Jennifer Carroll MacNeill <\/a>strongly rebutted Kearney\u2019s concerns. The hospital, she said, had hired more than any equivalent facility in the State and \u201cby some margin\u201d. She denied there were patient safety concerns due to staffing issues.<\/p>\nKearney\u2019s letter brought the issue to public attention, but background correspondence shows that staffing and financial overruns had been a source of friction for months. There were disputes between the hospital and regional management over the number of unfilled posts and on spending controls in a facility facing a \u20ac60 million deficit this year.<\/p>\n
In April, Kearney had expressed deep unhappiness at how an internal meeting on financial controls had been handled, criticising the \u201cpresentation of predetermined outcomes\u201d. <\/p>\n
She said she and her team had been \u201csubject to sustained and, at times, disproportionate criticism in relation to whole time equivalent (WTE) levels and the financial position\u201d.<\/p>\n
On April 29th, senior managers in HSE Southwest wrote in reply that it was \u201cregrettable if the engagement was perceived as challenging, that was neither our intention nor perception of the engagement.<\/p>\n
\u201cDiscussions of this nature \u2013 focused on performance, compliance with the approved WTE ceiling and financial sustainability \u2013 require direct and evidence-based scrutiny.\u201d<\/p>\n
On the same day, the head of HSE Southwest, Andy Philips, acknowledged in a note to Lynch that there were \u201csignificant tensions\u201d between the region and clinical and management personnel in CUH.<\/p>\n
These tensions can be seen in letters between hospital staff and regional management. From the hospital side there were repeated concerns raised about staffing and patient safety.<\/p>\n
Management also had issues about CUH.<\/p>\n
On July 30th, Lynch told Philips she was \u201cgravely concerned by the recent recruitment decisions emanating from CUH\u201d. <\/p>\n
She pointed to \u201cinformal recruitment actions that do not comply with the recruitment code of practice to which the HSE must comply or risk losing its recruitment licence, nor do they comply with financial or funded workforce limits or most critically the direction of the CEO and you as [regional executive officer]\u201d. <\/p>\n
She maintained that \u201call local recruitment processes must cease in CUH to allow for oversight and appropriate governance\u201d.<\/p>\n
On the same day, Dr Maura Moriarty, consultant endocrinologist, wrote to Philips warning of a \u201cserious and immediate patient safety risk\u201d in the diabetes and endocrinology department as funding had not been approved for a locum to cover for a consultant taking leave.<\/p>\n
\u201cWe anticipate a significant adverse impact on patients including delayed diagnosis and missed cancers, arising from disrupted outpatient clinics and unreviewed results, preventable, life-changing complications in patients whose conditions, particularly diabetes, require regular specialist review and increased emergency department attendances, as patients previously stable in outpatient care deteriorate without access to their usual specialist pathway,\u201d she wrote. <\/p>\n
On August 5th, Kearney warned the interventional radiology service could become unviable if a consultant took sick leave or was unavailable.<\/p>\n
Ironically, the HSE region itself appeared to acknowledge there were critical staffing issues. <\/p>\n
Philips had written to HSE chief executive Anne O\u2019Connor on August 8th, saying he had paused about 700 posts on the register awaiting a decision on authorisation \u201cpending further review of affordability\u201d. <\/p>\n
He set out posts that needed to be filled as a priority \u201cto maintain [health watchdog] Hiqa registration, to prevent closure of beds, enable us to open surge to support the delivery of patient flow, discharge pathways and compliance obligations\u201d.<\/p>\n
Philips wrote: \u201cAs accountable officer, I need to bring to your attention the risks to patient safety within the anticipated winter pressures.\u201d<\/p>\n
His submission on the minimum number of positions the region needed included about 116 posts in services for older people, graduate nurses and healthcare assistants as well as consultant posts in interventional radiology, paediatric neurology and endocrinology. He said if the paediatric neurology post was not approved, the service in Cork would close to new children.<\/p>\n
Meanwhile, HSE headquarters took issue with some of the content in Kearney\u2019s letter of August 17th.<\/p>\n
In August, acting chief executive Damien McCallion told Philips: \u201cYou need to reinforce the CUH CEO\u2019s responsibility to ensure that patient safety risks and service delivery concerns are identified, assessed and mitigated with escalation through the hospital and regional governance structures in compliance with the HSE\u2019s enterprise risk management policy.<\/p>\n
\u201cThis is the responsibility of all senior leaders and cannot be abdicated through correspondence.\u201d<\/p>\n
McCallion argued there was \u201ca significant number of inaccuracies\u201d in Kearney\u2019s letter including vacancy levels, safer staffing framework formula and numbers in CUH and the level of staffing growth. <\/p>\n
McCallion also told Philips, in essence, that he needed to keep an eye over what was sent to Hiqa, which had sought a report about CUH on foot of the concerns raised by Kearney.<\/p>\n","protected":false},"excerpt":{"rendered":"On Monday August 17th, the top executive at the largest hospital in the south of the country sent…\n","protected":false},"author":2,"featured_media":672551,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[46,50043,103,397,1418,396,61,60,1421],"class_list":["post-672550","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-cork","tag-cork-university-hospital-cuh","tag-health","tag-health-care","tag-health-service-executive-hse","tag-healthcare","tag-ie","tag-ireland","tag-jennifer-carroll-macneill"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/672550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=672550"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/672550\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/672551"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=672550"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=672550"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=672550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}