Review to 'consider the case' for second emergency department in mid-west region 

The ED at the Limerick hospital is the only one in the region, with ones in the likes of Nenagh and Ennis having been closed.

Health Minister Stephen Donnelly has said he will now "initiate a review into urgent and emergency care capacity in the mid-west region to determine whether a second emergency department is required".

The Department of Health said the decision to close smaller emergency departments in the region 15 years ago was based on "very clear clinical advice" at the time.

However, since those decisions were made, the population in the Midwest has also "grown considerably" and is also older than it is in most other regions.

"Older populations have a greater need for urgent and emergency care," a spokesperson for the Department of Health said.

Overcrowding at UHL's emergency department is continuing, and trolley numbers have increased by 39% there so far this year.

This figure contrasts with the national trend, with the average morning trolley count falling by 11% during the first four months of the year, the department claims. 

While some reforms are underway at UHL, "significant changes are still required in terms of how UHL is run and how patient flow is managed," a statement acknowledged.

This was highlighted in the recent report by the Health Information and Quality Authority (HIQA), which said greater operational grip was needed at the hospital.

That report showed UHL continues to struggle with an “ongoing mismatch” between patient and bed numbers, while improvements may not fully protect patients from harm.

It comes as last month, an inquest into the death of Aoife Johnston in UHL returned a verdict of medical misadventure.

Ms Johnston, 16, died in December 2022 in UHL after suffering from meningitis-related sepsis and was left for more than 16 hours without antibiotics.

The Irish Nurses and Midwives Organisation (INMO) have welcomed the review, saying they look forward to engaging with Hiqa and the Minister on the terms of reference.

INMO Assistant Director of Industrial Relations for the Midwest region Mary Fogarty said the union wants to have input into the drafting of these.

Overcrowding at the hospital has been “well-flagged” by the INMO, she pointed out.

“So far this year, 8798 patients have been admitted to University Hospital Limerick to be treated on a trolley, chair or in another inappropriate bed space,” she warned.

“There is huge pressure on our members working in University Hospital Limerick due to capacity issues and staffing deficits coupled with changes in demographics in the Midwest region.” She added: “It is clear that at this point we will need a Model 3 hospital in the Midwest.” 

 Model 3 hospitals provide 24/7 acute surgery, acute medicine, and critical care. Hospitals such as the Mercy University Hospital also operate a 24/7 emergency department.