ED. 

Minister Donnelly also met with representative groups of nursing and NCHD staff. 

“Those hospitals that are improving their performance, are doing so through a combination of increased resources – we have more beds and more staff, right across our health service albeit not to the same extent as here in Limerick – and reformed work practices," said Minister Donnelly. 

These measures include senior decision-makers, on-site at UHL after hours and at weekends. 

Community and Health and Social Care Professional support will be made available for weekend discharge, with seven-day rostering.

There is to be a targeted campaign to increase the number of consultants on the Public-Only Consultant Contract in UHL. 

An improved deployment review of those on the POCC to extend decision-making capacity.

All non-long stay beds – hospital and community will now come under one bed management system and with one person managing flow.

A Social Inclusion Hospital to Community Team will tackle the demographic and social challenges, which lead to the over-utilisation of hospital pathways.

The CAMHS Paediatric Liaison Team will work in the paediatric wards to support children with mental health needs.

CDM and ICPOP teams are to be distributed to the highest-need areas of the population.

All national clinical and reform programmes are to be deployed for the immediate benefit of the hospital. 

Central Referral Management and Patient-Initiated Reviews in scheduled care are to be introduced.

The Minister also said there will be a reorganisation of working plans of the Executive Management Team on-site at UHL across the week to provide operational leadership and support to staff across the hospital. 

“These measures have proved to be successful when deployed in Waterford, Mullingar, Beaumont and elsewhere, and I expect that they will be successful when they are rolled out here in Limerick, said Minister Donnelly.