Understaffing and patient overcrowding at Cork hospital a concern, says Hiqa report

An unannounced Hiqa report in to Cork University Hospital (CUH) has raised concerns about staffing vacancies and overcrowding.

Overall, patients were complimentary about the staff and the care in the hospital, and this feedback was “consistent with what inspectors observed throughout the inspection”, the report said.

The inspection was carried out in March and in the report, published on Thursday, CUH was found to be compliant in one area, substantially compliant in five, and partially compliant in five.

Inspectors said that improvements were required to progress the recruitment of vacant posts. At the time of inspection, there was a 13% nursing shortfall, which represented a notable deterioration from the 10% deficit identified during the previous Hiqa inspection.

The wider hospital was funded for 309 whole-time equivalent consultant posts across various specialities. Inspectors were informed that all posts were filled, but documentation highlighted a shortfall, with 299 posts filled.

Pharmacy

The hospital was funded for 73.25 whole-time equivalent pharmacy staff, but 11 pharmacist posts and nine pharmacy technician posts were unfilled. Pharmacy staffing was recorded as a high-rated risk on the hospital’s corporate risk register.

In the paediatric emergency department (ED), inspectors were informed by staff that when the paediatric service transferred to CUH the full complement of staff did not transfer with the service, leading to shortfalls.

During interviews, inspectors were informed that of the approved 14 posts in the Quality and Patient Safety department, six were vacant at the time of inspection.

Additionally, hospital staff who spoke with inspectors reported that the vacant medical-manpower manager post posed significant operational challenges, further compounded by a large number of vacant administrative positions, many of which were being filled by agency staff.

The hospital’s absenteeism rate in January 2025 was 6.6%, an increase from 6.07% in January 2024, and a significant rise compared to the 4.7% reported at the time of the previous HIQA inspection. The HSE’s target absenteeism rate is 4% or less.

Hiqa advised that management should address the vacancies, review staffing in the paediatric ED, and look at actions to address the hospital’s absenteeism rate.

Concerns

Concerns were also raised about overcrowding, with HIQA saying that the hospital should review the appropriateness of accommodating patients on trolleys in the ED corridor.

“While privacy and dignity were upheld for patients accommodated in individual cubicles and pods within the department, this was not the case for patients placed on trolleys in the corridor of the emergency department,” the report said, though added that staff informed inspectors that if a patient on a trolley required assessment, they would be moved into a cubicle.

Additionally, “physical distancing of one metre between trolleys in the adult ED was not maintained, due to overcrowding”.

The HSE advised, after the inspection, that there was “ongoing recruitment for unfilled professional and administrative disciplines” and that they planned to “return the overall HR department to full complement” to help address absenteeism.