A new facility could be established at University Hospital Limerick (UHL), or the existing campus extended, to increase the number of beds available, according to recommendations from the State’s health watchdog.
It said the risk to patient safety at the hospital will not be fully solved until the “mismatch” between demand and capacity is tackled.
In mid-2024, then minister for health Stephen Donnelly asked the Health Information and Quality Authority (Hiqa) to review the delivery of urgent and emergency healthcare services in HSE Mid West, which covers Limerick, Clare and North Tipperary.
The request, which was made on foot of patient-safety concerns, also considered the need for a second emergency department (ED) in the region.
RM Block
UHL is consistently one of the most overcrowded hospitals in the State. It came under particular public scrutiny following the death, in December 2022, of 16-year-old Aoife Johnston, who waited more than 13 hours for antibiotics to treat suspected sepsis.
In its advice to Minister for Health Jennifer Carroll MacNeill, published on Tuesday, Hiqa put forward three possible options.
The first option is to expand capacity at UHL’s Dooradoyle site. The second is the extension of the UHL campus to include a second site nearby under a shared governance and resourcing model, and the third option is the development of a new hospital in HSE Mid West, providing a second ED for the region.
“Each of the options has merits in terms of addressing the capacity challenges. There are risks with each option and we have considered potential risk mitigations,” the review said.
“A key driver for this review is patient safety; specifically, the safety risks associated with the significant mismatch between current capacity and demand in comparison with other Model 4 hospitals.”
Model 4 hospitals are generally located in larger towns and cities and take referrals from other hospitals.
Hiqa said the first two options were preferable “in the interest of addressing patient-safety concerns in the shortest possible time frame”, adding that these options were “likely to yield the required bed capacity more quickly”. The first option would probably be the least costly, but building a new facility would potentially meet longer-term bed requirements.
The midwest has seen an increase in resources and funding in recent years, including the 128 beds committed to be opened at the site by the end of this year, with a further 96 beds estimated for delivery in 2029.
In addition to the options presented, Hiqa said there are other areas that require consideration by the Minister and her department, including taking a system-wide approach to strengthening capacity in the immediate future by increasing ambulatory care, step-down capacity, private care, GP numbers and primary care.
Melanie Cleary, from the Mid West Hospital Campaign group, said the push towards the first two recommendations was “very disappointing”.
“It’s very disrespectful to the memories of our families that we lost in UHL,” she said, adding that the 96-bed block “took years” to come onstream and a new emergency department was “the right option for our region”.
Sinn Féin’s health spokesman David Cullinane said a second ED is “clearly needed”, emphasising his view that it is the “only safe option”.
“The Government must now act urgently to resource a plan to deliver a second emergency department and Model 3 hospital in the midwest, while simultaneously expanding safe capacity at UHL,” he said.
Labour’s Conor Sheen, a Limerick TD, said there needed to be “urgent progress” on the first two options to provide “immediate relief”.
But, he added, a new ED was “essential if we are to create a sustainable, safe, and modern healthcare service for the people of Limerick and the wider midwest”.
Dr Anne Dee, president of the Irish Medical Organisation (IMO) and a public health consultant based in Limerick, said aspects of the findings were “hugely concerning for patients and the medical workforce working in the region”.
