New hospital manager has hopes of increasing services

You can hear the passion in Su-zann O’Callaghan’s voice as she talks of her time working as a physiotherapist.

A clinician at heart, the Magherafelt native and Ballyjamesduff resident now finds herself as manager of Cavan and Monaghan Hospitals. She’s taken up the role on an interim basis following the departure of David Lynch last month.

It’s not an understatement to say she has had to hit the ground running. Despite fulfilling the role temporarily in the past, the buck now well and truly stops at her feet as she oversees over 1,500 staff across the two counties.

“You have everything from the carpark to the labour ward and everything in between,” says Su-zann of the job.

Increasing COVID-19 numbers have seen the reintroduction of early closing times for the hospitality sector and ongoing discussion around further measures being needed to slow the virus’s incidence rate.

Cavan and Monaghan Hospitals have so far escaped the worst of the fourth wave but it is still expected to have an impact on services.

“Cavan and Monaghan have a bit of a tendency to buck the trend. Five or six weeks ago they were the worst in the country and we would have been feeling the pinch more than compared to this week and last. However, given the numbers we’re seeing in the community, we would expect that to rise again,” says Su-zann.

“It will get to the point when we do cancel procedures. We thought we’d never get back to this point but those conversations are being had in the last week or two.”

The decision to postpone procedures or appointments is not one taken lightly by the management team but it is seen as a necessary one on a number of levels. Staff may be needed to bolster teams in ICU or in the Covid ward as case numbers increase and it’s also about protecting the members of the public involved too.

“If you’re the person sitting at home waiting on your procedure, you’ve already waited maybe six, eight, 10 months, it’s important you get your procedure but at the same time, there will be a point we decide we need to maintain safety in our Covid ward and we have an onus on keeping the community safe by not bringing them in for their procedure.”

Su-Zann spoke to the Celt before news of the Omicron variant emerged but, even at that stage, she was clear it was a matter of when and not if services would have to be cut.

One of her first tasks in the role was to implement a memorandum from the hospital’s management group, RCSI Hospitals Group, dealing with unvaccinated staff. It followed a direction from the HSE this summer for hospitals to risk assess patient-facing staff.

Eighteen staff in Cavan have been reassigned from patient-facing roles to other duties because they are unvaccinated. For Su-zann, it wasn’t an easy decision but it is the right one.

“There have been very natural questions. There’s a strong feeling of ‘we were here during Covid, we were the first to put on PPE and put our hands up’. That’s all acknowledged and appreciated but we do have the PPE now, we do have the vaccination, we do have the other controls. All we can do now to protect these staff further is to take them away from where the clinical risk is.”

For years there have been questions over the future of services at Cavan Hospital and downgrading of its Emergency Department. A report from the Trauma Steering Group in 2016 led to uproar from local representatives and groups after it named Cavan as one of the units to close in a proposed centralisation of services.

However, plans have now been drawn up for a new Emergency Department at CGH and a planning application is expected before Christmas (see page 9).

The extension is much needed as Cavan’s ED has been coming under increasing pressure in recent months.

Local GPs have been vocal in the lack of ‘new blood’ coming into General Practice and the difficulty in attracting doctors to posts in the region.

Su-zann is reluctant to comment on that but says the lack of services locally means many patients are given no choice but to present at the ED: “Unfortunately a lot of the GPs and community practices, because of the lack of access to diagnostics, their patients still have to access the acute services [for diagnostic procedures].”

The indirect impacts of the Covid lockdowns are playing their part in the increasing attendances at the ED: “I would say there’s an increase in frailty in the community. There’s an older population who have sat at home for a year and a half where they would have been going out to the shop or going to the Church. There is definitely a piece around that frailty and a piece around those who have sat at home who are backlogging for investigations and to access GPs.”

Waiting lists

While Cavan and Monaghan Hospitals are coming under pressure, there is good work ongoing and progress being made to tackling waiting lists.

Su-zann lauds the work done by staff, with 82% of people on the list for a procedure locally waiting less than 12 months - a figure that’s better than the national rate.

“Everybody requiring an endoscopy procedure in Cavan Hospital waits less than 13 weeks for an appointment, that’s way above the national average,” she says.

MLU

The proposed closing of the Midwifery Led Unit at Cavan in 2020 was met with consternation from the local area and medical groups. The decision, which caught management at the hospital and within the HSE by surprise, was quickly rowed back on by the RCSI Hospitals Group.

While there were concerns over the future of maternity services, Su-zann says work is ongoing to try to bring back some facilities to Cavan, with hopes the diabetic maternity services could return after they were moved to Drogheda Hospital.

She’s unconcerned about the future of the hospitals too: “With the recent investment by the HSE and the RCSI Group, they are certainly realising the value of Cavan Hospital. Cavan and Monaghan serve a huge area and it’s a diverse range of needs so the idea of lifting that and setting it into a Connolly or Beaumont or anywhere else, there’s not the capability to do that.”

Team effort

The post of Manager of Cavan and Monaghan Hospitals is expected to be advertised shortly following David Lynch’s move to a new role in the RCSI Hospitals Group. Su-Zann O’Callaghan has moved to the job from her role of Director of Operations.

While she now has overall responsibility for both facilities, she’s clear that she’s only one part of a large team, with everyone more than willing to go above and beyond, something highlighted by the pandemic.

“The boys in stores were buying stuff out of their own pockets. They were trying to source people who had PPE. You have maintenance putting up walls and taking them down to create more space. Everyone knows everyone else’s name. You’ll have a consultant who’ll stop to chat to a porter. Nobody thinks they’re more important than anyone else.”

The work put in by staff hasn’t gone unnoticed and, while any decision on a financial bonus is out of the hands of management at the hospital, other smaller measures have been organised.

Money donated by members of the public, with input from the HSE and Healthy Ireland, went towards a new staff courtyard area off the hospital’s canteen. Local businesses also played their part with donations organised across the last two years.

For Su-zann, it’s the little things that have the most meaning: “I don’t think people realise how much just a card can mean.”