Patient health in the West/North-West at risk due to excessive delays to care – says IHCA
Public hospitals in Saolta University Health Care Group have unmanageable waiting lists with over 131,000 people waiting for care; - Waiting lists for outpatient appointments, inpatient/day case treatment and procedures in the region have increased by 3,400 (3%) since start of the year; and by 39,000 (42%) since 2015;
- 2,850 appointments and operations cancelled at hospitals in Saolta Group between December 2022 and January 2023;
- No additional acute hospital beds planned in 2023; just 7% of all new inpatient beds opened nationally since 2020 have been in the West/North-West, despite region accounting for one sixth of the national population;
- IHCA President Prof Robert Landers: “There is a serious concern that unmanageable waiting lists for care are severely impacting healthcare outcomes for some of our most vulnerable patients. Government needs to agree, fund and timetable plans to expand hospital capacity and Consultant staffing in the West and North-West region.”
The Irish Hospital Consultants Association (IHCA) has today (9 May 2023) warned that the growing shortage of essential acute hospital beds and Consultants across the West and North-West region is resulting in waiting lists for treatment that is impacting on patient outcomes.
At the end of March there were 131,600 people waiting for an outpatient appointment, inpatient/day case treatment or procedure across the six hospitals making up the Saolta University Health Care Group.1
The Government’s €443 million Waiting List Act Plan for 20232 has set a target to reduce waiting lists for outpatient appointments and inpatient and day case treatment and procedures nationally by 69,000 (10%) by the end of the year compared with the number waiting at the start of 2023. This would equate to a reduction of approximately 12,800 across the Saolta Group.
Instead, more than 3,400 people have been added to the three main hospital waiting lists in the region since the start of the year, which is an increase of almost 3%.3 This is because the shortage of beds is so severe that acutely ill patients are admitted, and essential surgical and other care has to be cancelled due to the significant capacity deficits.
The IHCA has urged the health service management to significantly increase bed capacity and access to operating theatres across the region to address the repeated cancellation of hospital appointments and operations in response to ongoing emergency department (ED) overcrowding. A total of 2,851 appointments or operations were cancelled during December 2022 and January 2023.4 Over a third (988 or 35%) of these cancellations were at Galway University Hospitals, which continues to experience very high demand for hospital care resulting in some of the highest numbers of people being treated on trolleys and awaiting admission to a hospital bed.
Consultants say the overcrowding crisis and increase in cancellations are being compounded by a severe lack of adequate acute bed capacity and Consultant vacancies in the region.
Just 69 additional inpatient beds have been opened over the past three years at hospitals in the Saolta Group, including 13 beds at University Hospital Galway, 46 beds at Letterkenny University Hospital and 10 beds at Mayo University Hospital.5 That amounts to just 7% of the 970 extra acute hospital beds opened nationwide since the start of 2020, compared with the West/North-West accounting for approximately one sixth of the national population. Furthermore, not a single one of the 162 additional beds planned for 2023 are in the Saolta Group.6
This is despite the West/North-West recording the highest hospital bed occupancy rates in the entire country during January and February at 105%, with Galway University Hospitals at 117% over the winter – the highest rate in the country.7 This is dangerously above the maximum recommended occupancy rate of 80%-85% and is accepted by the HSE to be an “unsafe” level.8
It is understood and welcomed that a new elective hospital is planned for Galway, which is expected to include eight operating theatres, seven endoscopy suites and nine minor operation rooms, intended to provide 175,000 additional procedures, treatments and diagnostic appointments per year.9 However, despite Government approval last year, progress has been extremely slow, with the new facility – likely to be located at Merlin Park Hospital – not due to be operational until 2028.
The IHCA agrees with Minister Stephen Donnelly that the public service needs to speed up the planning, procurement and tendering process and set a more ambitious target for the hospital build. The IHCA also wants funding committed to deliver the five proposed surgical hubs nationally – including one in the West – in the October Budget.
The Association welcomes plans to expedite capacity expansion through a rapid build programme, and calls on the Government to commit the promised €1 billion capital budget to deliver the 1,500 beds in the Budget this October.
It believes Government must take a whole-of-service approach and work with Consultants to put in place credible, time-bound capacity and Consultant staffing plans to ensure the delivery of more timely patient care. Figures show that approximately 30% of permanent Consultant posts are vacant or filled on a temporary/agency or locum basis across Saolta Group hospitals.10
Commenting on the waiting list and hospital beds analysis, IHCA President Professor Robert Landers said:
“There is a serious concern that unmanageable waiting lists for care are severely impacting healthcare outcomes for some of our most vulnerable patients. Government needs to agree, fund and timetable plans to expand hospital capacity and Consultant staffing in the West and North-West region.
“Nationally, we estimate that we need to deliver and open at least 700 hundred extra hospital beds every-year for the next 7 years, whilst appointing around an additional 300 permanent Consultants on an annual basis, in order to keep patients off trolleys and bring down waiting lists for hospital treatment.
“For the Saolta Group, this equates to around 120 beds each year until 2030 in order to treat patients in a timely manner, bring down unacceptable waiting lists and address population and demand changes.”
ENDS
Notes to editors:
1. The Saolta University Health Care Group includes: Galway University Hospitals, Sligo University Hospital, Letterkenny University Hospital, Mayo University Hospital, Portiuncula University Hospital, and Roscommon University Hospital.
2. The 2023 Waiting List Action Plan allocates €363m to reducing hospital waiting lists and an additional €80m for various community and primary care waiting list initiatives: https://www.gov.ie/pdf/?file=https://assets.gov.ie/249526/8b203212-06b9-4ddc-96f7-9938b0707e19.pdf
3. Analysis based on latest NTFP data as at end of March 2023: https://www.ntpf.ie/home/nwld.htm
4. HSE PQ responses to Deputy David Cullinane, 23rd February 2023: https://www.ihca.ie/_fileupload/HSE%20PQ%20Reply%20to%20D%20Cullinane%20Dec%2022%20Jan%2023%20cancellations.pdf
5. HSE PQ response to Deputy Jim O’Callaghan, 15th February 2023: https://www.hse.ie/eng/about/personalpq/pq/2023-pq-responses/january-2023/pq-4772-23-jim-o-callaghan.pdf
6. Irish Times, 28th April 2023: https://www.irishtimes.com/health/2023/04/28/record-health-budget-yields-just-162-additional-hospital-beds/
7. HSE PQ response to Deputy David Cullinane, 30th March 2023: https://www.ihca.ie/_fileupload/PQ%2012388_23%20Deputy%20David%20Cullinane%20Bed%20Occupancy%20Jan%20Feb%202023%2030032023.pdf
8. HSE Chief Clinical Officer Dr Colm Henry at the Oireachtas Joint Committee on Health, 26th April 2023:
https://www.oireachtas.ie/en/debates/debate/joint_committee_on_health/2023-04-26/3/
9. Establishment of the Elective Care Centre (ECC) in Galway Preliminary Business Case: https://www.gov.ie/pdf/?file=https://assets.gov.ie/251542/aae0d315-4a3d-4c93-8fda-eb2b77383846.pdf
10. HSE PQ Response to Deputy David Cullinane, 28 June 2022: https://www.hse.ie/eng/about/personalpq/pq/2022-pq-responses/june-2022/pq-31525-22-david-cullinane.pdf
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