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
• Clear HSE evidence of commitment, through leadership, support and funding;
• Explicit, integrated, short, medium and long term plans to support transition for current
services and deliver the final network of regional and local ‘centres of excellence’,
supported by a robust project management structure and implementation team; and
• A professional media awareness and information programme.
2. Establishing a transitional support programme to improve current services.
• Temporarily expanding the A&E medical staffing numbers to the level of being able to
establish a suitable rotation out of the A&E service at Dooradoyle to serve both Ennis
and Nenagh, until such time as nurse-led local Urgent Care Centres are established as
part of the Emergency Care Network;
• Specifically linking the general medicine duty teams across the Mid-West with the duty
team at Dooradoyle, with clear responsibilities for providing urgent advice and patient
transfer to the centre; and
• Establishing an effective Medical Assessment Unit/Clinical Decision Unit at Dooradoyle to
overcome the present interdepartmental bottlenecks between the A&E, acute medicine
and emergency surgery services.
3. Developing new governance structures to support the overall implementation plan.
The HSE needs to lead the joint development of:
• A Clinical Governance strategy, designed to manage the clinical governance dimensions
of clinical networks and integrated care being delivered by multi-disciplinary teams. The
strategy therefore needs to primarily cover the acute services but also reflect shared care
arrangements with PCCC and include the academic dimensions, through the University
of Limerick medical faculty; and also
• A Corporate Governance strategy and code of practice, aligned with managing the
inherent complexities and accountabilities in the funding, devolving and delivering of
integrated models of care across a number of key stakeholders and organisations.
4. Establishing a regional ‘best practice’ programme to reduce the overall acute bed
needs through improved service efficiencies, in preparation for full transformation.
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