Tipperary TD raises concerns over future planning for hospital's Minor Injury Unit

Tipperary Sinn Féin TD Martin Browne has questioned whether an analysis is planned to ensure that the ability of the minor injury units in Nenagh and Ennis to take pressure of the emergency department at UHL can be strengthened in line with the anticipated increase in presentations at the Limerick ED.

He raised the matter at a briefing this Monday with the UHL Hospital Group following the publication of the Deloitte report on patient flow at University Hospital Limerick and UL Hospitals Group.

The report, released last week, recommended significant investment in inpatient and day beds to meet current and future demand at the group, including increases in medical, nursing and allied health staff in Limerick and across the group of six hospitals; the implementation of a range of admissions avoidance initiatives; greater integration with community services in line with Slaintecare; and an upgrade in ICT infrastructure and systems across the acute and community health sectors.

Reacting, Deputy Browne said: “We are all aware of the intense pressure the emergency department at University Hospital Limerick has consistently been under over recent years, and the impact on patient experience this has resulted in.”
He revealed that the briefing report, UHL Hospital Group estimated that ED attendances in Limerick will increase by a further 3,000 or 4% this year.

“Given that the minor injury units at Nenagh and Ennis are relied on to take some pressure off UHL’s Emergency Department, it is appropriate that forecasting is done to ensure those units have the capacity to deal with the corresponding increase in demands they will experience,” he said.

He said that he had asked whether such forecasting had been done or was planned for the near future.

“Nenagh has a lot of potential to assist in meeting the demands that are being placed on University Hospital Limerick. I, for my part, will continue to highlight this,” said Deputy Browne.

The report, Deloitte UL Hospitals Group Patient Flow Report, also highlights the need for:

- An additional 302 inpatient beds by 2036

- An additional 63 day beds by 2036

- Additional medical (consultant and NCHD) and nursing staff in the Emergency Department are an immediate priority

- Additional medical staff to extend the operating hours of the Acute Medical Unit at UHL

- Address significant deficits in health and social care professionals on wards across the Group to facilitate admissions avoidance, earlier discharges and development of integrated care pathways

- Upgrade the eHealth systems across the hospital and community to a fit-for-purpose single electronic healthcare record

“The key findings of the report underline how we have been managing record demand for our services, from a population with greater health needs, with fewer beds and fewer staff per head of population. Publication of the Deloitte Report is an opportunity to address this fundamental imbalance as we move towards population-based resource allocation,” said Prof Colette Cowan, CEO of UHLG, who commissioned the report.

Meanwhile, Prof Cowan told Cllr Seamus Morris in response to questions at the September meting of the HSE West Forum, that 6,352 people had used the minor injury clinic at Nenagh in the first half of 2022, with a total of 9,971 using in in 2021.

She acknowledged that staffing issues had forced the closure of the unit recently but said these issues related in the main to NCHD resources post the annual changeover and to Covid-19.

Plans were at an advanced stage to stabilise medical staffing for these services and the group expects that these temporary closures will be kept to a minimum going forward.

“These recent disruptions in service are unfortunate as the increase in activity through all three Injury Units (Nenagh, Ennis and St John’s) is a very positive development,” she said.