*Ambulances at UHL.
AMBULANCES in West Clare have an average turnaround time of four hours per call for emergencies to University Hospital Limerick (UHL).
In a protected disclosure compiled by a primary emergency care worker in West Clare which has been brought to the attention of Minister for Health, Jennifer Carroll MacNeill (FG) and senior officials in the HSE, the stark case of failings of health services in the Mid-West have once again been laid bare.
The Clare Echo has obtained a copy of the disclosure which warned that, “Clare and Limerick are at a serious disadvantage when it comes to patient safety. Sadly, reports like the Aoife Johnston case are not unusual”.
A series of observations have been made in the disclosure. “The emergency department is beyond capacity, it’s no surprise people are neglected. The public use the emergency department as a walk-in clinic. GPs use the ED as a referral clinic whereby many a patient calls an ambulance at the request of a GP for non-emergent cases. GPs no longer feel safe making diagnosis and over-refer to the ED. Although Ennis currently is unfit as an ED so too is Limerick”.
Only four beds per day are made available at Ennis Hospital for patients admitted by ambulance with no calls accepted beyond 4pm. “The current sticking plaster of allowing ambulances present to Ennis for a small amount of medical calls is too restrictive. Ennis only allocate four beds a day for ambulances and don’t accept calls from ambulances after 4pm”.
Ennis Hospital being unable to accept patients with trauma leads to average ambulance turnaround times of four hours from West Clare to UHL, the document warned. “The Ambulance service cannot transport patients with any trauma to Ennis whatsoever no matter how minor yet the public can self-present there. The result in Ennis not allowing enough ambulance cases causes the West Clare ambulance to have an average turnaround time of four hours per call from West Clare UHL”.
Since the closure of the emergency department in Ennis in 2009, the county’s population has “dramatically increased and aged. The ambulance service has turned into a proxy mobile medical unit akin to the video rental vans of old, although we are now well trained we are not covered to leave patients behind, we cannot make referrals of our own, this puts further pressure on resources and we needlessly transport people that do not need to go.
“Sometimes they have their own means of transport but wrongly think an ambulance will get them seen faster. There is scope for ambulance staff to refuse or redirect patients after careful assessment. This is done in the UK and other similar medical services. Recently new services have been launched such as the Pathfinder and the app car which try to filter our low acuity calls and try to keep the patient at home but these services are very limited”.
According to the medical worker, “The HSE cannot seem to differentiate between negligence and mistakes. If GPs and practitioners received better protection from claims it would definitely help our system and Ireland in general, surely this is the elephant in the room, so many aspects of society have been ruined by insurance and litigation”.
There is potential to accept more patients at Ennis. “If Ennis were to allow the public arrive self-referring or via ambulance to be assessed twenty four hours a day as a worried well clinic it would better serve the whole of the Mid-West than then the A&E could be dedicated to actual emergencies
“If HIQA decides not to support the obvious need for an emergency department in Clare, then at least allow a place for all the low acuity calls to be seen. They are strangling the whole health service. I often have to take people with drug overdoses of heroin or alcohol to the emergency department, they don’t need a team of medics, they might need basic care and medical observations but not a whole emergency department. With some changes, Ennis general is suitable for this,” the document concluded.
