Review of acute hospital services in the Mid - Health Service Executive

Review of acute hospital services in HSE Mid-West
An action plan for acute and community services
• However, if there had been one acute regional general medicine service, there would
have been more than enough consultants (10 full time + 8.2 part time) to manage an
average of 39 patients per day, from a population of 360,000, and the consultant
workforce and workload would meet the critical mass criteria for high quality standards of
care;
• High quality care is also based upon consultant availability, with no other commitments
when on emergency duty and continuity of care. The common approach of consultants
having either split site or part-time appointments (8.2 wte out of 18.2 across the Mid-
West) is satisfactory for delivering planned care sessions, but substantially
compromises the sustainable provision of continuous consultant emergency care;
• The present services at Ennis, Nenagh and St John’s are not sustainable, either in terms
of the number of consultants or volume of workload:
- St. John’s hospital has no full time consultant and only 2.4 visiting wte to run the
service;
- Ennis has only 2.0 wte full time consultants and admits an average of only 10 patients
per day;
- Nenagh has only 3 wte full time consultants and admits an average of only 7.4
patients per day; and
• At Dooradoyle, although there are 8.4 wte consultants, only 5 are full time on site, while
2.0 wte have split appointments, and 1.4 wte work part-time. As already stated, the
element of consultant resources that are dispersed substantially detracts from consultant
availability and continuity of consultant care needed for emergency patient management.
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