Acute services to cease at two hospitals

24-hour emergency care is set to end at Louth County Hospital, Dundalk early next year as part of a major reorganisation of hospital services for Louth-Meath announced by the HSE.

The hospital revamp plan, expected to be implemented over the next nine months, involves the eventual transfer of all A&E services, acute medical and critical care from Dundalk and Navan Hospitals to Our Lady of Lourdes Hospital in Drogheda.

The HSE has said facilities at Drogheda will be expanded between now and mid-2010 to cater for the transfer of services.

It says it is "no longer sustainable" to have Dundalk and Navan continuing to maintain fully-functioning and staffed emergency departments (EDs) out-of-hours seven days a week. The HSE has already transferred major emergency and acute care out of Monaghan Hospital.

Under the new plan, the majority of patients, that is those who need only routine levels of urgent or planned care, will be managed locally and the minority of patients, requiring major emergency or more complex planned care, will be managed in Drogheda.

The HSE says the centralisation of acute ED and medical/critical care will first take place from Dundalk and then Navan.

It says when a new ED, medical assessment unit and other associated facilities are available in Drogheda from the end of the year, Dundalk will move, probably early in the new year, from a 24-hour to a 12-hour ED service.

When the new Drogheda ED opens, planning will continue on the transfer of ambulance-borne trauma cases from Navan to Drogheda.

Remaining ED, acute and critical care services are expected to transfer from Dundalk and Navan to Drogheda during the first half of 2010.

The HSE says when acute medicine is transferred from Dundalk to Drogheda, the 12-hour ED service in Dundalk will convert to a minor injuries unit and the Navan ED will also eventually convert to minor injuries care.

The HSE has not provided exact dates for the transfer of specific services from the two smaller hospitals to Drogheda.

It says services will not transfer until enhanced services at Drogheda are put in place.

In addition to a new ED and medical assessment unit, Drogheda is also to get more ICU and critical care capacity and an enhanced ambulance service. These are expected to be in place by mid-2010.

At this stage all A&E (other than minor injuries), acute medicine, and critical care will have been transferred from Dundalk and Navan to Drogheda.

The HSE says future facilities at these two hospitals will include day medical and surgical care, endocsopy, minor injuries, step-down and rehab facilities, outpatients, CT scanning and laboratory services.

The HSE's reorganisation plan for the north-east involves the centralisation of major hospital care into Cavan and Drogheda Hospitals.

Plans to build a major new regional hospital in Navan have been long-fingered in view of current economic circumstances.

However, the HSE says that it it ultimately the long-term plan to centralise all major hospital care into the new regional hospital.

It wants more effective links to be developed between primary and hospital care for improved "admissions avoidance" and earlier safe discharge.

The HSE was warned in an independent report last year that the hospital reconfiguration planned in the north-east will require a massive investment in community and primary care.

Consultants at Our Lady of Lourdes Hospital in Drogheda have repeatedly warned the HSE in recent years that services and staffing in Drogheda will have to be enhanced, particularly in view of the transfer of services to there from other hospitals.

[Posted: Fri 04/09/2009]