Questions over hours of operation of hospital"s new unit

Concerns about the operation of the proposed Our Lady"s Hospital, Navan, medical assessment unit (MAU) after 8pm at night have been raised by Sinn Fein concillor Joe Reilly, who gave a cautious welcome to news that the new unit is now expected to be in place by November. The unit is being established by the Health Service Executive (HSE) to provide a more 'appropriate alternative for assessment for many of the patients who typically attend emergency departments'. The MAU proposed for the hospital will adopt case mix criteria supporting direct GP access, priority access to diagnostics, closure at night and will be consultant-led. Under the HSE plan, patients arriving outside of MAU opening hours (8am - 8pm_will be referred to emergency departments. The organisation says that it has been shown that the workload of emergency after-hours from 8pm to 8am is only one quarter of the activity during daytime hours. It is expected that the MAU will be set up on an interim basis to alleviate the emergency department pressures at Navan and provide 'a safe, faster service for Navan medical patients typically attending emergency departments'. It is expected that of the order of 13 posts will be required to support the opening of the MAU. The particular multi-disciplinary staffing needs are yet to be determined but are expected to include medical consultants, nurses, radiographer, cardiac technician, laboratory, clerical support and portering staff. The HSE said that these resources will be funded primarily through other service changes in Navan, with two key posts (consultants) being funded by the hospital network on the basis that all other required posts necessary to open the MAU are achieved within current resources. 'What needs to happen or be in place before this change can be implemented is that other service changes will be needed in order to release the posts/staff required to open the MAU. Priority access to diagnostics for patients attending the MAU will need to be provided,' the HSE said. Cllr Reilly said that, in general, he welcomed the HSE report on the implementation of the HSE plan. It was essential that the delayed implementation of the MAU plan should go forward for November. 'However, I have concerns about how it will be funded and I also want to flag up the absolute need for the support of the general practitioners in the county for the post-8pm situation. After 8pm, where will the GPs and doctor-on-call service refer patients to, if there is a need to do so? Will it be to the already-overcrowded accident and emergency department at Our Lady of Lourdes in Drogheda? If that is the case, it will be unsatisfactory,' said Cllr Reilly. He said that it was 'not on' to have emergency sites 20 miles away from Our Lady"s in Navan. He wanted to know what would happen to patients after 8pm at night. 'This is a vital question and there needs to be very clear answers on it from the HSE,' he said. He said that he also wanted clarification about the personnel involved in the pathology services to Navan hospital. He said that part of their income was based on the 'on-call' service which they gave after-hours and he said he wanted to know what the MAU changes would mean to that situation.