Tipperary councillor told hospital group needs an additional 200 beds
An additional 200 inpatient beds would be required to bring University Hospital Limerick Group, which includes Nenagh Hospital, in line with the national average, a Tipperary councillor has been told by the Regional Health Forum West.
The group has the lowest inpatient bed capacity when benchmarked per population against other Model 4 Hospitals, according to a reply given to Cllr Seamus Morris.
The councillor had asked what efforts had management made to get increased Acute (sub Acute allocated for the region and ICU beds also) bed capacity for the region.
It was "very disappointing" to see that as part of the national service planning programme for 2021, 411 beds were allocated nationally with none in the Mid-West, he said.
In a written reply to Cllr Morris by Prof Colette Cowan CEO of the hospital group, he was given a breakdown of how inpatient bed capacity and emergency attendances at the group compare to other Model 4 hospitals.
These showed that with 530 in-patient beds, University Hospital Limerick saw 76,473 Emergency Department cases in 2021. This was compared to 698 beds in St James's Hospital in Dublin, one of the country's busiest hospitals, but which had just 48,397 Emergency Department cases, and the Mater Hospital in Dublin which has 614 beds but saw 89,335 people in 2021.
Prof Cowan said that it was the belief of the group that the Mid-West must have an elective hospital to serve the well described needs of patients in the Mid-West.
Admissions through the ED at UHL account for 83% of inpatient bed days, leaving limited capacity for elective activity. Frequent cancellations of elective activity to accommodate increases in demand for emergency care had resulted in long and growing inpatient/ day-case waiting lists, she said.
"We welcome the recent significant investment and bed capacity provided in response to the Covid-19 pandemic. However, it does not sufficiently address the well-documented bed capacity shortcomings in the Mid-West region, nor does it adequately address the continuing growth in demand for emergency care," she said.
The CEO said that, in addition to inpatient bed capacity shortages, there was a need to significantly increase the number of non-consultant hospital doctors (NCHDs) employed at University Hospital Limerick in order to alleviate growing pressures and to support new consultant posts approved by Government in recent years.
An additional 68 NCHDs are required to adequately address the shortcomings, she revealed.
These amounted to the whole time equivalent of 31 registrars, 31 senior house officers and six senior house officers in ED.
Prof Cowan said that ULHG's next significant project in terms of bed capacity was the 96-bed block for UHL.
This project has full planning permission, fire certification and is fully designed. The tender process has now been completed and are commendation has been made to the HSE for their approval to appoint a contractor.
Construction of this four-storey, single room inpatient facility will take approximately 18 months to complete.
However, it is envisaged that when the new 96-bed block opens, approximately half the beds will be used to replace older bed stock on the UHL site, stemming from a long-identified need to move away from nightingale wards to single en-suite rooms in hospital due to cross-infection issues.
In relation to not receiving any increased acute bed capacity, Prof Cowan said that it should be noted that the allocation of funding for capital development projects was decided nationally and not by UL Hospitals Group.
While additional beds were welcome, the group had consistently stated that even sizeable ward block developments of the kind opened at University Hospital Limerick in the past two years would not fully address the long-standing, well-documented hospital bed shortfall in the Mid-West, she said.
"This is not to minimise the importance of additional beds. We added an additional 98 beds at UHL and an additional 10 critical care beds in response to the Covid-19 pandemic during 2020/2021.This new capacity has enabled us to keep vulnerable patients safe, including haematology, oncology and renal patients; to provide a safe pathway for people attending UHL for surgery; and to isolate Covid-positive patients.
"We had at all times said the 60-bed block would only go some of the way in meeting the acknowledged historical shortage of inpatient bed capacity in the Mid-West.
"In addition to bed capacity, reducing overcrowding in our hospitals depends on whole system approaches around integrated care, admissions avoidance, community access to diagnostics and patient flow initiatives, all of which are committed to under Slaintecare," said Prof Cowan
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