Children's services at Tallaght re-open without full acute services

By Mary Dennehy

The Children’s Hospital at Tallaght re-opened last week,  but without full acute services – a situation that has faced criticism in recent days.

In March, the paediatric services at Tallaght were temporarily closed and relocated  to make available additional staff, emergency facilities and bed capacity for sick adults being cared for at Tallaght University Hospital.

Tallaght hospital 7 1

Tallaght Hospital

As part of contingency Covid-19 planning, Children’s Health Ireland (CHI) temporarily relocated its acute paediatric services in CHI Tallaght to its other two children’s hospitals at Crumlin and Temple Street .

In a statement released last week, CHI confirmed that paediatric services at Tallaght were re-opening on Thursday, September  3 – as a 24/7 ‘Emergency Care Unit’.

As an Emergency Care Unit, services provided at Tallaght will, according to CHI, include medical inpatients, day case surgery and medicine, X-ray and outpatients.

However, there is no return of acute surgical services - with critically ill and critically injured children being re-directed to Crumlin and Temple Street.

According to CHI: “As we transition towards a new Urgent Care Centre at Tallaght we are opening on 3rd September as a 24/7 Emergency Care Unit.

“The difference from a Paediatric Emergency Department is that we are re-directing critically ill and critically injured children to our CHI Emergency Departments at Crumlin and Temple Street.”

As part of the development of the new national children’s hospital at St James’s, a new paediatric Urgent Care Centre is currently being built on the Tallaght campus.

This centre was due to open in late 2020, but that timeframe has been pushed out to 2021.

The Echo spoke with Dr Ciara Martin, Clinical Director of the Paediatric Directorate, on Wednesday, just under one week after children’s services at Tallaght re-opened.  

Dr Martin confirmed that any child brought to Tallaght who requires acute surgical care, will be stabilised at the local unit before being transferred to Temple Street or Crumlin.

“The change [with children’s services at Tallaght] is that we don’t have emergency surgical on site”, Dr Martin said.

“However, we do have pathways in place to ensure children get to Crumlin and Temple Street quickly if need be.”

Dr Martin told The Echo that the same team, and the same number of consultants and nurses, are back at Tallaght.

When asked about reports of staff being upset by the ‘sudden’ change introduced last week, Dr Martin said: “It is understandable...our staff in Tallaght closed down and moved to support paediatrics in other hospitals and adult services.

“It was a lot of change in six months, and to come back to another change has made people feel upset and vulnerable.

“As much as possible all week, we are telling staff that there is no material change in their job contracts, terms and conditions and that Tallaght paediatrics will remain a busy part of CHI, serving the people of the community.”

Based at Tallaght since 1998, becoming a consultant in 2005, Dr Martin added:  “I think the timing of the decision was hard for all of us.

“I understand that the decision was sudden and hard but it is the right decision for the children.”

Normally, paediatrics at Tallaght would see around 100 young patients a day.

According to Dr Martin, last week started off with around 25 to 40 young patients presenting, with numbers this week increasing to around 60 a day.

The re-opening has faced criticism from both the Tallaght Hospital Action Group (THAG) and the Irish Nurses and Midwives Organisation (INMO).

Triona Murphy, Chair of THAG, told The Echo that at a time when waiting lists are increasing right across the health service, reducing surgical capacity for children at Tallaght is a “disgrace”.

“We raised concerns [when children’s services were temporarily moved in March]”, Triona said.

“Things have happened in Tallaght before, when with the stroke of a pen services walked out the door.

“We were reassured [in March] that all services would stay in Tallaght until the [new children’s] hospital at St James’s and the Urgent Care Centre were open... but we’ve been let down again.

“How is this the way of planning for a service?

“I would worry about the governance in CHI group.”

INMO Industrial Relations Officer for CHI Tallaght, Joe Hoolan, describe the changes as “sudden and unplanned”.

“Reconfiguring services in such a frantic manner is simply unsafe”, Mr Hoolan said.

“Despite the hospital’s statement implying that this was planned, it has come as a major shock to the frontline.

“Staff and clinicians are left scrambling to develop safe pathways of care for services in Tallaght, Crumlin and Temple Street – with no extra resources.”

For further information and guidelines on the re-opening of services at Tallaght visit www.tuh.ie/chi

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