TROUBLED Portlaoise Hospital is to have its A&E downgraded and will no longer carry out complex surgery, it was announced today.
The move comes after last month's damning Hiqa report into care standards at the hospital which followed a number of baby deaths over several years.
The opening hours of the hospital’s A&E department, which has already survived previous plans for downgrading, will be reduced to 8am to 8pm.
Complex surgery will be transferred to St James' Hospital or the Midland Regional Hospital Tullamore “as the volumes are too low to maintain the requisite expertise of clinical staff.”
A HSE spokeswoman said :”This will result in the discontinuation of undifferentiated surgical cases (all manner of conditions) that present at the hospital’s emergency department. There is a progressive complex planning processfor surgery that will in the medium- to longer-term will result in a reduction of ED opening hours (overnight).”
She added:”This planning process will be done with the engagement and input of relevant staff.”
The HIqa report expressed concern about the ability of the hospital to carry out complex surgery because doctors were not seeing enough of these patients to maintain expertise.
Hiqa criticised all levels of management in the HSE for failing to heed warnings about safety standards at the hospital where five babies died.
“ There were many reasons why the HSE should have maintained very close oversight of the quality and safety of services at Portlaoise Hospital. These reasons included local and national HSE inquiries and clinical reviews into patient-safety incidents, significant service failures, statutory investigations of hospital services, and resultant publication of findings and recommendations.
“ However, there was no evidence that the HSE nationally was proactively exercising meaningful oversight of the hospital and the inherent risks identified there," it said.
The HIQA investigation found found that Portlaoise Hospital continued to provide:
* undifferentiated (all manner of conditions) emergency services 24 hours a day seven days per week (24-seven), and
* undifferentiated surgical services where there is a low number of complex surgical cases.
In addition, it found that the hospital had major deficiencies in corporate and clinical governance arrangements.
Although described as a ‘model-3 hospital’ by senior HSE and local hospital staff, the Investigation team found that the hospital was neither governed, resourced nor equipped to safely deliver this level of clinical services.
“ Furthermore, the HSE itself in 2012 and 2013 had specifically identified clinical risks associated with surgery, emergency medicine and acute medicine, going as far as to say that surgical services at the hospital should cease,” it added.