HEALTH Minister Simon Harris wrote to the management of a hospital asking them how overcrowding seemed to be getting worse even after a new €24 million A&E had been opened there.
The new emergency facility had opened at University Hospital Limerick (UHL) during May amid promises of three times more space and far better conditions for patients.
However, no sooner had it opened than the chronic overcrowding that had plagued the previous A&E reared its head once again.
Documents obtained under FOI reveal how the patience of Health Minister Simon Harris finally ran out in July when promised improvements had not taken place.
In an email, he wrote: “I see that UHL has worsened this afternoon rather than improved as per their expectation [and] undertaking. 27 on trollies on a summer day … is far too high and a cause of significant concern.
“We have invested heavily in a new Emergency Department and additional staffing for Limerick. I would be grateful if you could convey my concerns and the need for actions [and] improvement.”
The records also show how the hospital was hit with an outbreak of the highly drug resistant superbug KPC, which has been an ongoing problem in Limerick.
This latest outbreak temporarily shut the orthopaedic/trauma ward of the hospital, causing further chaos in accident and emergency as they tried to deal with surging patient numbers.
The hospital later responded to Minister Harris saying the opening of the new €24 million A&E was never going to solve all their problems.
Chief Executive Colette Cowan told the minister that the emergency department had seen a spike in use of over 5% in its first weeks of operation.
She wrote: “Literature suggests a 10% growth in activity when new infrastructure is opened that normally peaks and reduces after 4 to 8 weeks. A similar rise occurred when the Mater Hospitalâ€™s Emergency Department opened.”
Ms Cowan said the hospital had consistently said the new unit would not “resolve our capacity issues” but said it had greatly improved the “privacy and dignity for our patients”.
She wrote: “[A] study in recent weeks … indicated that UHL at 89% occupancy would require 50 additional beds immediately. We continue to operate at 110-115% occupancy.”
The hospital said they had a long list of measures in place to manage their A&E but that they faced a “challenged environment with high activity and low bed stock”.
The documents also reveal how within days of the €24 million facility opening, Limerick was cropping up in daily reports with a surge in patient numbers.
On June 1, an email said: “The system nationally remains very busy and many sites have not been able to de-escalate including … Limerick.”
A separate briefing on the same day said there had been a “very significant admission rate overnight” and that all possible measures were in place to deal with overcrowding.
Repeatedly, throughout the summer the hospital was mentioned in daily briefing reports as one of the “sites of most concern”.
One report described how there was 36 extra beds/trolleys in use on July 5 with “no prospect of reducing same given steady demand”.
A week later, a separate briefing for the Department of Health described how the hospital was now dealing with an outbreak of the superbug KPC (Klebsiella Pneumoniae Carbapenemase).
It said: “One of the biggest risks to flow is that KPC is now in the orthopaedic/trauma ward therefore closed to admissions and transfers out which is impacting very significantly on other wards as this is the main trauma season. Site remains severely congested.”
In a statement, the hospital said a range of measures were in place to “relieve pressure” on the emergency department with a separate plan already in place for this winter.
They said: “While patients still face delays in the new Emergency Department, it provides for a much improved patient experience compared to the old department which had 33 bays and has greatly improved the privacy, safety and dignity of our patients.”
The Department of Health said: “The minister has sought assurances that actions are being taken to address the situation in the UHL Emergency Department. It is understood that the Hospital is currently finalising a plan aimed at improving access to emergency care and reducing trolley numbers.”