ALARM STILL RINGING Serious issues at MUH have been flagged for many years, but little has changed.

We are still in early September but already the signs for the winter ahead at Mayo University Hospital in Castlebar are not promising. As we reported last week, a record number of patients were left waiting for a bed in Mayo University Hospital during August, according to the latest trolley-watch analysis by the Irish Nurses and Midwives’ Association (INMO). The monthly report shows that 407 patients were left on trolleys in MUH during the month. That’s a staggering 40 percent jump since the previous record for the month, set in August 2021 when the INMO recorded 290 patients waiting for a bed. The trolley watch figures have been recorded by the INMO on a daily basis since 2006. The lowest number for August was eight, in 2011. The massive jump to the current numbers is a significant cause for concern ahead of the winter season, where seasonal flus always put pressure on hospitals, while Covid is still a factor also. In recent years, we’ve reported regularly in these pages on major issues at the hospital – staffing, overcrowding and procedural – particularly in the Emergency Department. Both nurses and patients alike have highlighted concerning conditions, and many staff fear little has changed. Local and national pressures are at play. The number of patients on trolleys in August were high across the country – but concerns about how matters have been managed in MUH have been repeatedly raised for many years. INMO General Secretary Phil Ní Sheaghdha issued a stark warning ahead of winter, in light of these latest figures. “The consistently high levels of overcrowding we have seen this summer are sounding the alarm for a very bleak winter ahead unless immediate action is taken by the Minister for Health and the HSE in the form of a fully funded winter plan,” she said. “This plan should be published prior to the Emergency Taskforce reconvening in September. It is not good enough to publish a plan for winter when healthcare workers and patients are in the throes of a winter crisis,” she added.

Limerick model Action has been taken in University Hospital Limerick and if the Minister for Health Stephen Donnelly is serious about reducing trolley numbers across the country, he has a template to act from. For the first time since September 2021, University Hospital Limerick is not the most overcrowded hospital, and Phil Ní Sheaghdha believes that Limerick’s strategy must be replicated across the country. UHL’s success, she said, ‘is due in part to the work of the expert team led by Dr Mike O’Connor’, which she said listened ‘to what nursing ward managers staff nurses and nursing managers have been constantly saying’. “Now this team are actioning into improving the operational processes in UHL, which has seen significant results. This has been achieved by ramping up the discharge and internal/external patient flow processes through robust implementation by the Review Team. “What has been implemented in University Hospital Limerick in the last six weeks must be replicated in other hospitals with chronic overcrowding problems. It should not take [the INMO] and its members consistently shining a spotlight on problems with overcrowding for action to be taken.” It is not as if Minister Donnelly is unaware of the reality on the ground in MUH. Speaking in August 2021, following reports in this newspaper, including testimonies from patients at the hospital, Minister Donnelly acknowledged the need to act. “I’ve read the articles in The Mayo News, and they’re truly heartbreaking … The coverage in the paper is important, powerful stuff for the people of Mayo and everyone involved,” he said. “The hospital and the HSE will take it very seriously, and I’ve seen some of the response from the HSE already. They’re under sustained pressure and they’ve referenced Covid, the cyber attack and deferred care. However, incidents such as these should not happen. I’ve no doubt the hospital will be looking at these incidents very closely.” Not a whole pile has been said about actual outcomes since Minister Donnelly’s words. Covid has not gone away, but it does not present the same challenge that it did when he made those comments. The cyber attack was over a year ago. Yet still, hospitals like MUH forced over 400 patients to languish on trolleys in August. It is hard to know what an acceptable number of patients on trolleys might be. Zero might be a pipe dream, but 407 is off the charts. It cannot go on. Something has to change.