Table 1

Regional characteristics and service reconfiguration summary, 2006 to present

Region (constituent counties)Population density (population per km2)Service reconfigurationClinical governanceED changesGP out-of-hours care
North East (Meath, Louth, Cavan, Monaghan)54.6Region-specific plan partly implemented in 2006–20107No unified region-level structureTwo EDs reconfigured to local injury units. Some centralisation of trauma, coronary and stroke careOne regional cooperative in place
Dublin North East (North Dublin City and County)1093No reconfiguration of servicesNo unified region-level structureNo changesOne regional cooperative in place, supplemented by doctor on-call service
Dublin South (South Dublin and Wicklow)259.7Region-specific plan implemented in 20138No unified region-level structureOne ED reconfigured to local injury unit, reduced operating hours in another. Centralisation of trauma, coronary and stroke care to two hospitals but with limited differentiation and integrationMultiple cooperatives in place, supplemented by doctor on-call service
Dublin Midlands (South-West Dublin, Offaly, Laois, Kildare, Westmeath, Longford)89.8Limited reconfiguration of servicesNo unified region-level structureSome centralisation of trauma, coronary and stroke careMultiple cooperatives in place across the region
South East (Waterford, Wexford, Carlow, Kilkenny, South Tipperary)52.6Limited reconfiguration of servicesNo unified region-level structureSome centralisation of trauma, coronary and stroke careOne regional cooperative in place
South (Cork, Kerry)54.6Region-specific plan largely implemented in 2012–20139Region-wide structure establishedTwo EDs reconfigured to local injury units, with another closing. Single hub for acute coronary care, severe stroke and trauma cases, with support services provided at other centresOne regional cooperative in place
Mid-West (Clare, Limerick, North Tipperary)46Region-specific plan largely implemented in 2009–201310Region-wide structure establishedThree EDs reconfigured to local injury units. Centralisation of stroke, coronary and trauma at hubOne regional cooperative in place
West (Galway, Mayo, Roscommon, Leitrim, Sligo, Donegal)31.1Some regional reconfiguration of servicesRegion-wide structure establishedOne ED reconfigured to local injury unit in 2011. Single hub for acute coronary care, severe stroke and trauma cases, with support services provided at other centresMultiple cooperatives in place across the region
  • ED, emergency department.