Extending the opening hours at Medical Assessment Unit

During Question Time in the Dail, Deputy Michael Lowry asked Minister Stephen Donnelly about the feasibility of extending the opening hours at the Medical Assessment Unit in Nenagh considering that the current hours of opening are not being fully utilised.

Deputy Lowry said the idea and principal of expanding the opening house of Medical Assessment Unit at Nenagh and Ennis is understandable and logical. It would work if it was implemented properly.

The Tipp TD said: “It creates more activity in Nenagh Hospital and means that patients from North Tipperary can be referred to Nenagh by GPs rather than Limerick A & E. Patients can be assessed and triaged. Only those patients that are in need of acute care are sent to Limerick.

“It alleviates the pressure on A&E at UHL. It would also help to rotate beds faster for patients from North Tipperary who do need acute care in Limerick.

“Minister, there is only one problem. It is not working in practice. The existing MAU at Nenagh is malfunctioning and not being used to full potential. What we have in Nenagh is a Medical Assessment Unit which is currently staffed and available.

"However, every day several available slots are not used. Patients are not presenting to avail of the service. We have consultants, nurses and support services assigned but not enough patients to treat. Considering the current hours of service are not being utilised what is the point in extending the hours of opening.

“Minister, why are GPs reluctant to refer patients to MAU at Nenagh and Ennis and are instead referring them to Limerick. A discussion needs to be had to get the considered views of GPs. It would appear they obviously have legitimate reservations which need to be addressed by HSE. GPs need to be reminded and made aware of availability, capacity and capabilities of this unit. We need their co-operation for the unit to work effectively for the people of North Tipperary.

“The breakdown of this initiative highlights the complete lack of communication or consultation with staff in Nenagh Hospital. Had they been asked they would have immediately advised that their front line experience would indicate that current slots are not being filled.

“Management must engage with staff. Listen to them. Respect their opinions and formulate strategy in conjunction with them. Lack of consultation has led to uncertainty, confusion and disillusionment.

“This has created resentment against imposed work practices. We now have a standoff with a Ballot likely for strike action. The HSE need to use common sense, engage, sort out the problems and find solutions to implement.”

In response Minister Donnelly stated: “The Medical Assessment Unit at Nenagh provides an alternative to the Emergency Department for GP referrals. It is currently open 7 days per week from 8am to 8pm. This provides an invaluable service for the region. In 2023, 4,146 patients were referred to Nenagh Medical Assessment Unit. In 2024, more than 3,000 patients have been referred to date.

“Investment of €2.3m in 2023 enabled an extension of opening hours to a seven-day week from a five-day service. Opening hours were further increased to a 12-hour day from July 2024. Twenty-one whole time equivalent staff were recruited to support this progressive expansion.

“The HSE is working to further extend operating hours to midnight this year, and incrementally to 24 hours. Recruitment is already underway for the staff and essential service provisions to support this development.

“I know that there have been barriers to implementing these proposals. Staff representative bodies are currently challenging this expansion. The HSE has been regularly meeting with staff representatives to overcome objections and fill these posts. This engagement will continue with all stakeholders to extend this service and meet patient demand.

“Extending opening hours will allow more patients to access this service closer to home. The people of the Mid-West deserve access to responsive urgent and emergency care. I am fully committed to ensuring this access. In view of the information put before me by Deputy Lowry I will engage further with HSE Management on this matter.”