Stephen Donnelly (Wicklow, Fianna Fail)
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I have previously met with the HSE, University of Limerick Hospital Group (ULHG) management, and elected Oireachtas members from the Midwest to discuss the ED situation in University Hospital Limerick (UHL) and future developments in ULHG.

Urgent and Emergency Care pressures are no longer just experienced during winter periods. Prolonged levels of high presentations and congestion now occur throughout the year. While significant investment has been driven through Winter Planning and National Service Plans over the past three years, a new approach to Urgent and Emergency Care (UEC) planning is now required in response the changing demands.

This approach is twofold:

• The delivery of an Urgent and Emergency Care Operational Plan for 2023, which was signed off by Government at the end of July; and
• The delivery of a 3-year multi-annual UEC Strategy, which is expected to be submitted to Government in the Autumn.

The UEC Operational Plan 2023 focuses on improving four key performance indicators. There are specific targets to:

• reduce ED waiting times for older patients;
• reduce the number of patients with Delayed Transfers of Care;
• reduce the numbers of patients waiting on trolleys; and
• reduce average inpatient lengths of stay.

Surge periods of exceptionally high ED activity are anticipated for the remainder of 2023. The Plan contains surge measures, which were informed by the After-Action Review of the Winter Plan 2022/23. These surge measures will be triggered based on a composite risk assessment. Contingency measures for surge periods of exceptionally high urgent and emergency care activity in 2023 have potential additional expenditure in order of €5.7 million.

The UEC Operational Plan 2023 will lead into year one of the multi-annual UEC Strategy and will align with the governance structure of the overarching multi-annual UEC Strategy.

There are currently 867 inpatient beds across ULHG, which includes 530 beds in UHL. 150 additional beds have been opened in the ULHG since 1 January 2020; 98 of these beds in UHL.

There has been significant investment in infrastructure, including work on the new 96-bed inpatient block project at UHL, which commenced in October 2022. The project represents a total capital investment of just over €90 million. It will deliver an acute inpatient ward block that will go some way toward addressing capacity issues in the region.

The next phase of additional works on a second 96-bed inpatient block will commence following pending planning permission approval. These are in addition to a new 60-bed modular ward block opened in 2021. This follows the completion of two separate rapid-build projects, constructed in response to the Covid-19 emergency, which provided an additional 38 inpatient beds.

There has been significant recent recruitment into UHL Emergency Department, of both doctors and nurses. This has already facilitated additional rostering for consultants in emergency medicine. It is ensuring improvements in safe staffing levels in the Emergency Department. Recruitment is ongoing.

ULHG also remains committed to investing in their Model 2 hospitals to enhance non-acute patient care, and reduce presentations at the UHL Emergency Department.