It was confirmed by the Clinicians at the recent Emergency Surgery public meeting on the 22nd March 2023 in the Canal Court, Newry that the Southern Trust and Department of Health’s plan is to turn Daisy Hill Specialist Acute hospital into a Regional Elective (planned surgery) Centre. 

Daisy Hill Acute Hospital had been previously designated by Government to provide timely access to 24/7 Emergency Surgery and Emergency Medical Services and Consultant led Maternity Services but the Southern Trust’s Chief Executive confirmed that ‘plans to turn the hospital into an elective overnight stay centre were progressing’ at the Canal Court Hotel public meeting.

BUT WHAT DOES IT MEAN TO BECOME A REGIONAL ELECTIVE CARE CENTRE?

Department of Health (DoH) Reports are clear on how they intend to provide elective care (planned surgery rather than Emergency or unplanned treatment). “Hospitals designated as Elective Care Centres will be used for outpatient assessments, diagnostics, day surgery or short stay inpatient surgery UNINTERRUPTED BY EMERGENCY ADMISSIONS.”

The Patient and Client Council have stated that “Elective care centres are specialist STANDALONE units DEDICATED PURELY to the delivery of PLANNED assessment and treatment…In practice, this means providing more treatment on a smaller number of specially designed standalone sites by moving this activity away from the busiest hospital sites.”

If Elective care centres are DEDICATED PURELY to the delivery of PLANNED assessment and treatment (for Regional Consultants and their patients) – what other specialist acute inpatient care services will be provided in Daisy Hill, Newry City FOR THE LONG TERM FUTURE for the 159,599 adults and children on Newry and District GP Registers, should it become an elective care centre? These specialist acute services should include 24/7 Type 1 Emergency Surgery and Emergency Medicine, inpatient paediatric services, HDU, Diagnostics, Maternity etc and clinical staff and inpatient beds (other than for Elective care)

2 STEPS ON THE WAY TO BECOMING A REGIONAL ELECTIVE CENTRE:

STEP 1: REMOVE EMERGENCY SURGERY / STEP 2: REMOVE MORE ACUTE SERVICES 

 (1) The Trust controversially withdrew the life saving Emergency Surgery service from Daisy Hill in Newry city, in Feb 2022 requiring all Southern Trust patients to travel to Craigavon Hospital.  Having after being withdrawn temporarily, the Trust now proposes all life saving Emergency Surgery will be permanently withdrawn from Newry City and will be only provided only in future in Craigavon. This withdrawal of Emergency Surgery service will also assist in the plan to prepare to turn Daisy Hill Hospital into a Regional elective centre.

 (2) The Trust’s next plan is to REMOVE other acute services from Daisy Hill Acute Hospital and send these services to a Community Treatment Centre in Newry. This was announced by Future Group Chairman Dr Patterson at the Canal Court public meeting describing the arrangement with the phrase to “free up space.” (This community centre will be privately and not HSC owned).

>IS THE PLAN FOR DAISY HILL TO BECOME A REGIONAL ELECTIVE CARE CENTRE INSTEAD OF A SPECIALIST ACUTE HOSPITAL?

If so, this proposal is a HUGE change of purpose for Newry & District’s designated Acute Hospital, at Daisy Hill, Newry.  This means that any Regional Surgeon, (either NHS or from a Private hospital),  will come to Daisy Hill for planned (elective) operations on their own regional patients from anywhere in NI  using the existing  operating theatres, beds, staff, and equipment in Daisy Hill. 

Controversial changes such as the change in Status/purpose of ANY of the 9 designated NI Acute Hospitals in NI (including Daisy Hill) from a Specialist Acute Hospital to a Regional Elective Care Centre must go to DOH NI wide Regional public consultation before any such decisions are made.

POPULATION FACTS : THE NEWRY & MOURNE LOCALITY IS THE HIGHEST POPULATION IN THE SOUTHERN TRUST AREA

The former Newry & Mourne locality is one of 5 local government districts in the Southern Trust operational area. Newry & Mourne (which includes South Armagh) IS and ALWAYS HAS BEEN the highest population in the Southern Trust. This population (along with other neighbouring areas and visitors) is served by Daisy Hill Acute Hospital in Newry. 

The NI public pay for Health and Social Care services through Regional Rates bills, Taxes and National Insurance deductions from their wages. The public must be consulted and asked to agree /approve changes to services for which they are paying and have paid to maintain – especially Changes that involve Withdrawal of services from a designated NI Acute Hospital. 

CONCLUSION:

REGIONAL PUBLIC CONSULTATION IS REQUIRED BEFORE DAISY HILL ACUTE HOSPITAL  IS CHANGED TO A REGIONAL  ELECTIVE CARE CENTRE

This is potentially unacceptable further withdrawal of specialist acute hospital services from Daisy Hill Hospital on a massive scale without Consultation or any due regard to the NI Rural Needs Act 2016, Equality Legislation, Fair Treatment and Employment 1998 or Change or Withdrawal of Services and population needs assessment .

Any change in Status/purpose of Daisy Hill from Acute Hospital to Regional Elective Care Centre dressed up as ‘transformation’ or ‘reconfiguration’ must be challenged by the Public and all Elected Representatives who believe In Equality and Timely Access to Healthcare in Newry & Mourne- South Down and South Armagh. This cannot go ahead without NI wide Regional Consultation for scrutiny and evaluation by the NI Assembly and public alike under the 2009 Act before any such decisions are made.

To end the uncertainty surrounding Daisy Hill, and for more information on plans for Newry’s Daisy Hill Acute Hospital and elective care centres –you can ask the local representatives on the Southern Local Commissioning Group, the Southern Trust, DoH NI, and Patient Client Council.

These organisations should be able to clarify and explain in detail what future plans they have for Daisy Hill Hospital and whether the concerns written about here are valid.

References and Further Reading:

Patient Client Council, Elective Care in Northern Ireland, 10th July 2019.

 Main DoH NI Elective Care Framework links :   

   
https://www.health-ni.gov.uk/publications/elective-care-framework-restart-recovery-and-redesign 

https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-elective-care-framework-restart-recovery-redesign.pdf  (*pgs 24, 63, 74, 75)

Elective Care Framework Restart, Recovery and Redesign 2021

Elective Care, is care that is planned in advance as opposed to Emergency or unplanned treatment. (p24: *Elective Care Framework Restart, Recovery and Redesign 2021).

“This requires commitment from all Trusts that in sites identified as regional elective care centres, that BEDS AND STAFF must be RING FENCED for the delivery of regional elective care.” (p63 *Elective Care Framework Restart, Recovery and Redesign 2021)

“Partnerships and cross-sector collaboration are ESSENTIAL. New services or interventions created, or existing ones that are transformed, WILL NOT ALWAYS BE HSC OWNED.” (p74 *Elective Care Framework Restart, Recovery and Redesign )

“We need more sites providing dedicated elective services that are ENTIRELY SEPARATE from unscheduled care.” ( p75 *Elective Care Framework Restart, Recovery and Redesign )   

More References and further reading to follow soon

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