Saolta embarks on reform project due to capacity deficits

Saolta University Health Care Group has acknowledged significant capacity constraints within its hospitals in a recent tender request.

The tender is for consultancy support for a theatre optimisation and outpatient service project.

The surgical inpatient/day case waiting list in the Hospital Group consisted of 19,939 patients at the end of 2023. Of these, 4,106 were waiting more than nine months.

The tender for consultancy support stated there were “multiple” factors impacting negatively on theatre utilisation.

“Ongoing recruitment issues, skill mix and staff shortages continue to present major operational challenges,” according to the document.

It said bed capacity, including critical care, is another constraint.

The capital programme for Galway University Hospital identifies the requirement for over 200 additional inpatient beds and 34 day-case beds.

Also, the Covid-19 pandemic had a major impact on all hospital activities and “our surgical access continues to be challenged”.

In relation to outpatients, the document stated new service developments, as well as new consult- ant appointments, have resulted in an increase in demand.

This has placed “considerable pressures” on the outpatient departments (OPD) across the hospitals with a year-on-year growth in both activity and waiting lists.

“The loss in physical OPD capacity due to social distancing, reduction in patients willing to attend hospital coupled with the impacts of the recent HSE cyberattack

had seen waiting lists increase throughout 2021.”

There have been some reductions in waiting lists since 2022 with the use of additional clinical insourcing sessions carried out in the evenings and weekends outside of core working hours, as well as maximising outsourcing availability with full packages of care.

However, the tender stated “all Saolta hospitals are severely challenged for available outpatient capacity and functional infrastructure despite developments in virtual clinics and telemedicine”.

“While there is a national plan (as set out in Sláintecare) for trans- fer of services from acute to community provided services, there remains a year-on-year increase in [outpatient] demand,” according to the document.

The tender also referred to the establishment of the health regions, which commenced this year.

A “key challenge” will be to achieve the reforms associated with the regions “within significant resource constraints”.

In terms of the consultancy service sought in the tender, Saolta is looking for a demand and capacity analysis for each hospital within the Hospital Group for both surgical and outpatient services.

This should take into account the “provision of current models, unmet demand and future projections for current and future requirements”.

The successful consultancy service will be expected to provide advice on governance and leadership across the Hospital Group as well as proposing the steps required to ensure its recommendations are implemented.