Record numbers on trolleys in Nenagh

There was a total of 150 patients on trolleys at Nenagh hospital in January, according to the Irish Nurses and Midwives Organisation.

This was the highest monthly number recorded for Nenagh since the INMO began publishing its ‘Trolley Watch’ analysis for the hospital in 2006.

The INMO findings coincide with the introduction last week of new ambulance protocols that will see emergency patients treated at Nenagh hospital in certain cases, rather than being brought to the Emergency Department in Limerick.

National ambulance protocols were introduced last month to allow Mid West region ambulances take certain non-critical 999/112 patients to Ennis. These have been extended to Nenagh in order to further help with alleviating pressure at the Limerick hospital.

Ambulance staff have been informed that as of Tuesday, February 7, patients can be transported directly to the Medical Assessment Unit at Nenagh hospital, provided that the patient meets agreed clinical criteria, and the patient has been accepted by the MAU physician in Nenagh. This system will be in place from Monday to Friday only, from 8am to 6pm, and not on public holidays. Patients cannot be referred to Nenagh MAU outside of these hours.

In a statement, UL Hospitals Group said the new pathway allows stable medical patients meeting agreed clinical criteria to be treated in a Model 2 hospital. A key element is a telephone referral from the treating paramedic to the receiving MAU doctor, which ensures that the right patient is brought to the MAU.

This pathway will result in patients receiving medical treatment in a hospital closer to their home, will reduce patient presentations to Emergency Departments and will release ambulances more quickly to respond to other emergency calls.

112/999 patients that do not meet these clinical criteria will continue to be transported to Emergency Departments for assessment and treatment. The Medical Assessment Unit in Nenagh Hospital treats patients referred by GPs, ShannonDoc and now NAS paramedics. It is essential that unwell medical patients do not attend the MAU without a referral.

Nenagh and Ennis hospitals, along with St John's in Limerick, Croom Orthapaedic Hospital and local nursing homes, have been providing surge capacity for the region's hospital in Limerick. It is anticipated that the protocols will be also extended to St John’s in a bid to to further alleviate pressure on the Limerick ED.

SMALL HOSPITALS UNDER PRESSURE

The number of patients on trolleys in Nenagh last month was higher than that of Ennis hospital, where the INMO recorded 123 patients on trolleys. There were no patients on trolleys in Nenagh in January of 2022 or the previous year. The previous highest number was 75 patients, recorded in September 2019.

There were five patients on trolleys in Nenagh last Friday, according to the INMO, members of which take a count in hospitals around the country at eight o'clock every morning. Included are patients that have been admitted to the hospital but are waiting for a free bed; these patients are often being treated on trolleys in corridors, or on chairs, in waiting rooms, or elsewhere.

Roscommon/Galway TD Denis Naughten carried out an analysis of last month's trolley numbers and highlighted that the hospitals and staff under the most pressure due to overcrowding were the smaller hospitals in Nenagh, Bantry, Ballinasloe, Kilkenny and Naas. He found that even the Limerick hospital was under less pressure than Nenagh due to the average patient-bed ratio last month.

"If we delve down into the numbers of patients waiting on trolleys to date in 2023 and analyse this as a percentage of the number of beds available in each hospital, we get a much better indication of the pressure that each hospital was under last month," Deputy Naughten stated.

"The reason this is important is because while I have no doubt the HSE will put the hospitals with the big numbers at the top of their agenda, it is feared that the smaller hospitals under the most pressure will be ignored, because this is what has happened up to now."