Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank Deputy Munster for raising this issue and assure her that I will be taking it up with the HSE directly. I received an email from the Deputy earlier this week regarding the lack of a response to her queries, which is not acceptable for any public representative or citizen of this country. I will get back to the Deputy directly regarding that matter.

I wish to take this opportunity to address the performance of the emergency department and the medical assessment unit in Our Lady of Lourdes Hospital in Drogheda. While recognising the pressures our emergency departments face, it is worth pointing out that recent data from the HSE indicates that, despite an increase of over 3% in attendances for the first quarter of 2017, the situation at the Our Lady of Lourdes Hospital has been improving, with 42% fewer patients waiting on a trolley compared to the same period this year. It is easy to get lost in percentages but that equates to 850 fewer patients on trolleys so far this year in Our Lady of Lourdes Hospital in County Louth. While there are still too many patients on trolleys, I want to acknowledge the Trojan work being undertaken by staff. Despite the fact that additional patients have attended the emergency department, 850 fewer people in that hospital have experienced being on a trolley this year as compared with last year. We need to build on that progress and I am confident that the staff there will do that.

The emergency department has also seen a sustained improvement in patient experience times during this period. I am sure Deputy Munster will join me in acknowledging the great work of front-line staff and managers in driving this improved performance. I want to thank everybody at Our Lady of Lourdes Hospital for that.

Notwithstanding this, under the framework of the HSE's full capacity protocol, Our Lady of Lourdes Hospital has an agreed escalation plan in place in line with national practice. This plan comes into operation during periods of emergency department overcrowding. I think this is the issue the Deputy is getting to. The plan sets out a range of special measures which can be activated through the escalation process as a last resort. These measures aim to improve the flow of admitted patients through unscheduled care pathways. As part of this, a medical assessment unit may temporarily be used to accommodate a locally agreed number of extra patients to address overcrowding. This is often referred to as surge capacity. At these times, patients are seen in the medical assessment unit rather than in the emergency department. While this temporary change of use may not be ideal in terms of the utilisation of medical assessment units, it enables hospitals to alleviate overcrowding in emergency departments and, most importantly, affords patients a greater degree of dignity. When patients are in a very overcrowded emergency department, it is important to afford them a little more dignity and privacy where possible. That is why decisions of this nature are taken. I accept that it might not always be ideal to use such additional space for these purposes. I have been advised that management in Our Lady of Lourdes Hospital has used the medical assessment unit facility in full accordance with the standard operating procedures as set out in the HSE's full capacity framework.

I assure the Deputy that there will continue to be a strong focus on reducing overcrowding. This should result in medical assessment units being used less frequently for surge capacity purposes. My Department and the HSE are already engaged in a process of commencing planning for next year's winter period. We are continuing to build on and improve trajectory in emergency department performance. In parallel with this process, the HSE's special delivery unit continues to work closely with hospitals, including Our Lady of Lourdes Hospital, to identify improvements that can be made to support patient flow, reduce trolley numbers and improve patients' emergency department experience. The programme for Government includes a commitment to build on the capacity for our emergency and acute services. This Government has agreed to review the management, operation and funding of medical assessment units with a view to extending their hours of opening and providing for weekend opening. My Department is in the scoping phase of this review. I hope hospitals like Our Lady of Lourdes Hospital can benefit from it. A number of major capital projects are under way to increase overall capacity in our hospitals. One such project at Our Lady of Lourdes Hospital will see the construction of a ward block to accommodate a clinical decision unit. This ward block is expected to be completed later this year. I expect that this increased capacity will further reduce the need to initiate the full capacity protocol.

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