78 Donegal GPs have written to the Health Minister calling for urgent action at Letterkenny University Hospital’s Emergency Department.
Describing the system as broken, the letter asks Minister Stephen Donnelly to meet with GPs locally along with Saolta management to discuss how to address the situation.
They have concerns over patient safety in the Emergency Department, particularly over timely access to services, and say if there are no significant changes, patients will continue to have unacceptable wait times to access basic emergency care.
The GPs warn that if the people of Donegal don’t get access to timely healthcare, then they will be encouraging their patients to take to the streets to demand it.
Donegal GP, Dr Ciaran O’Fearraigh says patients are being impacted negatively…………
On today’s Nine til Noon Show, Dr Padraig McGuinness, a GP based in Tamney, Fanad outlined the reasons for sending the letter.
He began by stressing this is not a reflection on the medical and nursing staff at the hospital………..
Full text of letter –
Donegal General Practitioners
06/October/2023
To:
Mr Stephen Donnelly TD
Minister for Health
Minister’s Office, Department of Health, Block 1, Miesian Plaza, 50 – 58 Lower Baggot
Street, Dublin 2, D02 XW14
Ministersoffice@health.gov.ie
stephen.donnelly@oireachtas.ie
cc:
Mr Robert Watt, Secretary General, Block 1, Miesian Plaza, 50 – 58 Lower Baggot Street,
Dublin 2, D02 XW14
Mr Tony Canavan, CEO, Saolta Group, ceo.saolta@hse.ie
Dr Colm Henry, CCO, HSE, Colm.Henry@hse.ie
Dear Minister,
We are a group of General Practitioners working in County Donegal. We are coming to you,
your officials and others copied into this letter, with grave concerns about the emergency
department at Letterkenny University Hospital (LUH). We are seeking an external review
and action plan urgently regarding access to the department and acute services.
At the outset let us be clear that this is not about our clinical colleagues who are working
under extreme pressure and in unsafe conditions. In fact, it is about supporting them to get
the resources they need. Resources also highlighted and requested by our nursing
colleagues in recent weeks. It is not about the standard of care our patients are receiving,
but is about the timely access to that care. We have met with hospital management at LUH
but believe that the scale and speed of the progress of change at LUH is leading to our
patients being placed at risk. We have huge patient safety concerns and while we do not
take this decision lightly, we feel that the time has now come to highlight publically the
current issues affecting our emergency department and acute services at LUH.
As GPs we are finding it increasing difficult to make the decision to send our patients to the
ED. We have to weigh up the clinical appropriateness of sending very sick patients to ED
versus attempting to manage them at home, even though in our professional opinion they
do require secondary care. There is a morbidity and mortality associated with leaving
patients in waiting rooms for long periods of time untreated, or in ambulances at the door,
or on trolleys awaiting admission. We have patients who are refusing to attend the
emergency department because they would “rather take their chances” and stay at home.
There is a real fear, founded in the reality of other patients experiences, that they will not
be seen in an appropriate time frame and instead sit on hard hospital chairs for hours
awaiting treatment. Many of these patients are our geriatric population and our hearts sink
when we send them to the ED and know the ordeal that is ahead of them. Patients are
leaving and going home, sometimes on the advice of stretched ED staff, as the wait time will
be too long. We have huge concerns regarding patient safety here and feel like it is an
incident waiting to happen.
Target treatment times for sepsis and other conditions are frequently getting missed based
on what our patients and families are telling us. In August, on at least one occasion that we
know of, there was no ambulance available in the counties of Donegal, Sligo and Leitrim
because they were all waiting for drop offs at LUH for hours. This was in August before the
so-called “winter surge”. Our patients are at risk of death and we are no longer willing to
stand by and watch while little meaningful change takes place.
We acknowledge the work that is being done locally, often by clinicians and ailed health
professionals desperate to improve the system they work in. We welcome the rapid access
zone in the ED for assessment and the new clinical arrangements for seeing paediatric
patients in the department. We acknowledge the attempts to recruit new consultants and
other AHPs, despite the national bureaucracy and roadblocks associated with this. We also
welcome the new modular build for LUH which may help to decrease overcrowding, but
which will not come on stream for about eighteen months. Efforts are being made, but the
ambition, the speed and the delivery is not good enough.
In simple terms, the system is broken. We no longer have faith that the current system can
be fixed and appropriately managed without outside intervention, support and resources.
As the Minister we are asking you to intervene with immediate effect in two ways;
1. To meet with us locally, together with senior SAOLTA management so we can all
develop a roadmap to providing safer services for our patients this winter. The
obstacles we are hearing of from LUH management could easily be circumvented by
the Department of Health and the Minister – but only if the will is there.
2. To appoint an external review team to evaluate and provide solutions for the
Emergency Department including evaluation of alternate access to acute services at
the hospital. This must include GP input and must report back with tangible solutions
before year end, backed up by appropriate resources.
As GPs we are keen to be part of the solution, but we need national and regional support in
LUH to support the teams there to provide radical solutions to improve access to our
emergency department. We also need to improve access to our secondary care teams via
other routes. We need someone external to cut through the bureaucracy and put the
patient back at the centre of what we are all trying to achieve. We need to be able to send
our patients to our local emergency department with confidence that they will not wait for
24 hours on a hard chair to be seen.
Donegal is a unique county in Ireland, sparsely populated, sharing a land border with the
rest of the Republic of only a few miles. We have limited private capacity. As a result, we
need Donegal-based solutions taking our geographical location into account. This is not the
developing world, this is Ireland in 2023 with a huge budget surplus. And Donegal deserves
the same access to timely healthcare that patients get elsewhere in the country. If we don’t
get that access we will be encouraging and supporting our patients to take to the streets to
demand it.
Minister we implore you to take action. We are in this job to advocate for our patients, if
you are too, then please listen to our demand for support, before it is too late and more of
our patients suffer adverse outcomes.
Your sincerely,
The General Practitioners of Donegal
In alphabetical order;
Dr Paul Armstrong Lifford
Dr Finnian Bannon Ark Medical, Letterkenny
Dr Catherine Blair Donegal Town
Dr Rachel Boner Millbrae, Stranorlar
Dr Mark Boyce Grove, Donegal Town
Dr Victoria Bradley Arranmore
Dr Sarah Brennan Carrigart
Dr Ryan Byrne Scally Medical, Letterkenny
Dr Heidy Campusano Donegal
Dr Ronan Cassidy Moville
Dr Eamonn Coyle Ark Medical, Letterkenny
Dr Martin Coyne Lifford
Dr Pallab Datta Ark Medical, Letterkenny
Dr Samantha Davis Falcarragh
Dr Johan Debruyn Gaoth Dobhair
Dr Tony Delap Gaoth Dobhair
Dr Sarah Doherty Inishowen Medical
Dr Thomas Downey Carndonagh
Dr Garrett Duffy Moville
Dr Jarlath Duffy Raphoe
Dr Eoin Dunphy Mountcharles
Dr Catherine Falls Carndonagh
Dr Dan Gill Falcarragh
Dr Angela Gilligan Ark Medical , Letterkenny
Dr Margaret Gilligan King Fanad Health, Tamney
Dr Magdalena Hall Donegal Town
Dr Ryan Hall Stranorlar
Dr Edward Harkin An Bun Beag
Dr Mark Hudson Letterkenny Doctors
Dr Beverly Huss Grove, Donegal Town
Dr Peter Kardos Donegal Town
Dr Jarlath Kelly BuncranaDr Sile Kelly Lifford
Dr David Khavia Ballyraine, Letterkenny
Dr Gerard Lannon Carrigart
Dr Dervla Loftus Stranorlar
Dr Leemol Mathew Buncrana
Dr Elizabeth Maxwell Milford
Dr Brian McColgan Letterkenny Doctors
Dr Shane McCool Scally Medical, Letterkenny
Dr James McDaid Scally Medical, Letterkenny
Dr Ann-Marie McElroy Moville
Dr Dara McEniff Dungloe
Dr Collette McFadden Lifford
Dr John McGeehan Letterkenny Doctors
Dr Padraig McGuinness Fanad Health, Tamney
Dr Ciara McHugh Stranorlar
Dr Marie Therese McKenna Lifford
Dr Meta McLaughlin Newtowncunningham
Dr Charlie McManus Lettermacaward
Dr Evelyn McManus Glenties
Dr Aidan McMenamin Moville
Dr Caroline McMonagle Lifford
Dr Magdalena Meges Stranorlar
Dr Janinda Muhandiramge Dunkineely
Dr Sally Mullen Stranorlar
Dr Síofra Nic an Bhreithiún Brook Medical, Malin
Dr Mona O’Boyle Milford
Dr Emma O’Doherty Donegal Town
Dr Ciarán Ó’Fearraigh Millbrae, Stranorlar
Dr Raghavan Paratian Ark Medical, Letterkenny
Dr Nikola Porter Buncrana
Dr Rajesh Rajpal Buncrana
Dr Supriya Rao Ballyraine, Letterkenny
Dr Ciaran Roarty Scally Medical, Letterkenny
Dr Dara Scally Scally Medical, Letterkenny
Dr John Sheerin Cloghan
Dr Kevinder Singh Letterkenny Doctors
Dr Sarah Smyth Falcarragh
Dr Ciara Steele Buncrana
Dr Rory Stewart Creeslough
Dr Mary Sweeney Milford
Dr Edit Tidrenczel Donegal
Dr Avril Travers Millbrae, StranorlarDr Dolores Vigil Scally Medical, Letterkenny
Dr Leon Viljoen Millbrae, Sranorlar
Dr David Walsh Rathford, Milford
Dr Therese Wheatley O’Neill Derrybeg
