Any “proposed changes” to the emergency department (ED) in Our Lady’s Hospital, Navan (OLHN) will only be undertaken “in a planned and orderly manner, involving engagement with all the relevant stakeholders”, a spokesperson for the Ireland East Hospital Group (IEHG) has told the Medical Independent (MI).
In 2013, OLHN was included in the list of designated model 2 hospitals under the Smaller Hospital Framework. It is currently a model 3 hospital.
Yesterday, MI reported on serious concerns held by the HSE board, and at executive level, regarding patient safety at OLHN in its current form. At a meeting on 14 March last, the HSE board emphasised the urgency of implementing the reconfiguration of OLHN “as planned”.
The HSE board supported proceeding with reconfiguration within weeks if there was “undue delay” in engagement between the Minister for Health and local Oireachtas members.
In October 2021, Minister Stephen Donnelly told the Dáil he had instructed the HSE to “pause” plans in relation to the reconfiguration, pending consultation with the local community through elected representatives.
At the HSE board meeting, Chief Clinical Officer Dr Colm Henry said management and clinicians at OLHN believed the current acute model of care “holds significant risks from a governance and clinical care perspective”. They “fully support the planned reconfiguration to a model 2 facility”, according to minutes.
Concerns about “high risks” for patient safety had been previously considered by the board at its meetings on 28 July 2021 and 29 October 2021.
Dr Henry said there were concerns about the safety of undifferentiated patients referred to the ED and that “several incidents” had been reported to the HSE by the hospital since December 2021.
The minutes stated: “Given the extent of the clinical concerns, it is our [HSE] preference to progress with ambulance bypass with corresponding clinical protocols [which] will be fully implemented in advance of a full transition to a model 2 hospital.”
The HSE had met with Minister Donnelly and clinical leads in November 2021 and advised of the “critical imperative to proceed with the reconfiguration”. The minutes added: “A number of actions were identified for the HSE. These actions are now complete, and we are, at the request of the Minister, finalising responses to queries put to us by local Oireachtas members.”
HSE CEO Mr Paul Reid informed the board that the Minister had requested engagement with local Oireachtas members prior to any external communications, but planned meetings had been cancelled on a number of occasions.
“The HSE are finalising responses to the individual questions relating to the reconfiguration received from Oireachtas members which will be returned to the Minster with a request for an urgent rescheduling of the meetings with local Oireachtas members,” according to minutes.
The board asked that this engagement with local Oireachtas members be concluded as a priority.
Speaking in the Dáil in October 2021, Minister Donnelly said: “I am aware that the HSE initiated a process of planning for changes to the services at Our Lady’s Hospital, Navan.
“I am also acutely aware that any proposed changes to health services can be a source of great anxiety and worry for communities affected … I am determined that any consideration of changes to services at Navan must be happen in consultation with the local community in the first instance, through their elected representatives. I have, therefore, instructed the HSE to pause any such movements and to engage in a comprehensive manner with the elected representatives on behalf of the community.”
Campaigners seeking to retain the status of OLHN have argued that downgrading the level of service available at the hospital will exacerbate the trolley crisis and reduce access to acute care in the region.
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