Jack Chambers (Dublin West, Fianna Fail) | Oireachtas source

I thank Deputy Quinlivan for raising this important issue in the House. The Minister for Health, Deputy Donnelly, is very concerned and conscious of the significant and sustained pressures experienced in University Hospital Limerick.

He is committed to ensuring the appropriate supports are delivered to the hospital. In each of the past two years, there were approximately 80,000 attendances at the ED in Limerick, representing a 12% increase on the pre-Covid figures in 2019. While the number of people presenting to the ED last year was broadly similar to that in 2022, an additional more than 1,000 needed to be admitted. More important, the 2023 attendance figures for patients aged 75 or over increased by 30% compared with 2019, leading to admissions of our elderly patients increasing by 1,600.

Over the past year, alternative care pathways have been enhanced to reduce demand on the ED and better facilitate patient flow. These have included, but are not limited to, the alternative pre-hospital pathway, a new collaboration that commenced in September 2023 between University Hospital Limerick and the National Ambulance Service. It will see definitive care provided in the community to patients who call 999 and will reduce the number of ambulances bringing patients directly to the ED. This involves specialist emergency medicine doctors and ambulance service personnel responding to low-acuity ambulance calls. The team will respond in an ambulance service vehicle to appropriate calls within a 45-minute radius of the ambulance centre in Limerick city. Up to the end of December 2023, this service had seen 245 patients. Of these, 52% of patients were seen via an alternative care pathway and 48% were conveyed to the ED.

Pathfinder is a partnership between the ambulance service and the hospital that was launched in Limerick in October 2022 and recently expanded its geographical area of operations throughout the mid-west. The pathfinder rapid response team responds to low-acuity 999 calls, such as from someone who has experienced a fall at home or is generally unwell. The older person is assessed by both an advanced paramedic and an occupational therapist or a physiotherapist. Up to the end of December 2023, 517 patients had been assessed by the regional pathfinder team, 54% of whom were supported at home without the need to go to the ED.

The geriatric emergency medicine unit at UHL recently expanded to nine treatment bays and to 24-hour operations during weekdays. This unit assesses elderly patients in ED with a view to avoiding unnecessary admission to hospital. Data for 2023 shows that of the 2,007 patients seen in this unit, 1,194 patients, or 59%, were discharged to their home, 240, or 12%, were transferred to a model 2 hospital, such as St John’s Hospital, and 558, or 28%, were admitted to UHL.

The medical assessment unit pathway for 999 patients has been extended to St John’s Hospital. This initiative means all three of the hospital group's medical assessment units can now treat patients referred by GPs, ShannonDoc or paramedics.

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