'Smaller' Laois hospital to remain 'vibrant and critical' claims Dublin Midlands strategy

'Constrained resources', 'complexity' means smaller hospitals must be 'realigned' - HSE plan

Conor Ganly

Reporter:

Conor Ganly

Email:

news@leinsterexpress.ie

Portlaoise hospital hse a&e laois

Hospital services 'must be realigned' and reform is 'essential' according to the plan for Portlaoise and other Dublin midlands hospitals which points to 'constrained resources' as among the reasons for change.

The Dublin Midlands Hospital Group (DMHG) Strategy plan was leaked to Laois Sinn Féin TD Brian Stanley ahead of a 'sign-off' meeting last Wednesday.

Its executive summary outlines the future for 'smaller hospitals' like Portlaoise and Naas if the hospitals lose acute services starting with full A&E in Portlaoise.

"Spreading our constrained resources in this way is not in the best interest of patient safety, is not efficient, cost effective or best practice. Re-aligning how and where services are provided across our seven hospitals, such as high volume but low complexity services versus lower volume but higher complexity services, will ensure patient treatment is delivered in the most efficient, effective and collaborative way across the Group.

"The consequence of addressing this issue is that some high complexity services may move from smaller hospitals, in particular emergency and urgent care services. However, these hospitals will benefit from the addition of new facilities and a broader scope of services of lesser complexity.

"Developing the specialist capacity of smaller hospitals within the Group such as in the areas of endoscopy, diabetes care, geriatrics or elective surgery will ensure that these hospitals remain vibrant and critical parts of their local healthcare network, while also fulfilling a strategic function within the wider Group.

The DMHG chief executive Dr Susan O'Reilly has called the plan a 'blueprint' 

It proposes the cutting of A&E from Portlaoise replacing it with GP referred and local injury units but a public meeting in Laois has roundly rejected the plan.

While Laois TD and Minister Charlie Flanagan says it should be scrapped, a long time Fine Gael voter told an emergency meeting of the Portlaoise Action Hospital Committee that Laois should turn its back on Fine Gael if Portlaoise hospital is downgraded.

Health Minister Simon Harris has yet to decide what to do with the hospital nearly a year after getting a specific plan for Portlaoise. That plan is linked to the unpublished Dublin Midlands Strategy.

The following is the executive summary:

Dublin Midlands Hospital Group Strategy 2018-2023 Executive Strategy

The Dublin Midlands Hospital Group has developed its five year strategy, 2018-2023, to plan and address the challenges being experienced by Group hospitals including the increasing demand for services, changing care needs, pressure on existing infrastructure and the need to maintain a skilled and committed workforce.

The strategy’s objectives and priorities are informed by our population profile, projected demographic trends and the current capacity and activity across our hospitals. These key statistics will inform how we plan and develop services into the future. Our strategy also examines the factors that are likely to influence the design and delivery of healthcare services over the next five years to identify challenges and opportunities.

It presents priorities agreed by the Dublin Midlands Hospital Group Executive following consultation with the Management Teams in our hospitals including clinical and nursing leads, HSE national functions, community partners, and Trinity College Dublin Faculty of Health Sciences and the strategies that will be progressed to address them.

The strategy also recognises the need to transform the Dublin Midlands Hospital Group into a better integrated system. This will be done while still maintaining a focus on the priorities that will address the future needs of our patients. As a Group if we wish to achieve these objectives then reform of the Group’s existing service delivery model is an essential prerequisite.

The way, and in some cases the locations, at which we deliver particular clinical services must be re-aligned within the Group. Currently we do not utilise our resources in the most effective way, or optimise our complex care pathways, because our hospitals offer too broad a range of services at multiple locations.

Spreading our constrained resources in this way is not in the best interest of patient safety, is not efficient, cost effective or best practice. Re-aligning how and where services are provided across our seven hospitals, such as high volume but low complexity services versus lower volume but higher complexity services, will ensure patient treatment is delivered in the most efficient, effective and collaborative way across the Group.

The consequence of addressing this issue is that some high complexity services may move from smaller hospitals, in particular emergency and urgent care services. However, these hospitals will benefit from the addition of new facilities and a broader scope of services of lesser complexity.

Developing the specialist capacity of smaller hospitals within the Group such as in the areas of endoscopy, diabetes care, geriatrics or elective surgery will ensure that these hospitals remain vibrant and critical parts of their local healthcare network, while also fulfilling a strategic function within the wider Group.

Strategies for Surgical Services, Medicine Services, Women’s and Children’s Services, Medical Imaging Services, Critical Care Services, Cancer Care Services, Trauma Care are also broadly summarised in this document.

A range of important enablers will support delivery against the Group priorities and will be developed as the next steps to implement this strategy.

These include:

•Quality and patient safety improvements;

•Information and communications technology and technological development;

•Workforce strategy to support the attraction and retention of the highest quality of staff across our hospitals;•Groupwide financial planning;

•Improved Group communications; and

•Appropriate and sustained investment in capital and equipment infrastructure.