PLAYING WITH NUMBERS, PLAYING WITH PEOPLE’S LIVES

In a crucially important Population Plan Table*, created in 2013 for the influential ‘Transforming Your Care’ Health Review – Newry & Mourne Local Government District was made to look like the smallest population in Southern Trust area when it was really the largest.

This misinformation was used to plan future Acute Hospital services for the Southern Trust area and the rest of NI and is still being used today – so this error is why Newry & Mourne LGD and Daisy Hill Acute Hospital have been placed at the back of the queue for hospital buildings and specialist acute inpatient services for years, despite Newry & Mourne LGD being the HIGHEST LGD population in the Southern Trust area since it was formed in 2007.

WHAT IS WRONG WITH THIS TABLE?

This population plan table (shown in the graphic) implies that Newry & Mourne local government district (LGD) has the smallest Locality population in the Southern Trust area.  But this is wrong because Newry & Mourne was NOT the smallest population – it was the LARGEST (and still is).

Whoever compiled this Southern Locality Population Plan Table* incorrectly displayed the standardised NISRA population figures of the Southern Trust area and by doing this –masked the true population sizes of the five Localities / LGDs in the Southern Trust area. The effects of this misinformation are still being felt today.

WHERE DID THIS TABLE COME FROM? 

In 2011/12 as Part of the Transforming Your Care (TYC) Health Review and Consultation, the Health Minister asked the 5 NI Local Commissioning Groups for Draft Population Plans for each of their areas to assess the population in each Local Government District (LGD or locality) across NI to reflect local needs. “Population planning and local commissioning to be the central approach for organising services and delivering change.” (p8 TYC).

This Table is reproduced from the Southern Local Commissioning Group Locality -Population Plan ‘Changing For A Better Future’ 2013 Report on p18.* (A copy is available to download from the References section at the end of the article)

The Southern Local Commissioning Group (SLCG) created this Population Plan Report in conjunction with the Southern Trust which outlined how they jointly intended to commission and provide health and social care services in the Southern Trust area.

This information in this Population Plan was used for decision making in the Public Consultation on Transforming Your Care (TYC) Health Review.

EXPLAINING THIS POPULATION PLAN TABLE AND WHY IT IS SO IMPORTANT TODAY

The Table* shown from the 2013 Population Plan Report presents the Population sizes of all 5 local government districts in the Southern Trust in a very distorted way. There are FIVE Localities or local government district LGDs named in the Southern Trust area, they are:

(1) Newry & Mourne LGD, (2) Banbridge LGD; (3) Dungannon LGD; (4)Craigavon LGD and (5) Armagh LGD.

WHAT IS WRONG WITH THIS TABLE?

This population plan table (reproduced in the graphic) implies that Newry & Mourne local government district (LGD) has the SMALLEST locality population in the Southern Trust area.  But this is wrong because Newry & Mourne was NOT the smallest population – it was the LARGEST (99,900) in the table (and still is the largest today with a population of 106,813 people in 2020).

So whoever compiled this Southern Locality Population Plan Table incorrectly displayed the standardised NISRA population figures of the Southern Trust area and by doing this – masked the true population sizes.

MASKING OF TRUE POPULATION SIZES

To understand this distortion of locality/LGD  population size as displayed in the reproduced Table, please look at the BRIGHT BLUE ROW OF HEADINGS shown on the Graphic.

First start with the first column named:

YEAR– then > go along to the Next Column: ARMAGH/DUNGANNON >then next Column: CRAIGAVON/BANBRIDGE then > next column: NEWRY/MOURNE

These Headings are misleading as the places named are TWO local government districts grouped and added together in one column – that is until you get to the fourth column which instead displays only one local government District instead of two LGDs like the other columns before it.  

So the grouped double LGDs are compared against one single LGD. This single LGD is Newry & Mourne LGD which is being compared inaccurately and misrepresented so it appears as the smallest population.

IN DETAIL

The second column in the Table adds the population of the 2 local government districts of Armagh LGD and Dungannon LGD together in one column to form a higher combined population total (117,100) than the Newry & Mourne LGD population which appears as one LGD on its own in the third column. (99,900)

Armagh LGD + Dungannon LGD =117,100

Compared against

Newry & Mourne LGD = 99,900

The third column again adds TWO LGD populations together – it adds Craigavon LGD and Banbridge LGD together in one column to give a COMBINED population Total (141,600) and then this Total figure is then compared alongside the single local government district of Newry & Mourne population, (99,900) which appears again on its own as ONE LGD.

Craigavon LGD + Banbridge LGD =141,600

Compared against

Newry & Mourne LGD = 99,900

Of course 2 local government district populations added together are likely to be much higher than one single LGD even if the single LGD is the largest population, but this is not a fair use or acceptable standardised practice, and Newry & Mourne is losing out because of it.

The former 26 Councils or Local Government Districts (LGDS) or localities are still named in legislation and remain as the Operational area of NI Health Trusts (Establishment Order 2006) and Commissioning Groups. In the Southern Trust area. (See Background and References for more information)

The Graphic titled FACT below shows how the populations of the 5 LGDs in the Southern Trust should have been shown if represented fairly and accurately: it is obvious from this accurate representation using the official standardised NISRA statistics that Newry & Mourne LGD is the largest Locality population in the operational area of the Southern Health and Social Care Trust.

THERE ARE FIVE LOCALITIES OR LOCAL GOVERNMENT DISTRICT LGDS NAMED IN THE SOUTHERN TRUST AREA NOT THREE!

The original Population Plan Table* from the Southern Local Commissioning Group Locality -Population Plan Report also gave the impression that there are only THREE localities or local Government Districts in the Southern Trust/Commissioning area and wrongly implies Newry & Mourne Local Government District has the least need, instead of correctly stating that there are FIVE localities in the Southern Trust with Newry & Mourne being largest population with greatest need.

This misinformation about the size of the Newry & Mourne LGD and the other LGDs in the Southern Trust area was presented to the decision makers in charge of planning future hospital services in the Transforming Your Care Review.

This TYC Review made it clear that there should only be 5-7 Acute Hospital networks for the entire population of NI. This Review knew there would be a huge interest in Acute Hospital sites and their future role and outlined that the final functionality of each of the (hospital) facilities will be based on POPULATION NEED and the principles set out in the report. (p116 TYC).

The Transforming Your Care Health Review was a population based planning of Services which then formed the foundation for many future Health Reviews which followed including Delivering Together, Donaldson, and the Bengoa Report.

WHAT CAN BE DONE? – POPULATION NEEDS ASSESSMENTS AND HOSPITAL FUNDING

This misinformation as presented in the table* was used to plan the current Acute Hospital services in the Southern Trust area and the rest of NI and is still used today.

This error will have been a major reason why Newry & Mourne LGD and Daisy Hill Acute Hospital have been placed at the back of the queue for hospital buildings and specialist acute inpatient services for many years, despite Newry & Mourne LGD being the HIGHEST LGD population in the Southern Trust area since it was formed in 2007, and the fourth Highest Locality (LGD) population in all of NI since 1971 with Belfast, Lisburn (Greater Belfast) and Derry.

This injustice must be rectified now by the DOH as discussions take place about the future Hospitals services here.

Acute hospital-Emergency entrance

ACTION NEEDED TO REPAIR THE DAMAGE DONE BY POPULATION PLANNING MISINFORMATION 

Newry & Mourne Acute Area Hospital at Daisy Hill needs re-imbursement for the years of lost funding (when they were placed bottom of the Queue) and return of inpatient beds and specialist services, in a fully functioning Major Acute Specialist Hospital (as designated by Government in 2003 and again earmarked for a major new acute hospital in 2005) which has still not been delivered by the Southern Trust and Department of Health 18 years later.

The Population Plan Table* – which in effect was a population needs assessment reveals why Daisy Hill is being wrongly treated as a ‘small local’ hospital today.   

ACTIONS NEEDED

As verified by official NISRA statistics, for over 50 YEARS since 1971, Newry & Mourne LGD has ranked in the TOP 4 HIGHEST POPULATIONS in NI with Belfast, Lisburn (Greater Belfast) and Derry.  

The number of people living within a locality (LGD) is supposed to be the primary factor when commissioning health Services so the misrepresentation of population sizes which continues today in population planning in Southern Trust must be corrected urgently.  

So, in order to repair the damage done by this misinformation in 2013, which made Newry & Mourne LGD appear wrongly as the smallest LGD instead of the largest in the Southern Trust area there are two actions needed:

1. The Southern Trust and Southern Local Commissioning Group must stop putting forward the misleading idea that there are 3 localities in the Southern Trust when we know there are really 5 localities (LGDs). The population sizes of the Southern Trust area must be presented accurately acknowledging that Newry & Moure (single LGD) is the largest LGD/locality of the FIVE localities in the Southern Trust.

2. All Public Consultations (at both Regional and at Southern Trust level) must be based on accurate population size and accurately assessed population need. All Consultations (including the EQIA) must be population evidence based including for Emergency services (Emergency Surgery, Stroke, specialist acute services and reduction in status to a Regional elective Centre).

This should be organised by the Department of Health, The Strategic Planning and Performance Group, Public Health Agency and Southern Trust in the spending of scarce capital resources and decisions on spending on Hospitals (which have been paid for with public money). The public should have right to reply and challenge centralisation of services and when their hospital is used as a case study for closure.

Newry Mourne & Down Council, MPS, MLAs and the community all can be confident in the knowledge that Newry & Mourne LGD has been short changed and is long overdue the required investment in a major Specialist Acute Hospital in Newry City instead being bartered off with a Regional Elective centre or privatised Community Health Centre instead of a Major Specialist Acute hospital with a 24/7 Consultant- Led Type 1 Emergency Department & Consultant- Led Maternity.

Newry South Down and South Armagh Area Hospital -Daisy Hill, Newry City.

BACKGROUND AND REFERENCES

THE ORGANISATION OF NI HEALTH CARE IS STILL UNDER THE 26 COUNCIL MODEL

Operational areas in Health trusts still remain under the 26 council model.

The former 26 Councils or Local Government Districts (LGDS) or localities are still named in legislation and remain as the Operational area of NI Health Trusts (Establishment Order 2006) and Commissioning Groups. In the Southern Trust area.

The Five LGDs in Southern Trust in consistent order of size since Establishment of the Southern Trust on 1st April 2007 according to NISRA are:

>1st Newry & Mourne;

>2nd Craigavon;

>3rd Armagh:

>4th Dungannon:

>5th Banbridge

SoS Daisy Hill Hospital Campaign Rally - another show of community strength in Newry city on 25.06.2023. Estimated 10,000 attended the Rally in Marcus Square, Newry and then walked up to Daisy Hill Acute Hospital.

NEWRY & MOURNE LGD POPULATION

As verified by official NISRA statistics, for over 50 YEARS since 1971, Newry & Mourne LGD has ranked in the TOP 4 HIGHEST POPULATIONS in NI with Belfast, Lisburn (Greater Belfast) and Derry.

Based on population size, Daisy Hill should have a major Hospital the same size as Altnagelvin as its population size is very similar, and based on both population size, number of patients on GP Registers (c161,000)  and on its location -Daisy Hill should have a larger Specialist Acute hospital than Antrim, Craigavon, or Ulster Hospitals. Why? Because Newry & Mourne LGD has a population bigger than Antrim LGD, Castlereagh LGD, and also Craigavon LGD, who all have major acute hospitals already.

The Newry & Mourne LGD and Daisy Hill acute Hospital cannot be ignored any longer as there are many factors which require proper hospital services funding and commissioning in this area (1) it has the large population, (2) the highest number of births, (3) the Location

REFERENCES

Other References

Transforming Your Care : https://www.health-ni.gov.uk/topics/health-policy/transforming-your-care#toc-0

Transforming Your Care (TYC):  Vision to Action. A Consultation Document 9th Oct 2012 to 15th Jan 2013.

Transforming Your Care (TYC) : Vision to Action – A post Consultation Report  March – 2013 

The TYC Consultation Document ‘ Vision to Action’ was “based on the draft Population Plans which have been developed by Local Commissioning Groups with input from HSC Trusts, to reflect local needs and a Draft Strategic Implementation Plan which gives a wider NI overview.” (p3 Vision to Action. A Consultation Document 9th Oct 2012 to 15th Jan 2013).

“Population planning and local commissioning to be the central approach for organising services and delivering change.” (p8 TYC)

Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ Please Follow or Like the Page to receive updates. Thank you.

You can also read, like and share this post on Facebook at : Playing with numbers, playing with people’s lives

You may also be interested in other posts on Daisy Hill Acute Hospital, Newry city, like: https://savedaisyhillhospital.com/2022/02/28/daisy-hill-hospital-newry-is-one-of-the-nine-major-acute-hospitals-in-the-regional-network-designated-in-2003-like-antrim-ulster-etc/

Daisy Hill Hospital for Life


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Newry & Mourne LGD population abandoned by the Health authorities paid to provide for them in Daisy Hill Hospital, Newry.

FACT: For over 50 YEARS since 1971, Newry & Mourne LGD has ranked in the TOP 4 HIGHEST POPULATIONS in NI with Belfast, Lisburn (Greater Belfast) and Derry. (As verified by NISRA Statistics).

The highest population in the Southern Trust - Newry & Mourne LGD has been abandoned by the Health authorities paid to provide acute services for them in Daisy Hill Hospital, Newry.

Based on the population size of Newry & Mourne LGD, (106,813 people in 2020 (NISRA) – Newry City should have a Major Specialist state of the art Acute hospital (as planned by Newry & Mourne Health & Social Services Trust) with the same specialist acute services, inpatient beds and diagnostics as Altnagelvin Hospital and Craigavon Hospital.

It should be noted that while Newry & Mourne Local Government District (LGD) has a similar population size to Derry LGD, Newry & Mourne LGD has ALWAYS had a Higher population size than Craigavon Local Government District.

DAISY HILL, NEWRY IS A GOVERNMENT DESIGNATED MAJOR ACUTE HOSPITAL

In 2003 it was finally acknowledged by the Department of Health, that with the 4th highest population in NI, Newry & Mourne was entitled to have a major functioning acute hospital based on assessed need.

Following Regional Consultation on the DoH’s Developing Better Services, Daisy Hill Acute Hospital Newry City was designated one of 9 Major Acute Hospitals which would form a network of Specialist Acute Hospitals across NI.

This ensured that no matter where anyone lived in NI every person would have equal access within one hour to 24/7 Consultant Led Accident and Emergency Services, and 24/7 Consultant Led Maternity Services in one of nine Acute Hospitals in a Regional “seamless web of care.”

The number of people living within a locality (LGD) is supposed to be the primary factor when commissioning health Services – so why has the highest population in the Southern Trust in Newry & Mourne LGD been abandoned by the Health Authorities who are paid to provide acute services in Daisy Hill Acute Hospital, Newry City?

The Southern Health and Social Care Trust (who replaced Newry & Mourne Health and Social Services Trust in 2007) never had any intention of re-developing Daisy Hill Hospital into the major acute hospital the population of Newry & Mourne were entitled to. They were only interested in redeveloping Craigavon hospital.

Consequently now in 2023 after repeated excuses and public statements the Southern Trust have managed to destroy the reputation of the brilliant hospital they inherited from N&MHSST. The Southern Trust’s centralisation agenda and the organisation’s own inability/or refusal to recruit and retain staff has taken its toll on staff in the hospital resulting in the major public health crisis the population of Newry & Mourne now finds itself in.

The men, women and children of the Newry & Mourne population should not have the fear and worry which comes from the consistent drastic reduction of specialist services and inpatient beds from the major specialist acute hospital Daisy Hill, Newry City.

The main graphic shows the Southern Trust area and its 2 Acute hospitals. Newry & Mourne has the largest land mass (898.3 square Km) of all the 5 localities in the Southern Trust area.

Since the Southern Trust took over admin of Daisy Hill Acute Hospital on 1st April 2007, Newry & Mourne has ALWAYS has the highest population, highest number of births and highest number of children u18 of all the 5 LGDs in the Southern Trust.

Official statistics, as presented by NISRA must determine where Specialist acute Hospitals are located in NI.

BACKGROUND – The organisation of Health Care in NI

The former 26 Councils or Local Government Districts (LGDS) or localities are still named in legislation and remain as the Operational area of NI Health Trusts (Establishment Order 2006) and Commissioning Groups. In the Southern Trust area, there are still FIVE LGDs named as shown below and in graphic.

The Five LGDs in Southern Trust in consistent order of size since Establishment of the Southern Trust on 1st April 2007 according to NISRA are:

>1st Newry & Mourne;

>2nd Craigavon;

>3rd Armagh:

>4th Dungannon:

>5th Banbridge

Total LGD population order of size: (NISRA 2020):

>1st Newry & Mourne: 106,813

>2nd Craigavon: 103,341

>3rd Armagh: 63,874

>4th Dungannon: 63,552

>5th Banbridge: 50,567

Total LGD population Under 18’s: in order of population size, (NISRA 2020):

>1st Newry & Mourne: 28,116

>2nd Craigavon: 25,804

>3rd Armagh: 16,334

>4th Dungannon: 16,938

>5th Banbridge: 12,274

Official Northern Ireland Statistics and Research Agency (NISRA) Statistics.

Newry & Mourne, South Armagh Acute Area Hospital at Daisy Hill, in Newry city

ACTION 1

For Related Information

For another article on populations, the hospitals of the region including Daisy Hill Hospital, Newry -see also : https://savedaisyhillhospital.com/2020/01/15/ni-health-crisis-cut-in-number-of-specialist-acute-hospitals-their-uneven-spread-since-1995-is-a-major-factor/

The concentrated support of Newry Mourne and Down Council, to call for action and proper treatment of Daisy Hill Acute Hospital, the Area Hospital for Newry & Mourne and South Armagh is needed -for more info: https://wordpress.com/post/savedaisyhillhospital.com/3146

The people of Newry & Mourne LGD and surrounding areas show their support at the Save our Emergency Surgery March to Daisy Hill Acute Hospital, Newry on April 2023

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We welcome sharing of this info and the use of excerpts and links, please give full and clear credit to http://www.savedaisyhillhospital.com and Daisy Hill for Life with appropriate and specific direction to the original content. Thank-you.

Transformed before your very eyes – is the Plan for Daisy Hill Acute Hospital, Newry City to be replaced by a Regional Planned Surgery Centre?

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.

Newry South Down and South Armagh Area Hospital -Daisy Hill, Newry City.

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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Daisy Hill Acute Hospital for Life, Daisy Hill acute hospital, Newry city.

Newry & Mourne Local Government District (LGD) has consistently been ranked within the Top 4 LGDs by population size consistently since 1971.

Newry & Mourne Local Government District (LGD) has consistently ranked in the Top 4 populations by population size of LGDS in all N. Ireland consistently since 1971 – So where’s the Funding for Daisy Hill Acute Hospital, Newry?

Now is finally the time for proper investment for Daisy Hill, as Newry & Mourne LGD has a population bigger than Antrim LGD, Castlereagh LGD, and also Craigavon LGD, who all have MAJOR ACUTE HOSPITALS ALREADY.

Time for Investment for Newry and Mourne LGD and Daisy Hill Hospital , Newry.

Now is finally the time for proper investment for Daisy Hill, as Newry & Mourne LGD has a population bigger than Antrim LGD, Castlereagh LGD, and also Craigavon LGD, who all have MAJOR ACUTE HOSPITALS ALREADY.

10 Acute hospitals and Table of 15 largest populations in NI (2019), hospital map Northern Ireland

The picture shows the Present configuration of 10 Acute hospitals (red dots) now left in NI in 2019, alongside a Table of the 15 largest population settlements here (Source 2018 NISRA*).

There has been a Hospital on the Daisy Hill Hospital site in Newry since the 19th century, for its growing Population.  In 2003 it was officially designated as one of ten out of 19 existing Acute hospitals, under ‘Developing Better Services’ needed for the acute care needs of the people of NI.

New investment in acute specialist hospital services, hospital beds and specialist medical staff is due in the Newry & Mourne area, in Daisy Hill Acute Hospital, including in the Emergency Department.

But despite Newry & Mourne consistently having the largest LGD population in the operational area of the Southern Trust**, its funding for Acute services and Capital for Redevelopment as a MAJOR ACUTE HOSPITAL has never been equal to the other acute hospital in the Southern Trust, Craigavon.

The 19 acute hospitals in NI in 1995 were reduced to a total of ten after various Dept. of Health Reforms.  The LGD populations* or Settlements shown in the Graphic (source NISRA*) would suggest that Population size and need does not seem to drive current funding decisions.  Health investment in NI continues to focus on 4-6 Hospitals, instead of the ten designated acute hospitals on the map.

Only 6 URBAN hospitals (Royal, Belfast City, Craigavon, Antrim, Altnagelvin and the Ulster) continue to be allocated major funding.

These 6 hospitals, (from the previous 19) were given major investment as specialist acute hospitals, because of hospital size, NOT based on where the largest  LGD/settlements of population lived, [Regional Strategy for 1997 to 2002. – Detail available in previous article, link at the end of piece.]

>DAISY HILL ACUTE HOSPITAL, IN NEWRY & MOURNE LGD IS STILL BEING OVERLOOKED DESPITE BEING THE LARGEST LOCALITY OF ALL 5 LGDs IN SOUTHERN TRUST AREA & FOURTH LARGEST LGD IN N.IRELAND.

Just as in the Western Trust (with a total population of 301,448*) there is need for TWO Specialist Acute Stroke Units - so too, the Southern Trust (with a larger population of 380,312*) is also entitled to TWO Specialist Stroke Units (HASUs and Acute Stroke Units), at Daisy Hill Hospital, Newry and Craigavon Hospital. This would ensure that everyone in the Southern Trust has immediate access to CT scanning and life saving thrombolysis, followed by direct access into a stroke unit.

Daisy Hill acute Hospital, in Newry & Mourne LGD is still being overlooked for investment and specialist service provision, without explanation.  

Official NISRA demographic statistics prove that the population need exists in the area of Newry & Mourne (which includes South Armagh). This LGD has consistently been the FOURTH largest population in NI, as well as the highest locality population of all 5 localities/LGDs in the operational area** of the Southern Health Trust since its inception in 2007.

TIME NOW FOR PROPER INVESTMENT FOR NEWRY & MOURNE LOCALITY ACUTE HOSPITAL, DAISY HILL, INCLUDING INVESTMENT IN STROKE SERVICES, SCANNING EQUIPMENT AND HOSPITAL CAPITAL PRIORITIES

If Health Chiefs and those in charge of funding were to fully realise the actual size of the Newry & Mourne population, from valid NISRA statistics, then changes could be made to rectify the situation and put a stop to the wrong categorisation of Daisy Hill as a ‘smaller’ Hospital, when it should be a large Specialist Acute Hospital to truly reflect the population size and need in the area.

For example Even though the Executive Summary of the Bengoa Report*** P19 stated clearly to the NI Executive “IT IS NOT APPROPRIATE for this report to dictate to people in different parts of Northern Ireland what services they should and should not expect to be located in their area or local hospital” THEY DID EXACTLY THAT in THE FULL BENGOA EXPERT PANEL REPORT (P.73)

In this report all of Northern Ireland was inappropriately dictated to and told as a Local Case Study that Craigavon Area Hospital would be the site for a centralised Specialist Stroke Unit above all other locations in NI. Newry & Mourne’s population were also publicly inappropriately dictated to, that they would only get stroke rehabilitation in a community setting instead of retention of the existing Specialist Acute/Rehabilitation Stroke Unit in Daisy Hill acute Hospital.

Official statistics, as presented by NISRA must determine where Specialist acute Hospitals are located in NI.

NOW IS THE TIME FOR CHANGE & PROPER INVESTMENT

The Newry & Mourne population was left out of plans for future investment for a NEW hospital, left out of the NI 2019 Reshaping Stroke Services Options and IGNORED when it came to funding and long term future investment for CT, MRI and non obstetric scanners but NOW IS THE TIME FOR CHANGE.  

Time for Investment in Newry and Mourne LGD's acute Hospital Daisy Hill

>NOW is the time for proper investment (with Rebates) for Newry & Mourne and Daisy Hill Hospital as a Specialist Acute Hospital NOW,  just as had been intended under Government Backed Report in 2003 and Strategic Investment Report in 2005 which had Secretary of State backing.     

PLEASE SHARE WIDELY

Please Share widely – with your help this info could reach the right people with the power to make the necessary changes, such as the new Health Minister Mr Robin Swann MLA and new Finance Minister Mr Conor Murphy MLA.  Please keep supporting Daisy Hill Hospital for Life!

<       BACKGROUND INFORMATION                  >

Reference * NISRA is the Northern Ireland Statistics and Research Agency ; https://www.nisra.gov.uk/

IMPORTANT INFO ON LGDs AND COUNCILS

Despite the fact that there are now 11 Councils in Northern Ireland in 2020, the (former) 26 council model is still relevant today for the purpose of Health Funding. 

NISRA continues to also provide populations by HSC Trusts aggregated from the former 26 local government districts. These 26 former LGDs remain named in legislation as the ‘operational areas’ of the Health and Social Care Trusts in NI according to the Establishment Orders 2006.

Reference ** The 5 LGDs named  in the’ OPERATIONAL AREA’ of the Southern Health and Social Services Trust (SHSCT) –  in order of population size since the start of the Southern Trust in 2007 were in 2018 : Newry & Mourne (105,693); Craigavon ( 101,489); Armagh (62,976); Dungannon (62,666), and Banbridge(50,717) NISRA 2018 * Note: Newry & Mourne is ONE single LGD.

<Important>:

There are 5 LGDs/localities in SHSCTNOT 3 Localities or Local Government Districts.

They are as follows:

(1) Newry & Mourne: ONE LGD,

(2) Craigavon: one LGD

(3) Banbridge: one LGD ,

(4) Armagh one LGD,

and  (5) Dungannon :one LGD. 

THERE IS NO SUCH LGD/LOCALITY AS ‘ARMAGH/DUNGANNON’ or ‘CRAIGAVON/BANBRIDGE.’

Southern Trust/ SLCG Populations

1995 Southern Trust /Southern Local Commissioning Group SLCG Populations: Newry & Mourne (84,035); Craigavon (77,689); Armagh (52,675); Dungannon (46,958) and Banbridge(37,427) NISRA 1995.

2010 Southern Trust/ SLCG Populations:  Newry & Mourne (99,900); Craigavon (93,600); Armagh (59,400); Dungannon (57,700) and Banbridge  (48,000). NISRA MYE 2010  

2018 Southern Trust/ SLCG Populations: Newry & Mourne (105,693); Craigavon (101,489); Armagh (62,976); Dungannon (62,666) and Banbridge  (50,717) . NISRA 2018

Reference *** Bengoa Expert Panel Report ‘Systems not Structures’, 2016, https://www.health-ni.gov.uk/publications/systems-not-structures-changing-health-and-social-care-full-report

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https://savedaisyhillhospital.com/2020/01/15/ni-health-crisis-cut-in-number-of-specialist-acute-hospitals-their-uneven-spread-since-1995-is-a-major-factor/

NI Health Crisis – Cut in Specialist Acute Hospitals & their Uneven spread since 1995 is a major factor

Nurses and Health Workers in N. Ireland strike for pay parity, safe staffing levels Dec2019

2019 ended with Northern Ireland’s Health Care in crisis: Patient Waiting lists at record highs, healthcare workers on strike over pay and staffing levels, Nurses from the Royal College of Nursing on strike for the first time in its 103 year history. This ‘crisis’ is recognised by the Royal College of Surgeons, the Royal College of Nursing and Health Unions

NI Nurses and Health Workers province-wide strike January 2020

Health Care workers on strike here have been short changed in comparison with the rest of the UK, on pay and staffing levels. But in terms of Acute Hospital Care, are people in Northern Ireland being treated fairly in the number and location of specialist acute hospitals?

Before NI can start to fix the current Health Care Crisis –some background is necessary to find out how it got to this point.

There were 19 Acute hospitals in NI in 1995 as the map below, reproduced from The Department of Health’s Regional Strategy (1997 – 2002) shows.

Hospital map Northern Ireland with populations 1995 -shows acute hospitals.

According to the Department of Health:

“If the ratio of acute hospitals to population which currently obtains in England were applied to Northern Ireland (1,649,131 in 1995) there would be no more than 10 acute hospitals in NI. Thus many acute hospitals in NI serve much smaller populations than acute hospitals in England.”

Dept. of Health for Northern Ireland Regional Strategy (1997 – 2002)

Direct Rule Health Minister Mr Moss stated in a Hansard Report 5 March 1997:

The Department’s Regional Strategy for 1997 to 2002 was published last year and envisaged specialised acute hospital services being built around the cornerstone of Northern Ireland’s six major hospitals- the Royal Victoria hospital, the Belfast City hospital, Craigavon, Antrim, Altnagelvin and the Ulster.”

It clearly states also that:

While investment where appropriate will be made in other hospitals, it is expected that those SIX HOSPITALS will provide the main focus for FUTURE INVESTMENT in INPATIENT FACILITIES.”

Dept. of Health for Northern Ireland Regional Strategy (1997 – 2002) p65

These 6 hospitals out of 19 hospitals were envisaged as specialist acute hospitals, because of hospital size, NOT based on where the largest settlements of population lived, compared to England who the strategy stated would have 10 hospitals for a population the size of NI (1,649,131). The mid-year 1995 NISRA populations (Table) prove this.

They show that Daisy Hill acute Hospital, Newry & Mourne LGD – the FOURTH largest population (84,035) in NI, and Lisburn LGD (106,583), the SECOND Largest population in NI were COMPLETELY IGNORED for consideration as one of 6 major acute hospitals, while 3 other acute hospitals serving SMALLER populations in the local Government Districts of Craigavon, (population 77,689) Antrim (48,489), and Castlereagh (64,616) were listed for preservation.

Accurate population demographics, as provided by NISRA must inform health planning and future investment in inpatient facilities across NI

This trend of ignoring population size has continued into the present (as the next post will show), so to truly combat the Northern Ireland wide health crisis – ACCURATE DEMOGRAPHICS provided by NI Statistics and Research Agency (NISRA) must inform health planning. This includes using these official statistics, as presented by NISRA to determine WHERE Specialist acute Hospitals and specialist inpatient and outpatient acute services are located.

Acute Hospital accommodation and services are paid for through Rates and Taxes by everyone, irrespective of where they live in NI – Urban or Rural, everyone is entitled to equality of access to Hospital Care.

Further posts will look at the present and future NI Demographics in relation to location of acute hospital provision.

Official statistics, as presented by NISRA must determine where Specialist acute Hospitals are located in NI.

BACKGROUND
A Short History – Pre Centralisation – In 1995 there were 19 ACUTE HOSPITALS in Northern Ireland. (See Map or Full List at End of post.)

1995: All NI population: 1,649,131*

1995: 15 LARGEST POPULATION SETTLEMENTS IN NORTHERN IRELAND (Statistics from NISRA*)

(1st) Belfast: 288,932; (2nd) Lisburn: 106,583; (3rd) Derry: 102,123; (4th) Newry & Mourne: 84,035 (5th) Newtownabbey: 78, 426; (6th) Craigavon: 77,689 (7th) North Down: 75,519 (8th) Ards: 68,462 (9th) Castlereagh: 64,616 (10th) Down: 61,441.
[(11th) Ballymena: 58,039 (12th) Fermanagh: 55,405 (13th) Coleraine: 54,176, (14th): Armagh: 52,675 (15th) Antrim: 48,809 [NISRA]*

19 ACUTE HOSPITALS IN 1995 NI (Alphabetical order)
Altnagelvin (Derry); Antrim; Ards; Banbridge; Causeway (Coleraine); City (Belfast); Craigavon; Daisy Hill (Newry); Downe; Erne (Enniskillen); Lagan Valley (Lisburn) ; Mater (Belfast); Mid-Ulster(Magherafelt); Route (Ballymoney); Royal Group (Belfast); South Tyrone; Tyrone County (Omagh); Ulster (Castlereagh); Whiteabbey (Newtownabbey).

Sources:
NI Regional Strategy for Health and Social Wellbeing (1997- 2002) ‘Health and Wellbeing into the Next Millennium’

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