A&E access at Ennis and Nenagh falls significantly

THE HEALTH Service Executive (HSE) has confirmed that it is to review bed capacity at Ennis General and Nenagh General hospitals this year as new figures show that last year there was a significant drop in accident and emergency cases at both hospitals.

Health service figures show to the end of October last, Ennis General Hospital dealt with 10,705 A&E cases compared to 16,820 for the corresponding period in 2008 – a drop of 36.4 per cent.

The HSE ended 24-hour accident and emergency services at Ennis General and Nenagh General last April with the service open now 8am to 8pm each day. However, the drop in cases at Nenagh General during the same period was significantly lower than Ennis at 26 per cent with 10,687 A&E cases compared to 14,435 the previous year.

The drop in numbers attending the 88-bed Ennis General also came against the background of the damning Health Information and Quality Authority (Hiqa) report on services at the hospital last year.

On average, a quarter of A&E cases are admitted to hospital.

National director with the HSE John O’Brien said that elements of acute medicine will be transferred from Ennis and Nenagh to Limerick Regional Hospital during 2010. “Ultimately that will determine the bed requirement there,” he said.

Mr O’Brien warned: “We just can’t centralise services in Limerick and leave beds open in Ennis and Nenagh if they are not needed or required.

“The intention is to have a fully functioning hospital at Ennis and Nenagh, but what it will be doing will be significantly different from the past.”

Mr O’Brien confirmed that Ennis and Nenagh general hospitals will enjoy a significant increase in day-case surgeries this year that include vascular, ear, nose and throat (ENT) and orthopaedic specialities.

Mr O’Brien said yesterday: “We need to look at configuration of beds. We will need a significant cohort for day-case work while the inpatient surgery has stopped now.

“We are looking at bed capacity right across the region, whether it is acute inpatient capacity, day-case capacity, long-stay capacity. We are looking at everything in totality.” He added: “I would envisage a requirement for inpatient medical beds at Ennis.”

Asked if it will be at the same level as today, Mr O’Brien said: “I don’t know, it just really depends on what model of care we can provide safely and well at Ennis.”

He said: “I don’t accept there is any downgrading at Ennis.

“We have invested very significantly in the resources of Ennis and staffing numbers.

“I don’t envisage that changing dramatically in the coming years.

“I don’t accept the notion of downgrading if we are bringing in extra services there,” he continued. “If medical technology has moved to a point that we can do operations on a day-case basis, as opposed to inpatient basis heretofore, we should do that.

“I don’t accept that is downgrading at all at Ennis or Nenagh.

“There is no intention than to to do anything other than provide a safe service for the people of those communities, but it must be provided in an integrated way with the bigger hospital, which in this case is Limerick.”