A proposal to reconfigure 24/7 Emergency Department (ED/A&E) services at Portlaoise has been reworded in a new five-year 'roadmap' for hospitals in Dublin, Laois, Offaly and Kildare.
The HSE's Dublin Midlands Hospital Group Strategic Plan 2018-2023 was officially launched behind closed doors at Dr Steven's Hospital in Dublin. The plan has been drawn up by the Dublin Midlands Hospital Group (DMHG). It was signed off on by the CEOs and senior managers of the hospitals before Christmas. It has the backing of the HSE.
A draft of the plan leaked last October outlined a path for the future of Emergency Services in Portlaoise. It pointed clearly to removal of 24/7 emergency services.
The draft stated: "Develop 24/7 General Practitioner referred medical assessment unit and 12/7 local injuries unit in the Midland Regional Hospital Portlaoise (MRPH) in line with national clinical care programmes models of care".
However, the plan published by the HSE now states the following:
"We will develop a Medical Assessment Unit in the MRPH in line with National Clinical Care Programmes Models of Care. In conjunction with the Emergency Medicine Programme, we will develop appropriate streaming of patients for minor injury treatment," said the section on Urgent and Emergency Care.
The plan also says: "Prompt and optimum care for patients with serious conditions can only be provided where there are adequate numbers of staff with the essential skills to provide 24/7 service."
The press were not invited to attend the launch. The HSE is anxious to point out that the strategy is separate from an Action Plan on the future of Portlaoise hospital which has also been leaked.
It proposed the replacement of A&E with the MAU and a local injuries unit in line with a Category 2 hospital. It also proposes the removal of ICU, paediatrics, maternity and most surgery from Portlaoise.
The Minister for Health Simon Harris has yet to make a decision on the action plan.
The strategy was due to be published before Christmas but was postponed at the last minute when there was uproar in in Laois. The Portlaoise Hospital Action Committee threatened to picket its launch at Trinity College.
News that it would publish the report on Monday only emerged in an Irish Times story on Sunday online about accountability baby deaths at Portlaoise hospital.
The DMHG issued a statement saying Tony O’Brien, Director General of the HSE described the strategy as a ‘five-year roadmap’ for the delivery of hospital services for a population of more than 800,000 who may access care in the Group’s seven hospitals.
It said the strategy focuses on five key strategic aims that will drive DMHG’s reform and development priorities:
1. To deliver excellent standards of quality and patient safety
2. To optimise service delivery, ensuring patients are treated in the right place, at the right time, by the right people.
3. To develop integrated care between Dublin Midlands Hospitals Group and its Community Primary Care Partners
4. To foster education, academic research and innovation
5. To strengthen co-operation and collaboration between the Dublin Midlands Hospital Group Hospitals
The DMHG says the launch was addressed by its launch former DMHG CEO, Dr Susan O’Reilly. She played a lead role in writing the Strategy and the Action Plan for Portlaoise hospital.
“This strategic plan has one simple objective—to determine how we can support, sustain and develop our hospitals to deliver high-quality care for our patients.
“We have undertaken a substantial body of work to establish the Group governance and accountability frameworks. These frameworks provide the foundation on which we will build and deliver this strategy.
“The five-year strategic plan acknowledges the significant work already underway across the seven hospitals, in a very challenging environment,” said Dr O’Reilly in a statement.
The DMHG claims it is seeking to improve access for patients so they can be seen and treated in the right location by the most appropriate provider, to expand services in response to growth in demand, and to work in partnership to better integrate across Hospitals and community health care services, with patient empowerment at the centre.
In 2016, 11,000 staff delivered 735,915 outpatient appointments; treated 198,456 patients in the Group’s Emergency Departments; and delivered 9,788 babies with a budget of €1,020.2m.
Commenting Trevor O’Callaghan, Acting CEO and Chief Operating Officer of the DMHG. He also the chariman designated of the steering committee to implement the action plan to remove services from Portlaoise.
“The strategy provides a blueprint of how the Group will continue to deliver the highest quality acute hospital care services and continue to drive change, support innovation, and improve access to services for all patients.
"The plan acknowledges the main challenges for the acute sector in Ireland: access to health services and improvements in efficiency in the delivery of hospital services.
"To achieve this we will adopt a Strategy in Action. We will drive change in a collaborative, cooperative manner where, most importantly, patients will receive the best standards of care”, he said.
Professor Mary McCarron, Dean of the Faculty of Health Sciences at Trinity College also attended.
“Trinity College is very pleased to be part of the first Strategic Plan for the Dublin Midlands Hospital Group. Trinity College envisages the development of a clinical and academic healthcare model that will deliver best patient care, education, innovation, world class research and its translation into action. We look forward to further strengthening our existing partnerships with our Hospitals and the Dublin Midlands Hospital Group to achieve this over the next five years.
“We are particularly pleased to announce our intention to appoint a ‘hospital liaison’ who will work on developing a strong academic relationship to support health care delivery. We hope into the future this will evolve into a lead academic position for the Hospital Group.”
The HSE said this strategic vision has been agreed with all seven Group Hospitals, the HSE nationally, and the Group’s academic partners in Trinity College.
It is not clear what the Minister for Health or Department of Health's view of the process is.