Calls have been made for better transparency in the health system after a critical review on unplanned care across the country was released to the Irish Patients Association under a Freedom of Information (FOI) request.
An independent review team — including external clinical and management expertise from NHS Scotland, the Scottish government, and NHS England — was commissioned to carry out a review of unscheduled care performance across nine hospitals that were under the greatest pressures during winter 2018/2019.
The hospitals examined were Cork University Hospital, Naas General, Tallaght University Hospital, Midland Regional Tullamore, Mater Misericordiae University Hospital Dublin, University Hospital Limerick, University Hospital Waterford, St Vincent’s University Hospital, and Galway University Hospital.
The report was not published, and in a statement issued to The Echo, a spokesperson for the HSE said that the review as undertaken in 2019 has “limited if any material benefit to be considered today as a basis for implementation, particularly given the action plans in place to address our current and future challenges”, and that in this context “the draft report is outdated” as a result of the pandemic and investment in hospitals.
But Irish Nurses and Midwives Organisation (INMO) general secretary Phil Ní Sheaghdha said that organisations such as the Irish Patients Association “should not have to get important reports such as the Independent Review of Unscheduled Care Performance through Freedom of Information request”.
“It has been an extremely challenging two years for the health service on the back of several record-breaking winters in succession,” she said.
“It is not good enough for the HSE to deem Covid as a reason not to publish independent reviews."
She said that the results of the review are “particularly damning” when it comes to the times patients were waiting to be admitted to emergency departments and that these reports “cannot be written off as unimportant or irrelevant because of Covid” but should be viewed as even more important due to the implications of Covid on overcrowded hospital environments.
People Before Profit/Solidarity TD Mick Barry also criticised the HSE’s decision not to publish the review.
During its visit to CUH in October 2019, the review team described the hospital’s emergency department triage as “a bottleneck that needs addressing”. The team noted that ED was overcrowded with about 30 patients awaiting admissions during its site visit and that ED triage at CUH needed to be addressed as patient experience time (PET) was “long”.
The HSE spokesperson also said:
“The report has remained in draft format since January 2020 and close out of the review process to include factual accuracy checks and response from the nine sites reviewed was never completed.”
The HSE said “significant progress has been made” in enhancing capacity in both acute and community services to facilitate patient flow.
There are 1,224 additional acute beds with 829 beds delivered to date, 333 critical care beds with 301 beds delivered to date, 73 sub-acute beds delivered, 86,682 private beds days used to date since January 2021, 338 community intermediate care beds, and 568 private intermediate care beds contracted on a weekly basis.