‘Significantly understaffed’: Hiqa to conduct review into midwest care capacity after Aoife Johnston report

The State’s healthcare regulator has been asked to conduct a review into urgent and emergency care capacity in the midwest, including to determine whether a second emergency department is needed, Minister for Health Stephen Donnelly has said.
Mr Donnelly was speaking following the publication of a report by former chief justice Frank Clarke into the death of 16-year-old Aoife Johnston. Ms Johnston died of meningitis on December 19th, 2022, at UHL, after she was left for more than 13 hours without “vital” antibiotics.
Mr Clarke’s report found the hospital’s emergency department (ED) was “significantly understaffed” while overcrowding at the midwest hospital was “undoubtedly more severe than it should have been”. He also said that despite improvements since 2022, “a risk of reoccurrence will inevitably be present”.
Mr Donnelly said that Hiqa, the State’s healthcare regulator, has been asked to conduct a review.
[ Aoife Johnston timeline: Antibiotics for sepsis not given until 13½ hours after arriving at Limerick hospitalOpens in new window ]
“Hiqa has been asked to lead a review into urgent and emergency care capacity in the midwest region, including to determine whether a second emergency department is required. Implementation of Mr Clarke’s recommendations, as well as the actions and changes recommended by the HSE expert clinical review also published today, are important for the patients of the midwest, as well as the staff in UHL, to rebuild confidence in the safety and quality of the care and services provided there.”
“My thoughts today are with Aoife’s family. I know that each day is difficult for them as they deal with the devastating loss of their beloved daughter and sister. Their grief has been compounded by the circumstances, and failings, that led to her untimely death.”
“The report identifies a number of factors that contributed to delayed treatment and Aoife’s death, including unclear protocols, ad hoc systems, poor internal communication and a failure to deploy the escalation protocol,” Mr Donnelly said.
Sinn Féin spokesperson on Health, David Cullinanedescribed the Clarke Report into the death of Aoife Johnston as “heartbreaking”.
Mr Cullinane said the report and major population changes in the Midwest over the last decade show that there is a compelling case for a second Model 3 hospital with an emergency department in the Midwest, and that a major and urgent expansion in capacity across the Midwest is needed to end the crisis at UHL.
“Mr Clarke draws a very clear link between the closure of emergency departments in Ennis and Nenagh, when Aoife was just a small child, and the perpetual crisis at University Hospital Limerick today,” Mr Cullinane said.
“Fifteen years later, capacity at UHL is still below the recommended level before the closure of Ennis and Nenagh, and has not kept up in any way with population growth and demographic changes.”
Labour’s spokesman for health Duncan Smith called for “immediate and decisive action.”
“It is devastating to think that a young life has been lost due to avoidable shortcomings in our healthcare system. The report highlights the unacceptable staffing levels at the Emergency Department in UHL, and this is something that cannot be ignored. It is simply unconscionable that we continue to have a situation where lives are at risk due to inadequate staffing.”
“Minister Donnelly needs to urgently address this crisis.”
The Irish Hospital Consultants Association (IHCA) said the report provides “troubling and telling independent analysis.”
“Transparency, collaboration, and swift action are essential to restoring trust in and within UHL. While some measures are being introduced, more urgent and informed actions are needed.”
The Irish Nurses and Midwives Organisation (INMO) general secretary Phil Ní Sheaghdha said the organisation’s members have “long expressed deep and have felt frustrations arising from the failure of the entire system to respond effectively, or at all, when clinical concerns were raised.”
“Overcrowding in University Hospital Limerick has been out of control for far too long.”