Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I welcome the opportunity to address the House on the issues raised by Senator O'Donnell. According to provisional HSE TrolleyGAR data, there was a 17% increase in patients waiting on trolleys year to date in University Hospital Limerick accident and emergency department in September 2019 compared with the same period last year. In September 2019, there were 897 patients counted on trolleys in University Hospital Limerick, which was a 28% increase compared with the previous month. It is acknowledged that this is unacceptably high and the HSE is actively working with the University of Limerick Hospitals Group to ease congestion in University Hospital Limerick, with a focus on facilitating transfers to level 2 hospitals, as mentioned by the Senator, with regard to transitional care, assistance from rehabilitation units and community health organisation services, and prioritisation of diagnostics to aid inpatient discharges. Senator O'Donnell quite correctly and aptly referenced these.

The HSE has advised that University Hospital Limerick is experiencing high levels of occupancy combined with challenges from infection prevention and control measures. Ward rounds are ongoing in the hospital to identify patients for discharge and diagnostics are being prioritised to maximise egress. In addition, transfers to model 2 hospitals are being expedited and the surgical and acute medical assessment units are functioning to assist admission avoidance. The University of Limerick Hospitals Group has reported that indications for an MRI scan have greatly increased over the past 15 years and that an additional MRI scanner would have an immediate benefit in faster discharge of patients and reducing admissions. Proposals for funding of a second MRI machine and replacement of the existing scanner have been made by UHL. The HSE will have to consider the proposal in the context of the budget process.

Planning for the winter of 2019 and 2020 has commenced, and the Department of Health is working with the HSE to finalise the winter plan in the coming weeks. Individual community healthcare organisations and aligned hospital groups are preparing integrated winter plans that will focus on demand management and reduction, staffing availability, timely access to the most appropriate care pathway for patients, and the provision of appropriate and timely egress from acute hospitals. The local integrated winter plans will be delivered by local winter action teams. The winter action teams will report to the HSE winter oversight group, consisting of senior HSE staff across the relevant divisions and chaired by the chief operations officer.

The integrated winter plans will support the development of a single overarching strategic level winter plan for the HSE. Additionally, the Department and the HSE have been considering a comprehensive approach to the current high level of delayed transfers of care. However, recognising the urgency of the situation, approval was provided to the HSE to begin actions immediately to the value of €5 million in 2019 with a view to bringing the waiting times for the release of the nursing home support scheme funding back to four weeks, providing additional home support and increasing transitional care.

The health service capacity review published last year highlighted the need for a major investment in additional capacity. Progress has been made on increasing capacity in University Hospital Limerick, and the average number of open inpatient beds has increased by 4% between 2017 and March 2019. Since 2017, an additional 25 beds have been opened in University Hospital Limerick, including eight as part of last year's winter plan. In addition, a capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at University Hospital Limerick, with funding of €10 million allocated in 2019. The new modular ward will include three wards comprising 20 single-room occupancy with en suite facilities, two of which will be full isolation facilities and will provide care and treatment for patients from admission to discharge. The HSE has advised that the enabling works are complete and the main contractor is commencing work.