Severe pressure on UHG’s urology department in 2014 - says report

More than one in six outpatient attendances at Galway University Hospitals (UHG and Merlin Park ) in 2014 involved newly diagnosed cancer patients.

There were over 262,000 outpatient attendances recorded altogther and of those, 40,410 were related to the cohort of patients who were newly diagnosed with cancer, according to the Saolta Cancer Centre annual report for 2014.

These patients were seen in most specialities across the hospital and account for 15 per cent of overall outpatient activity.

The report outlines that 10,294 patients attended the symptomatic breast clinic, located on the grounds of UHG, 4,887 of whom were new patients. Some 275 of these were diagnosed with cancer. An additional 20 were breast cancer review patients.

In 2014 the BreastCheck western unit diagnosed 162 women with breast cancer. This cancer detection rate (6.86 per 1,000 ) is similar to other national and international breast screening services. In all, 30,265 women were invited for a screening mammogram and 23,950 women - representing an uptake rate of 78 per cent which compares favourably with other screening services - accepted the offer. A total of 1,119 women had an abnormal mammogram and were recalled to a triple assessment clinic.

The study outlined a new advanced diagnostic technique for patients with suspected prostate cancer known as transperineal template biopsies of the prostate which was developed in 2014. GUH was the only public/HSE hospital providing this service.

2014 was described as a “very difficult” year for the hospital’s urology department with severe pressure on the service. The report says its bed allocation (22 beds ) is inadequate to meet the urological needs of a population of more than 800,000. There is also inadequate access to day surgery.

“Emergency admissions continue to displace elective surgical admissions due to the ongoing trolley crisis and overcrowding of emergency departments. Difficulty recruiting and retaining vital theatre nursing staff has lead to rolling closures in operating theatres on a one in three basis limiting workload and worsening waiting lists. Significant investment in infrastructure and staff is required to meet the needs of patients. As our population grows and ages the incidence of cancer is expected to double in the next 20 years.”

Almost 1,000 patients are diagnosed with upper gastrointestinal cancers - oesophageal and gastric cancer - in Ireland each year, according to the report. Combined, they constitute the 10th most common cancer accounting for nine per cent of all newly diagnosed cancers. Due to the poor prognosis of patients with these cancers they account for almost 700 deaths yearly representing eight per cent of all cancer deaths.

There were 55 upper gastrointestinal referrals to GUH in 2014 with 208 new outpatient attendances, 1,063 reviews and 84 unscheduled attendances recorded.

The study pointed out that patient numbers at GUH reflected the projected increasing trends in upper GI cancers with surgery rates here increasing by 100 per cent on the previous year and referrals also demonstrating higher numbers.

Skin cancer is the most common cancer in Ireland and this is substantiated by the skin cancer service across the Saolta University Health Care Group which continued to be extremely busy in 2014 with consistently high volumes of referrals received.

The incidence of skin cancer, particularly melanoma, is rising annually and skin cancer is particularly common in the west of Ireland.

There were a total of 1,916 skin cancer inpatients at UHG in 2014, the majority - 948 - had basal cell carcinoma while 308 had melanoma.

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