Mr. Tony Canavan:

Similarly, we also have variability in performance, as we describe it, across each of the hospitals.

As Mr. Watt and McCallion have both described, there are a variety of reasons for that. One of the other key factors that we are challenged by is our geography. Many of the people who use our hospital services do not have an alternative nearby. If one takes County Donegal, for example, the only hospital that is available to the vast majority of people in that county is Letterkenny University Hospital. That puts particular pressure and demands on the hospital at various times. Again, within the region we take the same approach as has been described across the country. We try to focus performance on sites that really require it and we try to transfer the learning from one site to the other, where that is appropriate, to ensure that all of our sites are learning from one another. One of the key learnings we have picked up in the past 12 months, for example, is a focus on the number of patients waiting for over 14 days or with a length of stay over 14 days in each of our hospitals. That has been a very useful indicator to us over the course of 2023 in driving improvements. We have been watching those numbers as they are starting to increase and then addressing them at an early stage before they rise too high. That has proven particularly effective in Mayo, where we have seen a significant reduction in the number of patients on trolleys in the emergency department awaiting admission. It is also proving to be very relevant in terms of Letterkenny and Galway, although the improvements are not as striking just yet on those sites. That is an example of the learning from one site around the 14-day length of stay, how relevant that is in terms of the overall numbers of patients on trolleys awaiting admission and how we transfer that between our sites.