ULHG Statement on HIQA Report

UL Hospitals Group Statement on HIQA Report on Inspection Against the National Standards for Safer Better Healthcare University Hospital Limerick February 2023

(LIMERICK 23.06.2023) PUBLICATION of the HIQA report arising from its inspection at UHL in February 2023 provides some assurance that measures introduced to improve flow in the hospital and in the community are having a positive impact on patient care.

We also welcome the explicit acknowledgement in the report that overcrowding in our Emergency Department will remain the unfortunate reality until the fundamental mismatch between the demand on our services and our inpatient bed capacity is addressed.

The report reflects an overall increase in compliance with the national standards since the previous inspection. Of the 15 standards assessed in the ED and across the hospital, UHL was found to be compliant in one instance, substantially compliant in seven, partially compliant in five and non-compliant in two. The areas of non-compliance relate in the main to physical infrastructure in our older nightingale wards and to patient dignity and respect in our Emergency Department.

Overall, the report is positive about management and governance structures; patient safety and risk management arrangements; workforce planning and the kindness and professionalism of our staff. It is significant that every one of the patients who spoke to the HIQA inspectors during their two-day visit spoke positively of the staff at University Hospital Limerick.

The compliance plan published with the HIQA Report today includes measures being taken by UL Hospitals Group to build on the acknowledged progress on integrated care pathways and hospital avoidance; to address staffing deficits; to increase bed capacity; to improve operational effectiveness and other matters.

We accept the key finding that continued overcrowding in our ED is an affront to patient dignity and we acknowledge the negative impact this has on patient experience. We apologise to each and every patient who continues to experience excessive wait times in a suboptimal environment. This is not the kind of care we wish to provide to our patients and reducing these wait times is a continued focus for our staff.

Staffing deficits across a range of disciplines are also a feature of this HIQA report. This reflects the shortage of healthcare workers which is challenging care providers around the world and renewed travel opportunities associated with the lifting of pandemic restrictions that are particular to the Irish health system. Details of our ongoing recruitment campaigns are included in the compliance plan.

Commenting on the report, Professor Colette Cowan, CEO, UL Hospitals Group, said:

“Publication of the HIQA inspection report in June 2022 provided a fresh impetus for staff across the acute and community settings to improve processes and introduce new patient flow and hospital avoidance initiatives in line with Slaintecare. We have been aided in these efforts by the HSE National Support Team. We have had a particular emphasis on the increasing population of elderly patients with initiatives such as the Geriatric Emergency Medicine Unit at UHL which opened in October of last year and the Pathfinder programme where paramedics and allied health professionals assess older persons at home.

“The Enhanced Community Care programme continues to be built up in the MidWest, managing more patients with chronic disease in the community, improving access to community diagnostics and providing comprehensive geriatric assessments outside of the hospital setting in the three ICPOP centres in Limerick, Ennis and Thurles.

“The effect of all these initiatives is starting to have an impact on patient experience times in our ED. We have also seen improvements in triage times and in wait times to see a doctor. These improvements have been marginal to date but they are real and they give great encouragement to all of our staff who focus every day on patient flow.

“We are pleased to see these improvements reflected in the report published by HIQA today. This was the first inspection report of its kind which has a triangulated view, informed not only by hospital staff but also by the perspective of our colleagues in the community and in the HSE National Acute Hospitals Division.

“The report also accords with the longstanding view of hospital management, the consultant body and other key stakeholders that we cannot definitively address overcrowding in UHL until our bed capacity and our staffing resources are brought into line with comparable hospitals around the country and internationally. We must acknowledge that with the support of Government, we have increased bed capacity at UHL by over 100 and staffing levels by almost 1,000 since the start of the pandemic.

“Capacity remains far short of demand, however, and this is a key finding of today’s HIQA Report. Work is underway on the new 96-Bed Block for UHL and we welcome the more recent commitment from the Minister for Health that the second 96-Bed Block at UHL will be accelerated.” Prof Cowan said.