HSE statement on the re-organisation of Services at Mallow General Hospital

HSE statement on the re-organisation of Services at Mallow General Hospital

– 85% of current patients will continue to receive treatment at Mallow.

– New Medical Assessment Unit and Endoscopy Suite under construction.

– Emergency/acute and inpatient surgery replaced with increased day surgery.

HSE South has started the process of re-organising services provided at Mallow General Hospital (MGH). This re-organisation, of mainly surgical and emergency services, is in line with: the HSE national clinical programmes for emergency medicine, acute medicine and surgery; HSE South’s Roadmap for Acute Hospital Services; HIQA’s recommendations for Mallow General Hospital; and the principles of the Department of Health’s policy on the future role of small hospitals,

Widespread consultation has taken place with key people associated with MGH over the last three years in order to determine the best future for the hospital and the planned changes resulting from the consultation best meet the local patients’ needs.

Mr. Pat Healy, HSE South Regional Director of Operations said, “The re-organisation of services at Mallow General Hospital 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. The services it will provide 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 85%) of patients currently attending Mallow General Hospital will continue to do so and overall patient treatment will increase at the hospital annually due to a planned increase in the volume of day surgery. Patients should only have to travel to Cork city hospitals for complex services and emergency care. Emergency and complex surgical services will therefore transfer to Cork University Hospital (CUH) and the Mercy University Hospital (MUH). However, a range of day surgeries will transfer from the city hospitals to MGH, resulting in overall larger volumes of surgical activity at the hospital. There will be no change to medical patients attending the hospital.

“The changes that are taking place in order to re-organise the hospital’s 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:

Surgical Services

· Acute/emergency surgery will transfer from MGH to CUH, which has the wide range of specialist staff and facilities to deal with complex, emergency and trauma patients.

· Elective (planned, non-urgent) inpatient surgery currently performed at MGH will now be done as day case where possible, (the hospital will have the capacity to admit some of these patients overnight on pre-agreed criteria). Some inpatient surgical procedures will transfer to the Mercy University and South Infirmary Victoria University Hospitals.

· In parallel, some day case surgery will transfer from the Cork city hospitals to Mallow resulting in larger volumes of surgical activity in the hospital.

· The volume of endoscopy procedures will also increase with a newly built replacement endoscopy suite scheduled for completion in July 2013.

Emergency Services

The existing Emergency Department at MGH will be replaced by an Urgent Care Centre. The Urgent Care Centre will comprise of a Local Injury Unit and a Medical Assessment Unit resulting in patients being streamlined to attend the facility that best meets their healthcare needs.

· The Local Injury Unit (LIU) will open from 8.00am to 8.00pm, seven days a week. Led by a consultant in emergency medicine and staffed by local injury unit registrars and other expert staff, it will treat adult patients and children aged over five 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. The small number of patients (approximately six weekly) who currently attend the existing ED at MGH by night can either attend their GP/Southdoc, which may result in a direct GP admission to MGH, or some with more minor injuries may choose to attend the Local Injury Unit the following morning. Emergency patients will be treated at the Emergency Departments in Cork or Mercy University Hospitals.

· Medical patients will continue to be admitted to the hospital on a 24/7 basis. A new Medical Assessment Unit (MAU) is currently being built at the hospital and in the interim, the MAU will open in a temporary facility. The MAU will also open from 8.00am to 8.00pm, 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 Southdoc can admit medical patients directly to the hospital’s wards outside the opening times of the MAU.

In order to support this re-organisation of services, a number of additional supports have been put in place as follows:

Mallow General Hospital

· a new Medical Assessment Unit and a replacement Endoscopy Suite are being built at a cost of €4.5 million.

· an additional consultant with a special interest in respiratory medicine is due to start at the hospital in April 2013.

· pre-hospital emergency services have been greatly improved to ensure that patient treatment can start even before a patient arrives at a hospital. In 2012 an advanced paramedic team was deployed to North Cork and an intermediate care vehicle (dedicated patient transport vehicle) was also introduced to the Mallow ambulance service.

Cork University Hospital

· a surgical assessment unit, a dedicated emergency operating theatre, a day of surgery admission unit and additional surgical beds will be available at CUH to treat the additional emergency/acute patients.

Dr. Mike Paed, consultant anaesthetist and member of Mallow General Hospital’s senior management team, welcomed the re-organisation plan on behalf of the team and stated, “We have been working towards re-organising services at Mallow General Hospital over the last number of years, the construction firm is on-site working on the extension for the replacement endoscopy suite and new medical assessment unit. As a team we are now looking forward to implementing the changes, which will bring stability and a solid future, to benefit patients, staff and the local community in Mallow.”

Mallow General Hospital is part of the Cork University Hospital Group with a clinical director having overall responsibility for both hospitals to ensure that services are co-ordinated between the hospitals in the best interests of patients.

Prof. Richard Greene, Clinical Director, CUH Group said “The services delivered at Mallow General Hospital will be re-organised in a way that ensures that safe and 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 (e.g. general surgery, dental and some gynaecology and plastic), 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 laboratory medicine) and radiology (x-ray and CT scans). These wide-ranging services will ensure that Mallow General Hospital will work to maximum capacity.”

Prof. Greene emphasized that “the re-organisation will affect a minority of patients currently attending Mallow General Hospital. More than 85% of patients currently attending Mallow General Hospital 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 Mallow General Hospital will rise with the planned increase in day surgery and outpatient services.”

Ger Reaney, Area Manager, HSE Cork said “Over the last three years we have consulted widely with all those associated with Mallow General Hospital and we will continue to work closely with senior clinicians, professionals, management and staff along with local GPs, Friends of the Hospital and public representatives as the changes are being implemented. We are grateful to the professional and loyal management team and staff in Mallow whose dedication to the hospital will ensure that the changes once implemented will be in the best interest of their patients.”

Ends/

Notes for editors:

1. New Facilities at Mallow General Hospital

Building is underway on a two storey extension and is expected to be completed in July 2013, incorporating a Medical Assessment Unit on the ground floor and an Endoscopy Suite on the second floor. Over €4.5m is being invested in this development.

The Medical Assessment Unit (MAU) will be open 12 hours a day, seven days a week from 8.00am to 8.00pm, for patients with medical conditions referred by GPs such as chest infections and chronic diseases including asthma and diabetes. GPs and Southdoc can admit medical patients directly to the hospital’s wards outside the opening times of the MAU. Acutely ill medical patients referred to the MAU will be seen by a senior doctor within an hour of arrival with ready access to diagnostics such as x-rays, blood tests, scans, etc. This facilitates early diagnosis and initiation of appropriate treatment, which results in patients being discharged earlier, reduces the volume of medical admissions and shortens the length of time patients spend in hospital.

The replacement Endoscopy Suite will ensure a higher volume of scopes being completed at Mallow General Hospital. Figures show more than 1,900 endoscopy procedures were completed at MGH during 2012 and the hospital will have the capacity to perform an extra 1,000 annually once the new suite is operational. Mallow performs endoscopy procedures including investigations of the upper intestine (gastroscopy), lower intestine (sigmoidoscopy, colonoscopy) and the urinary system (cystoscopy).

2. Enhanced Prehospital Care Services

An advanced paramedic (AP) team with a fully equipped rapid response vehicle was deployed to north Cork in 2012 to respond to certain emergency calls. An AP is certified to perform advanced life support procedures including intubation, defibrillation and administration of drugs under direction from a doctor at the Emergency Department at CUH. These additional life saving treatments can now be done at the emergency scene rather than having to be done on arrival at a hospital. The APs are additional to the existing ambulance service in north Cork. An intermediate care vehicle (ICV) was also deployed to the area in 2012. Staffed by paramedics the ICV can transport patients to city hospitals for routine appointments, freeing up paramedics and ambulances to focus on emergency calls.

3. Timetable to Re-organise Services at Mallow General Hospital

4. Services Re-organisation at Mallow General Hospital in Figures

· More than 85% of patients currently attending Mallow General Hospital will continue to do so.

· Approximately six weekly patients who currently attend the existing ED at night with minor injuries will attend their GP/Southdoc, which may result in a direct GP admission to MGH, or some with more minor injuries may choose to attend the Local Injury Unit the following morning.

· Approximately 900 more surgical day cases will take place at MGH per year.

· MGH will have the capacity to perform an extra 1,000 scopes annually when the new endoscopy suite is operational.