QUESTION OF TRUST – comparing Southern and Western Trust’s Stroke Proposals for NI

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.

One of the Functions of the Southern Health and Social Care Trust under the 2006 Establishment Order is to PROVIDE SERVICES – (not take away existing services) to the population of the five former Local Government Districts (LGD)s  or Localities of            (1) Newry & Mourne LGD  (105,161); (2)Craigavon LGD (100,310); (3)Armagh LGD (62,427); (4) Dungannon LGD (62,149) and (5) Banbridge LGD (50,265).

The Southern Trust have a duty of care to plan provision of services in equal measure to all 380,312* people under their care.

Proof that the future configuration of Hyperacute and Acute stroke Units in the Northern Ireland Stroke Consultation Document 2019 was decided not only by the Department of Health, but also by all of the Health Trusts in NI,  can be seen from the Western Trust website which states:-

‘Speaking ahead of the meeting of the Western Trust Board this week, Dr Anne Kilgallen, Western Trust Chief Executive said:

“The Department of Health is leading on the Stroke Consultation and all Health and  Social Care Trusts have been actively involved in the discussions in preparation. We in the Western Trust are very pleased that both the South West Acute and Altnagelvin Hospitals are part of the options being considered.”‘

If only it could be said that the Southern Trust were also actively involved in discussions and preparations to make sure that the existing Specialist combined Acute Stroke /Rehabilitation Unit in Daisy Hill, Newry City (in the largest locality in the Southern Trust) was being put forward as a vital Hyperacute Stroke Unit, co-located with an Acute Stroke in the future network of specialist Stroke Units in NI.

Compare how inclusively the Western Health and Social Care Trust have reassured their staff and population of 301,448*, that they are doing their best to retain and enhance their TWO ACUTE STROKE UNITS in Altnagelvin Hospital in Derry and the South West hospital in Enniskillen, with the Southern Trust’s approach.

The Southern Trust (SHSCT), has consistently pushed forward at every opportunity, removal of vital life saving stroke services from Daisy Hill, out of reach to Craigavon in their Centralisation Programme of all specialist services to Craigavon.   (Even the 2016 Bengoa Report’s only Local Case Study promoted SHSCTs proposal to centralise all Stroke services to Craigavon and remove them forever from Daisy Hill, Newry City).

Because of this, Daisy Hill Acute Hospital, Newry City specialist combined Acute/Rehabilitation Stroke Unit, (in the largest of the five Local Government Districts in the Southern Trust), does not even warrant a mention on the list of options given in the Northern Ireland Stroke Consultation 2019.

A HASU and ASU is proposed for Craigavon, not on one, but on ALL SIX OPTIONS. It is clear from this, that nobody seems to have spoken out for provision of Stroke services in NEWRY CITY.

It also shows that the SHSCT are proposing to continue with their plans to withdraw existing life saving specialist Acute Stroke and Stroke Rehabilitation Services from Daisy Hill Acute Hospital, without making any provision of a NEARBY alternative Specialist Stroke Unit. They are required to do this under equality of access to provide EMERGENCY timely life saving specialist services e.g. CT scanning, thrombolysis, etc and acute Stroke Rehabilitation.

CONCLUSION

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).

This would ensure that everyone in the Southern Trust has, as they have at present, immediate access to CT scanning and life saving thrombolysis, followed by direct access into a stroke unit – the stroke pathway recommended by The Royal College of Physicians for better outcomes.

>The Southern Trust need at this stage to speak up for ALL the population they are duty bound to provide specialist stroke services for in the future stroke network in Northern Ireland, in the same inclusive manner as the Western Trust.

*NISRA 2017

Southern Trust population 380,312 : Western Trust population 301,448  : NISRA 2017

Sources: http://www.westerntrust.hscni.net/about/3857.htm

NI Stroke Consultation: Presenting an extra Option to include the EXCLUDED populations

Q6 SUGGESTED ANSWER : 5 Hyperacute Stroke Units (HASUs) and 5 Acute Stroke Units (ASUs) at 5 acute hospitals in NI at: (1)Royal Victoria, Belfast; (2) Daisy Hill Hospital, Newry, (3)South West, Enniskillen (4)Altnagelvin, Derry and (5)Causeway Hospital, Coleraine. This option is based on existing acute stroke units that already give specialist CT scanning and Thrombolysis.This option offers timely equality of access to these necessary specialist stroke services more evenly distributed across NI to include the rural population - ignored in the consultation. NI Stroke Consultation 2019: Presenting an additional Option to include all the excluded populations of Northern Ireland.

The NI Stroke Consultation: Reshaping Stroke Care – Saving Lives, Reducing Disability 2019 asks for the public’s agreement to choose an option between 6 possible options of future configuration of both hyperacute and acute stroke units in Northern Ireland (NI) even though many local Government Districts are excluded.

In these proposals, two existing stroke units in acute hospitals at Daisy Hill Hospital in Newry City and Causeway Hospital in Coleraine have been completely EXCLUDED from ALL possible Options to choose in the Consultation Questionnaire, and isolated from the process completely.

ALTNAGELVIN, CRAIGAVON AND ROYAL VICTORIA HOSPITALS SELECTED IN ALL OPTIONS

Altnagelvin, Craigavon and Royal Victoria Hospitals are proposed in every one of the 6 Options, which means the future of these three stroke units is perceived as definitely secure whatever happens.

These three stroke units may be recruiting on the strength of this, while other units and their staff are left out in the cold, despite actively participating in the Pre-Stroke Consultation in 2017, where they were assured that no decisions had been made.

Redress the unbalanced NI Stroke Consultation 2019 - additional Options needed to include the Excluded populations.

RESEARCH BIAS

The approach in the Questionnaire is considered bad practice in Research as the occurrence of the same 3 hospitals in all 6 Options shows bias and favouritism and employment unions may be alerted that this is a failure to follow due process in Employment Law.

This bias renders the whole Consultation invalid as the topic deals with the Change and Withdrawal of existing public services in hospitals, which are paid for using Public Money.

TIMING OF CONSULTATION

The timing of this Consultation is also called into question as it was timed at the same time as the recess for forthcoming Council Elections. This leaves populations without access to advice from full sitting Councils and Council reps on local Health Boards. Therefore the Consultation must be extended beyond the statutory 3 months consultation period to allow Newry, Mourne and Down Council Representatives and other Councils in other areas to make a response on behalf of their electorate.

NEWRY, MOURNE & DOWN COUNCIL – NEEDS A HYPER ACUTE STROKE UNIT & AN ACUTE STROKE UNIT IN DAISY HILL HOSPITAL, NEWRY

>Newry Mourne and Down Council – has the 3rd highest council population in NI of  179,000 people (of which 105,300 residents live in rural areas ). If any of the Six pre-selected Options in the Consultation are chosen – this entire local government district will be left with NO Hyperacute or acute stroke /Rehabilitation Units and no timely access to Thrombolysis.

This deliberate plan to remove without a trace the existing designated Daisy Hill Acute Hospital combined Specialist Acute + Rehabilitation Stroke Unit is deplorable, and a public health injustice which cannot be condoned. (Stroke services are assured in Derry City and Strabane Council with a population of 150,500 with only 49,900 people living in a rural area.)

OPPORTUNITY & HOPE

Despite all these issues – there is STILL an opportunity for our excluded populations to put the best case forward for their existing Stroke Units. The only positive aspect of the Reshaping Stroke Consultation 2019 is that we have been given the opportunity to answer Q.6 with additional options

PRESENTING A NEW OPTION TO INCLUDE ALL N.I.

The answer as shown in the graphic is suggested for public consideration. In the Consultation Questionnaire Q. 6 asks: “Are there additional options that we have not considered?”

Q6 SUGGESTED ANSWER : 5 Hyperacute Stroke Units (HASUs) and 5 Acute Stroke Units (ASUs) at 5 acute hospitals in NI at: (1)Royal Victoria, Belfast; (2) Daisy Hill Hospital, Newry; (3) South West, Enniskillen; (4) Altnagelvin, Derry and (5) Causeway Hospital, Coleraine.

This option is based on existing acute stroke units that already give specialist CT scanning and Thrombolysis. This option offers timely equality of access to these necessary specialist stroke services more evenly distributed across NI and to include the rural population – ignored in the consultation.

In this option Antrim, Craigavon (a satellite town of Belfast) and Ulster Hospital, Dundonald – are all within 30 minutes motorway journey of Belfast and can advantageously avail of both Thrombolysis + Thrombectomy in the Royal Victoria Regional Hospital (already confirmed as having a HASU and an ASU).

Daisy Hill Acute Hospital (DHH) Newry City is in a strategic location where patients from Banbridge (approx 15mins travel from Newry City) and South Armagh and Down can avail of timely access to specialist stroke services (scanning and Thrombolysis ) in Daisy Hill (DHH) Hyperacute Stroke Unit + Rehabilitation in DHH Acute Stroke unit.

CONCLUSION YOUR LAST CHANCE to air your views in support of Daisy Hill specialist stroke unit.

The most meaningful way we can put the best case forward for the existing Daisy Hill combined Specialist Acute Stroke/ Rehabilitation unit and its dedicated staff in the Reshaping Stroke Consultation is by taking our time to respond to the questionnaire (including answering Q6).

Don’t give any rushed answers – the closing date is not until June 2019, and you can only submit one response each.

It should also be noted that the Complete Online Form’ button, and online form is set up to force people to choose one of those six options – which all mean the end for the stroke units in Daisy Hill Hospital and in Causeway Hospital. 

WE CAN and have the right to CHALLENGE these decisions and the options given and put the best case forward for RETENTION and ENHANCEMENT of Daisy Hill existing acute stroke rehab unit and its specialist services to ensure its rightful place in the network of stroke services in NI for the LONG TERM FUTURE.

More posts relating to the Stroke Consultation coming here soon and on: https://en-gb.facebook.com/daisyhillforlife/

The united community of Newry and Mourne and South Armagh will work together to ENHANCE stroke services in Daisy Hill Acute Hospital

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