The downgrading of Navan Hospital’s emergency department (ED) will see five or six seriously ill patients a day having to be taken by ambulance to Our Lady of Lourdes Hospital in Co Louth instead for safety reasons, senior doctors have said today.
The HSE has insisted the switch or “evolution” of Navan’s ED to a 24-hour medical assessment unit with support from a local injuries unit would not amount to a “closure”.
However, Navan’s intensive care beds are going to close.
And although the new medical assessment unit will operate 24/7 patients attending there need to be referred by a GP.
Navan’s clinical director Dr Gerry McEntee said it will continue to see around 80pc of the 25-30 patients who currently arrive at the hospital’s ED daily.
He said that “an average of five to six more unstable patients per day, currently brought to Navan by ambulance but who cannot be managed there, will now be sent directly to an appropriate hospital, “thus ensuring they receive the highest quality of care without delay”.
This is likely to be Our Lady of Lourdes Hospital in Drogheda which “will have essential critical services to safely and appropriately treat their serious illness on arrival, thus ensuring the best outcome.
"These critical services, which do not exist at Navan, include interventional cardiology, interventional radiology, neurology, emergency surgery, infectious diseases and nephrology,” he said.
The timetable for the overhaul is not clear although the process starts from the end of this month.
The National Ambulance Service said it has developed a plan to facilitate this reconfiguration “thus ensuring that patients are transported safely and quickly to the most appropriate hospital for their time critical care needs”.
Dr McEntee said: “The critically ill patients of Co Meath will now be provided with the best opportunity of survival by being brought directly to the nearest Model 3 or 4 hospital.
"This reconfiguration is supported by the physicians, the surgeons, the anaesthetists, the junior doctors, and the ED nursing staff in Drogheda who have all expressed their concerns regarding current ED patient safety.”
Navan is no longer recognised as a training hospital for junior doctors.
For a number of years Navan’s ED has not treated major heart attacks, suspected strokes, major trauma, nor has it dealt with those requiring maternity or paediatric care.
HSE chief operations officer Ann O‘Connor said Drogheda has already got 44 additional beds to take patients from Navan Hospital.
“We know one of the biggest changes that will impact on Drogheda is the opening of a 30-bed step down unit in Navan to ease the pressures,” she said.
She said there will be another 10 medical beds going in to Drogheda to compensate. It is due to get extra staff and two additional intensive care beds.
The HSE’s chief clinical officer, Dr Colm Henry, added: “In line with what has been successfully implemented in other hospitals, Navan will maintain and expand on most of the services it now provides.”
The plan is for Navan to build on an existing partnership with the Mater Hospital, which had led to patients having day surgery there.
The new second general theatre, recovery room and day ward mean an increasing number of Mater Hospital surgeons will be providing more surgical services to the local community, said the HSE.
The decision to shut down Navan’s ED comes after years of speculation and local opposition.
Local TD and Aontú leader Peadar Tóibín and other public representatives are to be briefed on the plan by Health Minister Stephen Donnelly today.
Mr Tóibín said the decision to close the ED was “reckless”.
“HSE figures show patients in Drogheda A&E are waiting 12 hours or more for hospital admission. Staff in Connolly Hospital were out on a picket because of overcrowding conditions in their A&E a number of months ago,” he said.
He said 546 people were on trollies throughout the state on Thursday and the Mater Hospital asked people to avoid its A&E last week.
"This is in the middle of summer,” Mr Tóibín said.
"Orthopaedic treatment and elective surgery in Navan had to be suspended over the winter because of the pressure on the A&E in Our Lady’s Hospital, Navan.
"This was done to free up nursing staff to cope with the overcrowding in Navan A&E. Yet the Government now want to close it. It beggars belief.”
Mr Tóibín said that from 2017 to 2021 the number of adverse incidents related to mistakes in medical care nationally jumped from 79,000 to 105,000 – a 32pc increase.
"Extreme incidents, which includes death or permanent incapacity, rose from 373 in 2017 to 579 last year. Many of these are happening because under resourced staff are under so much pressure,” he said.
“The Government has refused to give me comparative data on Navan A&E but the information that they did give me shows that a closure of Navan A&E would push tens of thousands of patients from a hospital group with a low increase in adverse incidents into a hospital group with the highest increase in adverse incidents in the country.”
Mr Tóibín added: “Shockingly there has been no Hiqa analysis of overcrowding in any hospital in the state published so far. The HSE is not analysing the damage that’s done by these policies.”
Mr Tóibín said senior clinicians in the RCSI group have stated that closure of Navan ED would be dangerous and a threat to life and health.
"Closure of Navan is not just dangerous for the 210,000 people living in Meath but it will worsen overcrowding at Drogheda, Cavan and Connolly Hospitals. It will also worsen record hospital waiting lists. Over 851,700 people are waiting for treatment right now. Every time there is A&E overcrowding, work stops on patient waiting lists to deal with overcrowding and these lists then get longer.”