Mayo University Hospital operating at ‘unsafe threshold’ for 80 per cent of the year – the highest level in Ireland
Mayo University Hospital (MUH) has operated in the unsafe threshold for 80.2pc of days so far this year, the highest level in the country, while its Emergency Department (ED) experiences the worst congestion among Ireland’s Model Three hospitals.
Being in the unsafe threshold indicates that at least ten patients are on trolleys at 8am. Since January MUH has faced continuous overcrowding, with over 3,577 patients waiting on trolleys so far this year.
Minister for Health Jennifer Carroll MacNeill addressed the ongoing crisis. She said challenges at MUH can’t be explained by staffing levels or demographics alone. She stated the core issue lies in how staff are deployed and how patient flow is managed across the hospital.
However, concerns over staff wellbeing and patient safety have persisted. The Irish Nurses and Midwives Organisation (INMO) last week issued a notice of industrial action due to unsafe staffing levels and increasing pressure on ED staff.
The action is scheduled to begin on November 3, with the INMO urging the HSE and Government to fully implement the HSE’s Safe Staffing Framework.
INMO spokesperson Colm Porter highlighted that MUH’s ED currently faces a shortfall of over 10 whole-time equivalent (WTE) nurses. A total of 28.5 WTE nurses are needed to meet the safe staffing levels outlined in the HSE’s own Safe Staffing Framework for Emergency Departments.
“Attempts to downplay the severity of the situation in Mayo by the Minister for Health and hospital management in recent days are contrary to the very real lived experiences of our members and the patients they are trying to provide safe care to,” he said.
He added, “Nurses in Mayo University Hospital’s emergency department are advocating for patients who deserve safe staffing levels. They are now reminding the HSE, as their employer, that they are obligated to provide staff with a healthy and safe workplace. Hospital management has failed to ensure safe levels of nurse staffing for far too long.”
Minister Carroll MacNeill insists MUH is not understaffed. The hospital employs 1,502 WTE staff, a 31pc increase since 2019. She confirmed there are 617 nurses in post and 47 vacancies, most of which are replacements.
Regarding the HSE’s Safe Staffing Framework, she stated that Phase One is nearly complete. 27.5 of 29.5 positions are filled across general medical and surgical wards, with the remaining positions to start by the end of the month.
However, Phase Two, which concerns the ED, had been delayed due to administrative issues. The Minister said 18.5 WTE posts have been sanctioned for recruitment. This includes 15.5 nurse positions.
The INMO disputes this figure, maintaining that 28.5 WTE nurses are required to meet safe staffing standards.
The Minister says the problem is not understaffing, but rather an imbalance of staff. After making an unscheduled visit on Saturday, August 23, she witnessed 47 patients in the ED, including 20 admitted patients waiting for beds.
She has emphasised the need for patient flow to be actively managed seven days a week, as weekend discharges remain low: during the second week of September, there were 16 discharges on Saturday, one on Sunday, and 47 on Monday.
Mayo TD Keira Keogh welcomed the Minister’s response, stressing the urgency of addressing the issue before winter.
“As winter approaches, the risks associated with poor patient flow will only intensify,” she said. “It is now imperative that MUH rebalances its weekly activity to improve patient safety, reduce pressure on staff, and ensure timely care for the people of Mayo.”
Deputy Keogh said that since the Minister contacted Mayo’s public representatives on September 19, the situation has improved, with six ‘red days’ over the following 25 days, including three in October - compared with 17 in the first 19 days of September.
“This shows that focused attention and accountability can lead to real change,” said Deputy Keogh.
Minister Carroll MacNeill concluded that MUH’s challenges are not solely about staffing or demographics but about operational management. She praised the hospital staff and said that with better patient flow, MUH can become a safer and more effective place to work.
Deputy Keogh added, “This is not a simple binary issue of resources. Performance improvement and public safety in MUH depend on a combination of policy reform, resource allocation, and operational performance.”
This article has been funded by the Local Democracy Reporting Scheme.