Eleven consultants at Letterkenny University Hospital have written to the Health Minister expressing serious concerns over the operation of the Emergency Department and it’s impact on patient outcomes.
They have joined with 78 GPs across the county expressing concerns regarding the clinical risk to patients arising from the deteriorating conditions in the Emergency Department and a lack of hospital resources.
The consultants say the condition of the hospital’s services, many of which are under extreme pressure, has been repeatedly
brought to the attention of local hospital management, Saolta Group, Department of Health and
various Ministers over the last number of years.
Letterkenny ED is one of the largest in Ireland with almost 150 patient presentations per day, around 50 of whom are admitted and although Letterkenny is a very large Model 3 hospital, it is quite isolated in terms of poor transport infrastructure, no alternative hospital service providers while the nearest Model 4 hospital 150 miles away.
ED waiting times, the most visible sign of a hospital in distress, have deteriorated quite dramatically since 2020. Only 52% of patients are seen in Letterkenny’s ED within 6 hours of presentation, far short of the 95% target. In 2020 that figure was 80%. 27% of patients currently experience a wait time in excess of 9 hrs which compares to just 6% 3 years ago.
LUH is the country’s 6th busiest hospital in the country but is 14th in terms of funding per patient.
The 11 consultants call for an external review team to inquire into the operations of the hospital ED.
They also want the inquiry to include a broader range of issues
that affect the delivery of emergency care including:
1. Sustainability of medical and surgical services
2. Radiology services
3. Facilities and staffing levels in our ED
4. Hospital acute bed capacity
5. Access to Community Hospital beds for step-down
6. Urology, Cardiology and Endocrine Services at Letterkenny
7. Access to, and ring fencing of elective surgical beds to facilitate cancer, othopaedic and other
surgical services with restoration of operating time for surgeons at the hospital
8. Development of a Surgical Assessment Unit and ring-fencing the Acute Medical Assessment
Unit
9. Implementation of recommendations of RCPI Report in May 2023, specifically the recruitment
of additional medical registrars to provide a 2nd out-of-hours registrar on-call
10. Immediate release of funds for a new combined Intensive Care / High dependency Unit
11. Recruitment of medical & surgical sub-specialties for a hospital of this size, including
Geriatrics, Cardiology, Urology, ENT, Ophthalmology, Neurology, Rheumatology and
Dermatology.
In conclusion, the consultants say the hospital is in crisis and rapidly approaching a tipping point beyond warning failed recruitment of medical and surgical specialists will lead to a failure of on-call rosters.
Such a scenario, they say, would inevitably lead to service curtailment and raise the possibility of service collapse.
