Extra cardiac lab at Waterford hospital not justified, report finds

Minister for Health Simon Harris has ordered a review of all major cardiac service nationally to ensure as many patients as possible have access to a 24/7 service.

Mr Harris also says he will provide extra resources for University Hospital Waterford as well as developing it as a centre of regional excellence for orthopaedic patients.

However, the Minister said he accepted the findings of an independent clinical review of cardiac services in Waterford which found that a second catheterisation lab in the hospital was not justified.

Publishing the review by Belfast-based Dr Niall Herity, the Minister said it recommended some services be provided elsewhere but in order to do this "a number of operational processes would have to first be embedded".

“However, he also recommends investing in UHW to enhance the existing cardiac services including, increasing the number of weekly sessions currently provided, in order to address waiting times and to provide improved access for patients.”

Mr Harris said he had asked his officials to carry out a national review of all primary percutaneous coronary intervention (PPCI, or angioplasty) services for heart attack patients, to be completed by July 2017.

New equipment would also be provided for Waterford’s existing cath lab to ensure there was a back-up when radiological equipment failed. The lab will open for an additional eight hours a week, and additional staff will be provided.

“During this period of investment and enhancement of services, the situation will be closely monitored. To assess the impact that these improvements have had on the volume of patients attending the cath lab, I will have a further independent review carried out in early 2017.”

The statement from Mr Harris makes no reference to Minister of State for Skills John Halligan, who has threatened to resign if the hospital is not equipped with a second cath lab.

Transferred

Dr Herity says the intervention provided in Waterford does not meet the clinical standard of 100 primary percutaneous coronary interventions (PPCIs, or angioplasties) a year and “will not do so under the current model”.

Patients arriving at Waterford’s emergency department with a major heart attack should be transferred to Cork University Hospital, 90 minutes away, “without delay, irrespective of the time of day or night”.

For patients who are more than 90 minutes away from a 24/7 PPCI centre, a group of local clinical stakeholders should design the best future way of restoring blood flow (reperfusion).

This may be the existing strategy of clot-busting drugs with immediate transfer, a default helicopter transfer or “an alternative strategy”.