Major oncology staff deficits at UHL were escalated to REO

Serious staffing deficits in University Hospital Limerick’s (UHL) oncology service were escalated to the regional executive officer (REO) in September after several weeks of crisis, according to records seen by the Medical Independent (MI).

A meeting of the hospital executive management team (EMT) on 21 August 2024 heard that the “collapsing” oncology service would be entered onto the corporate risk register (CRR).

This month, a HSE Mid West spokesperson told MI that oncology services at UHL experienced a “significant increase in demand in 2024”. They said deficits in consultant staffing, which were discussed at several EMT meetings last year, have been addressed.

The EMT meeting minutes from June to September 2024 were released to MI under Freedom of Information law. The EMT meeting on 5 June discussed consultant oncologist staff deficits and outsourcing the care of a “small” number of patients. Its meeting on 17 June noted there were three funded vacant consultant posts. The then CEO Prof Colette Cowan advised that the consultant deficits should be recorded on the CRR. On 31 July, the EMT discussed a “significant staff crisis” in cancer pharmacy services, “risks” associated with shortfalls in cancer nursing and pharmacy staff, and difficulty securing locum consultants.

On 21 August, the EMT again discussed the consultant deficit. The Clinical Director of the Cancer Services Directorate, Dr Denis O’Keeffe, did not “envisage improvement” until there was an increase in the number of consultants. A meeting was due to take place that day with the Directorate’s Director of Nursing and other personnel “regarding the reduction of patients attending day ward due to nursing deficit”.

At the 4 September meeting, it was noted that Dr O’Keeffe had issued correspondence to the Acting CEO Ms Noreen Spillane regarding these matters. “Staffing deficits will affect the administration of chemotherapy. Delayed patient care was highlighted,” stated the minutes.

The meeting heard that Ms Spillane would escalate the staffing shortfalls to the REO of HSE Mid West, Ms Sandra Broderick.

The HSE Mid West spokesperson told MI that staffing deficits across the region’s acute services were placed on the CRR in early 2024. This issue remains on the CRR.

They noted that the HSE recruitment embargo, which “ceased” in July 2024, caused delays in recruiting staff nationally.

“Challenges in consultant staffing levels identified in the minutes have been addressed,” they added. “Five consultant oncologists are now in post with a further two having been recruited and expected to take up their posts in the near future. In addition, five consultant haematologists are in post at UHL.”

The spokesperson added:  “Our dedicated staff across all grades worked additional hours to ensure our patients were seen in a timely manner, and this ensured disruption to patients was kept to a minimum. We are unaware of any adverse patient outcomes.”