HIQA report on the review of governance at the ULH Group – Topical Issue

Check against delivery

Speech by Minister for Health, Dr James Reilly T.D.

I would like to thank the Deputies for raising this matter and for affording me the opportunity to welcome the publication of the HIQA report on the review of governance at the University of Limerick Hospitals Group.   ULH Group is the first hospital group to be assessed against the National Standards for Safer Better Healthcare, which I approved in accordance with the 2007 Health Act.  The review is an independent assessment of services against explicit standards and I believe that it is important that the findings, both good and bad, are made clear.  This will help drive improvements in the quality and safety of our health services.

While the report makes it clear that significant challenges remain, particularly with regard to emergency services, it also identifies the significant progress that has been made in relation to corporate and clinical governance, and in the reorganisation of services within the Group.   Among the many positive developments are the establishment of a new management structure – the board of management, CEO and management team and clinical directorate; reconfiguration of surgical, critical care and paediatric services; and the establishment of an Infection Prevention and Control Team.

In relation to risks, the HSE has identified actions that have, and will be, taken to address the concerns raised and to provide an improved and safer service to patients.  The key risk area identified is unscheduled care.  I fully acknowledge that there are ongoing pressures on the ULH ED – that is why an extensive capital project is underway to build a new state of the art ED.  The new facility will open in 2016.  In the interim, the HSE has put in place a number of initiatives to address the limitations for patients and staff in the current ED, in particular;

  • A separate paediatric emergency area is now fully open since the review visit.  This provides a separate, family-friendly area for children who require an emergency response.
  • Ø A 17 bed short stay unit opened on 25th April and is being managed by the acute medicine physicians.  The unit admits patients who are short stay and can be discharged within 48 hours of admission.
  • A new €35 million critical care unit opened recently at UHL.  This is a major step forward in the development of acute hospital services across the region.
  • The acute medical and surgical assessment units are open and take direct referrals from GPs and referrals from the ED.
  •  Further information campaigns will be undertaken locally, to advise GPs and the public of the availability of three local injury units and medical assessment units in the region, in Ennis, Nenagh and St John’s Hospitals.

In parallel with these measures, the Special Delivery Unit will support the ULHG and provide the expertise required to provide both interim and long term sustainable solutions to deal with bed capacity, excessive trolley waits and overcrowding in the ED.

The establishment of hospital groups has the potential to bring about significant improvements in the way we organise our acute hospital services.  In that regard, I am satisfied that group boards are capable of exercising authority assertively and constructively on an administrative basis until a statutory framework is in place.  In advance of legislation, voluntary hospitals will continue to report to the HSE through service level agreements.

To conclude, I note and welcome the actions that have been put in place to mitigate risks in the UHL ED, and the development of a robust quality improvement plan to strengthen and develop Quality and Patient Safety performance across the ULHG group.  I can assure the House that my Department will engage with the HSE National Director of Acute Hospitals to ensure that the issues raised in the HIQA Report are satisfactorily addressed.