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

Within three years
Review of acute hospital services in HSE Mid-West
An action plan for acute and community services
In years 1 to 3, we envisage a period of: progressive refurbishment of facilities to enable
most services to be reprovided in their appropriate local or regional setting; consolidation and
completion of the PCCC development programme; acceleration of the workforce
development programmes for APs and ANPs to lead the development of the local ambulance
emergency response and Urgent Care Centres; and, strong infrastructure development to
support the clinical networks.
Within 4 years
Years 3 to 4 should see the regional ‘centre of excellence’ able to deliver all the core acute
services not associated with new builds with further development of the local ‘centres of
excellence’.
We now proceed to describe the implementation plan in more detail.
Areas for urgent action and implementation
The first priority has to be for the HSE to take immediate action to reduce the current level of
clinical risk and improve patient safety in a number of service areas where the quality of care
needs to be addressed.
1. Taking action to reduce clinical risk and improve patient safety.
a) All major trauma patients must be taken directly to the regional trauma centre
In the opinion of the trauma consultants, the current practice of the ambulance service
taking major trauma patients to the nearest hospital, instead of directly to the regional
trauma centre at Dooradoyle, exposes the patient to increased risks.
It delays the patient’s access to prompt and definitive emergency management,
management that is not available in the smaller hospitals.
Therefore, the HSE needs to restate the instruction that all major trauma patients must
be taken directly to the regional trauma centre, with no ambulance stopover at a
peripheral unit. This will immediately improve patient safety with regard to the transfer of
trauma patients to hospital.
In addition, there needs to be an urgent review of why the Helicopter Emergency Medical
Service (HEMS) is so infrequently used. There is a general impression that it should be
getting used much more frequently.
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