Health Service Executive

News Release

HSE DML

7th November 2013

Re-organisation of Services at Columcille's Hospital, Loughlinstown

The HSE is making changes to emergency services for people in Dublin South and Wicklow from the 27TH November 2013. Services provided at St Columcille’s Hospital, Loughlinstown (SCH) are being re-organised. This re-organisation of emergency services is in line with the HSE national clinical programmes for emergency medicine, acute medicine and surgery, HIQA’s recommendations for St. Columcille’s Hospital and the Department of Health’s policy on the future role of small hospitals.

The Acute Hospital Service in HSE Dublin South East /Wicklow, is provided through a collaborative arrangement across three sites, St. Vincent’s University Hospital (SVUH), St. Michael’s Hospital (SMH) and St. Columcille’s Hospital (SCH). As part of the current arrangements between the hospitals, ‘by-pass’ protocols are in place in the areas of trauma, stroke, cardiology, paediatrics and maternity and these ensure the patient receives the most appropriate and timely treatment in the most appropriate setting.

David Walsh, HSE Regional Director of Performance and Integration said, “The re-organisation of services at Columcille’s Hospital, Loughlinstown secures the future for the hospital ensuring that it remains a vibrant, busy, modern hospital and guarantees its sustainable, central role in healthcare delivery for the region. Over €1 million has been invested in capital projects to support this re-organisation plan. The services that will be provided at St. Columcille’s are appropriate for the hospital and for the local population, delivering non-complex care as close as possible to patients’ homes.

“The vast majority (over 80%) of patients currently attending St. Columcille’s Hospital will continue to do so through the Local Injuries Unit and Medical Assessment Unit. It is anticipated that overall patient treatment will increase at the hospital annually due to the increased volume of day services. Patients should only have to travel to St. Vincent’s University hospital for complex services and acute emergency care.”

“The changes that are taking place in order to re-organise acute services, will deliver the best care for patients as they will receive the right care in the right place from the right person. “

Services are being re-organised as follows:

Emergency Department

As part of the re-organisation of acute services for the region, from 8.00 a.m. on the 27th November 2013 the emergency department at St. Columcille’s Hospital will transfer to St. Vincent’s UniversityHospital, and there will be a single integrated emergency department for the region. Patients requiring in-patient care will be admitted to the hospital most appropriate to their medically assessed needs.

Local Injuries Unit & Medical Assessment Unit

On 27th November 2013,from 8.00 a.m., St. Columcilles’ Hospital will open a Local Injury Unitand aMedical Assessment Unit. These will result in patients being streamlined to attend the right facility that best meets their healthcare needs.

  • The Local Injury Unit (LIU) will open from 8.00am to 6.00pm, seven days a week. Led by suitably trained medical and nursing staff under a cross site clinical governance structure. It will treat adult patients and children aged over fourteen with minor injuries, such as suspected broken bones, sprains and strains, facial injuries, minor scalds and burns. Patients can self-refer to the LIU or be referred by their GP. Acute emergency patients will be treated at the Emergency Department in St. Vincent’s UniversityHospital.
  • The Medical Assessment Unit (MAU) will open from 8.00am to 6.00pm, seven days a week and see patients, referred by their GP, with medical conditions such as chest infections and chronic diseases including asthma and diabetes. GPs and out of hours services can refer medical patients directly to the MAU.

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In order to support this re-organisation of services:

St Columcille’s Hospital, Loughlinstown

  • Ambulance Service –Pre-hospital emergency services have been improved to ensure that patient treatment can start even before a patient arrives at a hospital. A comprehensive Intermediate Care Service has been established to support the successful integration of SCH and SVUH. Current ‘on duty’ resources include a mix of Emergency Ambulances, and Rapid Response Vehicles (including Officer Response and Motorcycle Response). An additional advanced paramedic response vehicle has been resourced to support this initiative. Additional emergency ambulance capacity has been made possible by the introduction of Intermediate Care Vehicles. These vehicles undertake inter-hospital and inter-facility transfers and reduce the reliance on emergency ambulances to provide this service.
  • Laboratory Services & Diagnostics – The use of the CT facility at St. Columcille’s Hospital will increase and there will be an expanded range of diagnostic services available. This will facilitate speedier access for GPs for Diagnostic tests.
  • Outpatients – Outpatient services are being enhanced and further developed across the network to ensure that patient access is improved and patient outcomes are enhanced. Routine Haematology, Radiography and ECG Services will be available during the outpatient operational hours. Pulmonary Function Testing will be available during Respiratory Clinics as will exercise testing and routine Echocardiography during Cardiology clinics. In addition, open access referral pathways will be available to GPs for Cardiology and Endoscopy Services.
  • Stroke Rehabilitation – A dedicated Stroke Rehabilitation Unit will be developed and delivered by a consultant led multidisciplinary team.
  • Ortho-Geriatric Rehabilitation – A cross site Ortho-Geriatric rehabilitation unit is being developed in SCH and this will improve patient flow thereby facilitating increased capacity in the acute setting.
  • Weight Management Service – The current inpatient Obesity and Weight Management Service will continue at the hospital. The service will be enhanced through the development of a dedicated 4 bed unit. Bariatric surgery activity will transfer to SVUH.

Investment

Considerable investment has been provided to the region in order to facilitate these developments:

  • Capital investment has been provided to facilitate the development of medical assessment units, local injuries unit, additional Emergency Department bays and the provision of pulmonary equipment (PFT) and enhanced endoscopy facilities.
  • Revenue investment facilitated the recruitment of four additional consultants to improve and enhance regional capacity in acute and emergency medicine.

Professor Donal O’Shea ofSt Columcilles Hospital, Loughlinstown said “The services delivered at St. Columcilles Hospital will be re-organised in a way that ensures that safe, quality services continue to be delivered. These services are appropriate to the hospital’s level of care model determined by the HSE’s Acute Medicine and Surgical Programmes.

These include day surgery, acute medicine (for patients with GP referrals such as chest infections and elements of chronic disease management which require hospital care), minor injuries (fractures, minor burns and lacerations), diagnostics (endoscopy and pathology services), Stroke Rehabilitation, Ortho-Geriatric Rehabilitation, Weight Management Service, Palliative Care and radiology (x-ray and CT scans). These wide-ranging services will ensure that St. Columcille’s Hospital will work to maximum capacity.”

Prof. O’Shea emphasised that “More than 80% of patients currently attending SCH will continue to receive treatment in the Local Injury Unit, the Medical Assessment Unit or by direct admission to the medical ward. Overall patient attendances at SCH will rise with the planned increase in day surgery and outpatient services.”

Mr. Bob McQuillan, Regional Director of Emergency Medicine, said: “The Emergency Services between St. Vincent’s University Hospital, St. Columcille’s Hospital, and St. Michael’s Hospital have been closely integrated over the last eleven years. The current change is a further development based on evidence-based Clinical Programmes, and will improve patient safety and care. I believe this is an important further development.”

Prof. Michael Keane, Chairman of St. Vincent’s Healthcare Group medical board and clinical director for the area said: “the consultants, medical staff and GPs in the area work on a collaborative basis and support these changes, which further enhance the services we can provide to patients in the area. There will be patient transfer arrangements between the hospitals, which will ensure that patients can be admitted to the most appropriate hospital as determined by their medical needs, to receive the right care in the right place and at the right time.”

Martina Queally, Area Manager, HSE Dublin South East / Wicklow said“St. Columcille’s Hospital will remain a strong, healthcare anchor for patients from the Wicklow and South East Dublin area providing quality care to those living locally. The HSE will continue to work closely with senior clinicians, management and staff along with GPs, Friends of the Hospital, public representatives and all those associated with St. Columcille’s Hospital, as the changes are being implemented. We value the clinical and management leadership and staff dedication which has ensured that changes made to date. and the current changes being implemented, are in the best interest of patient care and the continuous development of quality services. In addition, I wish to acknowledge the committed contribution of all those involved in the region to promoting better safer patient care.

Ends/

Further information from: Communications Department, HSE DML

Tel: 057 9359795Email: /

Note to Editor:

St Columcilles Hospital is part of the largest hospital grouping ‘Dublin East Hospital Group’ incorporating Mater Misericordiae University Hospital; St Vincent's University Hospital; Midland Regional Hospital Mullingar; St Luke's General Hospital Kilkenny; Wexford General Hospital; National Maternity Hospital; Our Lady's Hospital Navan; St Michael’s Hospital Dun Laoghaire; Cappagh National Orthopaedic Hospital; Royal Victoria Eye and Ear Hospital. The primary academic partner is University College Dublin (UCD). Work is underway to develop a strategic alliance for this group which will have a group interim board and CEO, yet to be announced.