Cavan Monaghan Hospital Group Profile – June 2011

Cavan and Monaghan Hospital Group comprises of two hospitals, Cavan General Hospital and Monaghan Hospital. Both Hospitals deliver a wide range of services to our population which includes assessment, diagnosis, treatment and rehabilitation of both acute complex conditions as well as non-urgent conditions. There is an interdependency in the roles of the hospitals which strive to provide a seamless patient service providing timely and appropriate care in the most appropriate setting.

A significant focus across the hospital sites in 2011 will be the development of the delivery platforms for each of the National Clinical Programme elements as appropriate. The introduction of the Care Programmes will require commitment to changes in service organisation and delivery and aim ultimately to ensure the best quality outcome for patients and the best value for money for the health service.

The activity targets for Cavan and Monaghan Hospital Group set out in the local Service Plan 2011 are based on the patient activity in 2010 and the allocated resources. The oversight and monitoring of the service plan is undertaken by the Senior Management Team. Progress and compliance with the service planning targets are reported to the Service Area Manager as part of the Service Planning Performance and control meeting held with the Regional Director of Operations.

On Thursday 16th June 2011 representatives from the Cavan & Monaghan Health Service Area met with the Minister for Health & Children, members of the Monaghan councils and the Monaghan Community Alliance. The key points arising from this meeting for consideration and further analysis are as follows:

  • An independent feasibility study regarding a Medical Assessment Unit in Monaghan Hospital.
  • Additional Day Services to be planned and implemented in 2011 – 2012 in Monaghan Hospital

The Minister stated that if the feasibility study did support the MAU then the issue would be finding the necessary monies to establish same on the basis that they are not there now – he also indicated that it would take a number of months to progress a feasibility study.

Cavan General Hospital:
The current range of acute services in Cavan General Hospital is as follows:-

  • General Medicine
  • General Surgery
  • Obstetrics / Gynaecology including Midwifery Led Unit
  •  Paediatrics
  • Acute Psychiatry
  • Day Services
  • Out-Patient Services
  • Renal Dialysis Services
  • Pathology Services
  • Radiology Services
  • Physical Medicine Services
  • Oncology – outreach service from Mater Hospital Dublin
  • Dermatology (sessional 1 day per week – visiting consultant)
  • Orthopaedics (sessional 1 day a week – visiting consultant)
  • Palliative Care

The bed compliment at 1st January 2011 is as follows:-

  • General Medicine 97 (including 4 CCU beds)
  • General Surgery 27 (including 4 ICU beds)
  • Paediatrics 22 (including 6 SCBU cots)
  • Obstetrics 33 (including 2 MLU beds)
  • Gynaecology 8
    Total 18
  • Acute Psychiatry 25
    Total 212
  • Dayward/Minor ops/Endoscopy 20 day places
  • Renal Dialysis 10 stations (this is currently being expanded).
  • Geriatric Dayward 10 day places
  • Oncology 10 day places
  • Transit Lounge 12 Day places
    Total Day Places 62

Planned Service Developments in Cavan General Hospital 2011

  • National Cancer Screening Service – Endoscopy screening site (Capital works commencing Q3 2011).
  • Centralisation of Acute In Patient Mental Health services.
  • Expansion of Renal Dialysis Unit.

Emergency Services in Cavan General Hospital 2011

The Emergency Department underwent a capital development in 2010 enabling an expansion of the existing environmental facility and enabling improved patient space and dignity (1 additional single room, 1 double room, 1 Minor Injury Room and a disabled toilet facility within the Department). The new layout of the Department including relocation of the waiting area has improved the patient and staff environment.

In February 2011 the ED patient experience time was on average 7.6 hours (national target 6 hours) however for March and April 2011 this wait time has increased to 12.9 hours. ED Staff and Management continue to make concerted efforts to address the patient waiting times in the Emergency Department and a major planned development to assist in improving the patient experience time is the Paediatric Assessment Unit.

Planned Service Development for Emergency Care in Cavan General Hospital 2011

Paediatric Assessment Unit (commencing July 2011)
This Unit will remove non trauma Paediatric Care from the Emergency Department to a dedicated area staffed by Paediatric trained nurses. This will result in a 20% decrease in overall activity in the ED allowing the staff in the ED to focus and process patients through the Department more efficiency resulting in reduced waiting time for ED patients.

The benefit to the children being seen in this Unit is immediate access to Paediatric specialist nurses and doctors, child friendly environment (separate to the general ED waiting and treatment area) resulting in improved patient experience of hospital and significant reduction in waiting times for children and their parents.

Monaghan Hospital
Monaghan Hospital’s primary role includes the continuing care for medically discharged patients requiring in-patient step down and rehabilitation care and extensive OPD, theatre, day services and a Minor Injury Unit.

Services currently provided at the Monaghan Hospital site include the following:

  • Step Down Unit (13 beds).
  • Rehabilitation Unit (13 beds).
  • The 13 Step Down Beds and the 13 Rehabilitation Beds allow patients to transfer from Cavan General Hospital and, where they are residents of Co. Cavan or Co. Monaghan, other Hospitals within the HSE Dublin North East area for rehabilitation and step down care.
  • Day Medical services.
  • Day Surgery.
  • Elective Endoscopy.
  • Cardiac Rehabilitation and non invasive Cardiac Diagnostics.
  • Outpatient Services.
  • Radiology.
  • Diagnostic Urology.
  • Dentistry Services.
  • Ear Nose & Throat Services.
  • A 12 hour/7 day Minor Injury Unit.
  • Allied Health Professional led out patient services, e.g., Physiotherapy, Dietetics.

Monaghan Hospital will continue to provide services in the context of the HSE Clinical Care Programmes.

Planned developments for Monaghan Hospital 2011:

  • An additional 4th Obstetric and Gynaecology Consultant commenced in September 2010 in the Cavan & Monaghan Hospital Group. This will enable additional Gynaecology Day Case procedures to be undertaken in Monaghan Hospital from June 2011.
  • Additional out-patient clinic sessions will be provided in Monaghan Hospital in 2011. Two potential specialities have been identified for re-location from Cavan General Hospital to Monaghan Hospital.
  • Plans are being developed to provide a Genito-Urinary Medicine (GUM) service supported by Cross Border CAWT funding with weekly dedicated sessions in Monaghan Hospital.
  • It is planned to expand the existing Ear, Nose and Throat (ENT) service to include long waiting patients from Louth County waiting list.
  • In Q3 2011 additional Audiology services for community based patients will be provided as part of the ENT service.
  • The implementation of the National Clinical Programmes within the Cavan Monaghan Service Area provide an opportunity to further develop services for patients with chronic illness using Monaghan Hospital as a base for the development of the community services allied to the programmes. This includes the development of an outpatient rehabilitation service in Monaghan Hospital allied to the current inpatient service within the 13 rehabilitation beds. This will reduce Average Length of Stay for rehabilitation patients in Monaghan Hospital and facilitate the patient flow from the planned stroke unit. In addition, outreach COPD clinics are being planned as part of the Chronic Obstructive Pulmonary Disease (COPD) Clinical Care programme.