A decision must be made regarding the future of Portlaoise Hospital,– or patient safety is not sustainable.
ThatÂ’'s according to health watchdog HIQA, which found that significant risks remain at the Midlands Regional Hospital Portlaoise.
The HSE and the Dublin Midlands Hospital Group - which runs the hospital - admit that significant challenges remain at the Hospital, particularly in the Emergency Department and Critical Care, and say they're having trouble hiring and keeping staff.
Juliette Gash reports;
Fianna Fáil TD for Laois Sean Fleming TD has today responded to HIQA's progress report on the Midland Regional Hospital in Portlaoise by saying that all the problems in the hospital are a result of a lack of resources made available by the HSE to allow the hospital provide a sustainable service.
Deputy Fleming said, “There is a new regional manager in the HSE responsible for hospitals in Laois, Offaly, Kildare and South Dublin. The manager has a policy of not providing adequate resources to Portlaoise. She has stated her intention to downgrade the Emergency Department and this has put a cloud over the future of the hospital. The knock on effect of this, as highlighted by HIQA, is that the HSE is finding it difficult to recruit senior medical staff into Portlaoise."
“Everybody recalls the recent problems in the maternity unit. The HSE responded in a positive manner by providing adequate resources and staff alongside introducing a new governance supervision arrangement with the Coombe Maternity Hospital. This has resulted in substantial improvements in the maternity unit. The same positive approach must now be taken with the Emergency Department. If this is done then patient care will be enhanced and we will have a sustainable service in the hospital."
This progress is backed up by HIQA, who say that maternity services at the hospital are now being provided in a safer and more sustainable way. This improvement has been facilitated by enhanced leadership, governance and management within the service, increased investment, and an improvement in the staff to birth ratio, which has been largely driven by a reduced number of births. Efforts to begin the process of integration with the Coombe Women and Infants University Hospital have also seen service quality and the safety of services enhanced at Portlaoise Hospital, but more remains to be done to progress this clinical network.
Significant risks remain, and the future of the hospital is uncertain.
HIQA’s Director of Regulation Mary Dunnion said “This Review was carried out in order to support the provision of safe and quality services at Portlaoise Hospital. While some progress has been made, significant risks remain and the future of the hospital is uncertain.”
“Those with responsibility for the ultimate decision making on the hospital’s future must determine the range of clinical services that Portlaoise Hospital can or could safely deliver. Making these decisions will require careful planning to avoid unintended knock-on impacts on other hospitals in the Dublin Midlands Hospital Group, neighbouring hospital groups, the National Ambulance Service and community services. Once the decision has been made, the plan should be implemented as quickly as can be safely achieved.”
HSE admits significant challenges remain
The HSE acknowledges that significant challenges remain at Portlaoise Hospital, in relation to general acute services, particularly in the Emergency Department and Critical Care. Despite investment a key challenge is the recruitment and retention of clinical staff.
Dublin Midland's Hospital Group, which operates Portlaoise Hospital has welcomed HIQA's report.
It says progress made over the course of the past 18 months is due to investment, recruitment, and in particular the commitment of local clinical and management staff.
The hospital’s 2016 budget of €51.7 million is €6.8 million or 15% greater than its 2012 base. In that period, there has been an 18% increase in staffing levels across maternity, paediatric, medicine and emergency services, as well as investment in quality and safety. There are now six funded obstetrics and gynaecological posts, four of which are joint appointments with the Coombe Women and Infants University Hospital. Funding for midwifery posts is consistent with Birthrate Plus national standards.
Notwithstanding the substantial financial and staff investment in the hospital, HIQA recognises that significant challenges remain, including general services, particularly in the Emergency Department and Critical Care. Recruitment, and the dependency on agency staff is also a notable challenge.
