Joe Carey (Clare, Fine Gael) | Oireachtas source

I thank the witnesses for coming and for their presentations and opening statements. I acknowledge the work of Professor Cowan and her management team in UHL. It is challenging. I also recognise the work of Ms Bridgeman and her team on the community side of things. There have been many advancements, even if we look at community healthcare. I refer to investments in all our community hospitals, including those in Kilrush and Raheen, or the new community hospital planned for Ennis, which will be state-of-the-art. There has also been investment in primary care centres. A fabulous facility will be opened on the Station Road in Ennis and another is planned for the Tulla Road. It is the same with Sixmilebridge and Killaloe. These are positive developments from a community care point of view.

The glaring problem, however, is with our accident and emergency departments and the waiting times. Like every public representative in this room, on this committee and in this Dáil, I get calls concerning this problem and the hardship families go through. Patients end up lying on trolleys for extended periods of time. This issue came to a head with the HIQA report. We also had the performance improvement unit going into the hospital. I would like to understand how that process works. I understand there was an initial visit in June, which was followed by a month-long stay in July, and that a further visit is planned. When is it expected it will be possible to report back with recommendations following the visit to the hospital?

Dr. Mike O'Connor:As the Deputy mentioned, the visit was for one month. In the first week, a deep dive was started to consider what might be the near-term opportunities to improve patient flow. Additionally, the process was absolutely collaborative. Therefore, this suite of actions is owned by the people in UHL. It is not a case of us prescribing actions, even though we did lean into some prescription items. We focused on several areas, especially concerning optimising the integration between community and acute hospitals. Equally, and has been mentioned several times, we have specifically and strongly suggested having a specific area for patients aged over 75, because the second highest attendance comes from people in that cohort. This is a significant issue. As we heard, that initiative will be operational in October. The third aspect, which is technical, is that at any one time about 10% to 12% of patients admitted to any hospital will stay for longer than 14 days, and they use about 60% of bed days. A small percentage of people admitted, therefore, about one-tenth of the patients, will stay for an extended time. There are multiple reasons for those outcomes.

We have brought a collaborative focus with UHL on digging down into those pages to see where the delays and blocks lie. In addition, there are a number of other areas around redesign of rotas and rosters. The piece is not so much a report - even though we will likely generate a report at the end - is actually owned by UHL, which is a better place to be. There are enough reports, such as the HIQA report. We are working alongside UHL and CHO to look at the short to medium term plan. We have heard clearly about the medium to long term plan, which nestles into capacity elective bed capacity. We clearly support that also. Our brief was to look at what we could do in the short term and bricks and mortar were not part of that.