MIDCARE© Report formally provided to the Minister for Health

MIDACRE© Brief formally provided to the Health Information Quality Authority (HIQA) and Chair of Health Committee

Executive Summary

MIDCARE comprises five interlinked studies presented in four articles addressing structural inequities in emergency and acute care provision, providing timely, evidence-based insights serving as a valuable complement to the Health Information and Quality Authorities (HIQA’s) current review.

MIDCARE was developed in response to the May 2024 request by the former Minister for Health for an independent review under Section 8(1)(e) of the Health Act 2007, tasking HIQA with evaluating urgent and emergency care (EC) services in Ireland’s Mid-West (MW). While HIQA’s remit focuses primarily on operational safety, service configuration, and regulatory compliance, the Hybrid Simulation Modelling Lab (HSML) initiated MIDCARE© to address broader structural and equitable issues not covered in the formal review.

The HSML led MIDCARE© series fills critical evidence gaps by examining long-term acute bed and consultant workforce deficits, regional inequities in EC access, and system-wide bottlenecks through a suite of forecasting, geospatial, and simulation models. It also incorporates public trust and utilisation data, offering a population-based (strategic) and EC (operational) perspective essential to realising the equitable and decentralisation goals of Sláintecare. This work enables policymakers to engage with timely, regionally grounded, and future-facing decision-support tools that extend beyond HIQA’s narrower review.

May 2025

Key Findings from a Five-Part Series on the Midwest Integrated Demand and Capacity Analysis for Regional Emergency Care (MIDCARE©): A System-Wide Modelling Initiative for Equitable Regional Resource Planning Aligned with HIQA’s Upcoming Review & Slaintecare Reform.

Policy Documents

Executive Summary

University Hospital Limerick (UHL), the only Model 4 hospital in Ireland’s MidWest region, faces persistent challenges with overcrowding and prolonged emergency department (ED) wait times. In 2023, UHL saw 80,113 ED attendances, averaging 219 daily presentations. By October 2024, this number exceeded 300 daily, straining the hospital’s 535-bed capacity. A spatial and capacity analysis projects a shortfall of 327 beds by 2031, including 128 unplanned acute beds and 199 outdated. Nightingale ward beds requiring replacement. The spatial analysis identifies Ennis, County Clare, as the most suitable location for a new Model 4 hospital. Redistributing 37,252 ED patients annually from UHL to regional hospitals such as Ennis and Nenagh (with 50 and 52 beds, respectively) is recommended as a short-term measure. In the long term, constructing a 353-bed hospital in Ennis would align with the Sláintecare framework’s goal of decentralising healthcare services, ensuring 1sustainable and equitable access for the MidWest region.

23 October 2024

Preliminary Quantitative Analysis and Strategic Approach to Emergency Department Overcrowding at University Hospital Limerick, Ireland’s Health Service Executive, Mid-West Region

Presented to Mr. Bernard Gloster, CEO Health Services Exectuive (HSE) Ireland at the Health Management Institute of Ireland (HMI) annual conference 23rd October 2024

Presented at public stakeholders event in Ennis November 2024, provided to all County Clare public representatives and forms the basis of a HIQA submission

Preliminary Quantitative Analysis of ED Overcrowding at UHL

MIDCARE© Proposal University Hospital Ennis (UHE)

Strategic Case for University Hospital Ennis (UHE) Campus
A Proposal under the Midwest Integrated Demand and Capacity Analysis for Regional Emergency-care (MIDCARE©) Series

Prepared for the National Development Plan 2026–2035

Provided to all County Clare Public Representatives June 2025

Executive Summary

This proposal, based on the Midwest Integrated Demand and Capacity Analysis for Regional Emergency-care (MIDCARE©) series, forms part of a submission to the National Development Plan 2026 to 2035. It outlines a strategic dual-site investment in County Clare’s health and education infrastructure and aligns with the Health Information and Quality Authority's review of emergency care in the Mid-Wes (MW).

June 2025

Project Brief: Prepared for Innovate for Ireland

Hybrid Simulation Modelling Lab (HSML)

This briefing, presented by Sinéad Madden on behalf of Hybrid Simulation Modelling, outlines an innovative project proposal developed for the Innovate for Ireland initiative. The brief reflects HSML’s commitment to integrating data, models, and decisions through hybrid simulation approaches. It showcases the Lab's capacity to solve complex, real-world problems by combining qualitative insight with data-driven system modelling. Focused on impactful, interdisciplinary research, the project aims to deliver value through transparency, credibility, and evidence-informed decision support.

July 2023

Innovate for Ireland

MIDCARE© Report