Navan hospital’s emergency department to close

The emergency department (ED) in Navan hospital is to close and be replaced by a medical assessment unit.

Emergency patients will be directed to other hospitals in Meath and Dublin instead, the HSE has announced.

Under the changes, more than 80 per cent of people going to Navan’s ED will continue to be treated there, it said. Only the critically ill – about four to five people a day – will be brought elsewhere by ambulance for specialist care.

The HSE said the change will not affect activity levels in the hospital, which will become busier as more elective and orthopaedic procedures are carried out.

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Describing the change as the final step in Navan’s transition to a model two hospital, it declined to say when it will be implemented.

“The critically ill patients of Co Meath will now be provided with the best opportunity of survival by being brought directly to the nearest model three or four hospital,” according to Navan hospital’s clinical director, Gerry McEntee.

“This reconfiguration is supported by the physicians, the surgeons, the anaesthetists, the junior doctors and the ED nursing staff in Navan, who have all expressed their concerns regarding current ED patient safety.”

Mr McEntee claimed the ED was not closing as “its doors will remain open”. The HSE said the ED was “evolving” into a medical assessment unit, which will remain open around the clock. The intensive care unit will close.

Navan does not meet safe clinical standards for some patients, the HSE said. It is already bypassed for heart attacks, strokes, major trauma, and it does not treat children or expecting mothers. Clinical cover is provided by agency doctors who are not specialised in emergency medicine.

Patients arriving at Navan requiring critical care often experience “potentially catastrophic delays” in accessing the treatment they require, it said.

Senior clinicians in the HSE have long pushed for the closure of the ED on safety grounds but the political decision was delayed for years in the face of trenchant local opposition.

In 2013, a report recommended the downgrading of nine EDs in smaller facilities around the country to injury units. Navan is the one hospital for which this recommendation has still to be implemented.

In 2018, then HSE boss Tony O’Brien referred to Navan’s ED as “a wasteful use of public resource” that sees few patients and was costly to staff with expensive locums.

Plans for closing the ED were ready last year but in September 2021 Minister for Health Stephen Donnelly paused the move until this year.

The Save Navan Hospital campaign group, which has organised a series of well-attended marches on the issue, says closing the ED will add to overcrowding at neighbouring hospitals.