‘Insurmountable challenges’ and ‘unacceptable risks’ to patients at Midlands Regional Hospital Portlaoise have been identified by a medical review team.
The Leinster Express has been furnished with the correspondence from the representatives from the Royal College of Surgeons in Ireland last August which outlines a number of significant concerns to Ian Carter, National Director of Acute Hospitals.
Several requests to the HSE for a comment on the concerns raised have not been responded to. The HSE was also given the opportunity to outline what steps have been taken in the meantime on the issues raised, but no reply has been received.
The review from Professor Frank Keane and Mr Kenneth Mealy, Joint leads National Clinical Programme in Surgery concluded that even with a commitment to address the issues identified by them, “the problems pose insurmountable challenges” for the hospital and “unacceptable interim risks in terms of patient care”.
It was noted that the National Clinical Programme in Surgery had carried out site visits at all the acute surgical hospitals in Ireland “and to date this is the first occasion in which our concerns are such that we feel the need to highlight safety issues within a hospital” the correspondence states.
“This letter should not be interpreted as one that is critical of the managerial, nursing or clinical staff who, we believe, remain dedicated and committed to addressing the challenges but are faced with overwhelming odds.
“Nevertheless, it is self-evident that currently the Midland Regional Hospital, Portlaoise is not set up to provide safe acute and elective surgical care. It is our belief that the matters raised here can only be dealt with within the context of providing a rationalised surgical service provision with their hospital group (Dublin Mid-Leinster). This, we feel, needs to be dealt with as a matter of urgency,” the letter adds.
Many of their problems, the hospital management feel are, at least, in part due to: the moratorium on staff recruitment affecting many departments within the hospital; the contention that there has been a significant increase in the local population as well as an increase in Emergency Department (ED) presentations. This is despite the questionable adequacy of medical cover.
“The relatively high number of emergency department attendance for Portlaoise has caused conjecture and raises questions about possible data accuracy in the past. Attendance levels of 40,000 patients annually would put Portlaoise emergency department on a par with attendance levels of the Dublin Area Teaching Hospitals (DATHs) and would make them the 6th busiest rural ED,” the letter notes.
The letter also notes that although a bypass protocol has been instituted, as per the National Trauma Ambulance Bypass, “this does not prevent the arrival of seriously ill patients into an ED, some of which the ED and the hospital may be ill equipped to manage”.
The National Clinical Programme in Surgery undertook a continuous series of hospital site visits to advise on best practice as defined in both the Elective and Acute models of Surgical Care, in addition to supporting process improvement across the metrics of Day Case activity and average length of stay (AvLOS).