Emergency Department Waiting Times Statistics published by the Department of Health NI indicate that when the number of Emergency Departments in NI was reduced, thousands more people waited over 12 hours in the remaining Emergency Departments in NI .
When there were twenty Emergency Departments in NI, between April and October 2008, statistics show that 49 people waited over 12 Hours to be seen across all the Emergency Departments in NI. (See Table )
The 20 Type 1, 2 and 3 Emergency Departments in NI during the period April to October 2008 are shown below on the map.
COMPARISON
In comparison, when the number of Emergency Departments had been reduced to fifteen EDs across NI, between April and Oct 2020, the number of people waiting over 12 hours had ROCKETED up to 13,365 people.
The figures for 2008 (April to October) are shown below alongside the figures for 2020 in the same 6 month period(April to October) so the comparision can be made. The huge increase in those waiting over 12 hours against the reduced number of EDs open in NI is evident.
The remaining Emergency Departments in NI, with information on whether they were open or closed during the period April to October 2020 is also shown on the map below. The Emergency Department Types ranged from Major Acute Hospital EDs (Type 1) to the Minor Injury Units (Type 3)
Daisy Hill Acute Hospitals’ Emergency Department (Type 1) in Newry was closed during the period Apr-Oct in 2020.
Daisy Hill was the only Acute Hospital ED in NI closed during this period and this closure contributed significantly to the extra numbers waiting over 12 hours in other Emergency Departments (EDs).
CONCLUSION AND SOLUTION
As these Statistics indicate, FEWER Emergency Departments mean THOUSANDS MORE wait over 12 hours, then a SOLUTION to decrease the numbers waiting in Emergency departments across NI, should be:
RESTORE THE NUMBER OF EMERGENCY DEPARTMENTS in NI BACK TO AT LEAST 20 while KEEPING AT LEAST 10 Type 1 EDs (with Emergency Surgery) , including Daisy Hill, Newry and South West, Enniskillen.
This suggested solution will also go some way to helping meet the obligations of Equality Legislation and the Rural Needs Act 2016 to ensure equity of access to emergency healthcare which all the population of NI (Urban and Rural) are entitled to.
BACKGROUND
As the Emergency Department Types in Northern Ireland discussed here ranged from Major Acute Hospital EDs (Type 1) to the Minor Injury Units (Type 3), definitions of each are given below:
DEFINITIONS OF THE THREE SEPERATE EMERGENCY DEPARTMENTS
Type 1departments are defined as those with a consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services on a round the clock basis.
Type 2departments are consultant-led service with designated accommodation for the reception of emergency care patients, but which does not provide both emergency medicine and emergency surgical services and/or has time-limited opening hours.
Type 3 departments are minor injury units (MIU) with designated accommodation for the reception of patients with a minor injury and/or illness. It may be doctor or nurse-led. A defining characteristic of this service is that it treats at least minor injuries and/or illnesses and can be routinely accessed without appointment.
(Source: Urgent & Emergency Care Waiting Time Statistics for Northern Ireland)
BACKGROUND In 2008 there were 20 EDs (Type 1, Type 2, Type 3) Type 1: Altnagelvin, Antrim, Belfast City, Royal, RBHSC, Mater, Causeway, Craigavon, Daisy Hill (Newry), South West, Ulster
Type 2: Lagan Valley, Downe
Type 3: Tyrone County, Mid Ulster, Whiteabbey, Bangor, Ards, Armagh Community, South Tyrone
Daisy Hill Hospital, Newry City – the Acute Area Hospital for Newry & Mourne, South Armagh
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2 Days to Go ! Consultation closes on Fri 1st July 2022 @ 5pm
Please respond to the DOH NI Consultation on Urgent and Emergency Care Services in Northern Ireland . For reasons why – Pls Read Why This Consultation Matters below.
By Post > A hard copy of your response Questionnaire can also be sent to:
Department of Health, Regional Health Transformation Directorate, Annex 3, Castle Buildings, Stormont, Belfast BT4 3SQ
WHY THIS CONSULTATION MATTERS TO THE FUTURE OF DAISY HILL ACUTE HOSPITAL IN NEWRY
The DOH NI Public Consultation on Urgent and Emergency care suggests we should agree to their proposals for future Urgent and Emergency care services in NI and that the services should be delivered as they were during March – Oct 2020. We can’t be expected to agree to this, as this was when Daisy Hill Hospital Emergency Department was closed, Daisy Hill staff were relocated and 3 Emergency Departments were provided in Craigavon and none in Newry.
Because they are planning for this again – the Southern Health and Social Care Trust has received funding for and works completed (Nov2020) for a dedicated additional ambulance handover zone for Craigavon Hospital – but not for Daisy Hill Acute Hospital (Southern Trust Delivery Plan 2021/2022).
The ‘No More Silos Action Plan’ published Oct 2020 is the document that is referred to in the NI Executive Summary Document, when Daisy Hill was excluded from the NI Regional ED Network, NI Critical Care Network and Southern Trust Rebuild Plans. The Executive have been told “Once the public consultation has concluded, proposals will be finalised and an investment and implementation plan will be developed for Ministerial consideration” (Ref: Executive Summary p2/3)
So we can’t agree to this consultation because Daisy Hill hospital ED Newry city – is not included in the No More Silos Action Plan. Daisy Hill Hospital doesn’t feature in this future provision of ED services in NI if they go by No More Silos. We have to tell DOH what’s been left out. Remember Daisy Hill was left out of stroke options, never again must this happen! We must act/reply now or find your way whatever way you can to Craigavon, Mid Ulster.
In 2003 Daisy Hill, Newry was designated as a Major Acute Hospital with a Consultant led 24/7 ED to ensure timely access within one hour to Emergency Surgery and Emergency Medical Care to its very large catchment population. This catchment population depending on access to timely Emergency Surgery and Emergency Medical Care , has increased yearly since then and in 2022 Newry & District has the second highest number of patients in NI (159,599) including the 2nd highest number of children U18 (36,117) registered with GP Practices. (The Highest is in Derry -Source: BSO).
This Consultation closes this Friday 1st July 2022 So please help the community, the economy and for Daisy Hill Hospital today – help keep our Type 1 Emergency Department in Daisy Hill, Newry.
We know you are all just waiting to do whatever you can to help Daisy Hill for all our futures. WE ARE ALL STRONG WHEN WE WORK TOGETHER!
No More Silos is the Department of Health’s action plan to support and maintain urgent and emergency care services, making changes to existing services and introducing new ones to ensure that patients can access the right care, in the right place, and at the right time. In October 2020, the Minister of Health published an urgent and emergency care action plan called ‘No More Silos’. This sought to maintain and improve urgent and emergency care services through the COVID-19 pandemic and beyond.
2. KEEP EMERGENCY DEPARTMENTS FOR EMERGENCIES (pg 7 No More Silos Key Action 2 )
“How will it work? This action is closely linked to the following action to develop Urgent Care Centres. Under the new arrangements, direct access to Emergency Departments will only be possible for patients who arrive by ambulance or who are referred to the Emergency Department from the Urgent Care Centre or by their GP. All patients who make their own way to a hospital site will be assessed by a health professional who will determine whether they should attend ED, the Urgent Care Centre, or some other service. Care will be needed to ensure this does not lead to an increase in 999 calls for an ambulance to access ED. All patients will continue to have 24/7 access to care and advice on current ED sites”
IMPORTANT STATS
Latest May 2022 figures show (after Derry) Newry & District has the Second Highest Number of patients in NI registered with GP Practices. (159,599) including the 2nd highest number of children U18 (36,117) (Source: BSO).
These GP Registers state:
Newry & District has: The Highest number of patients in NI with Heart Failure and Heart Failure due to Left Ventricular Systolic Dysfunction.
2nd Highest number of Patients in NI (after only Derry) with Cardiovascular Disease Primary Prevention, Osteoporosis and Depression
3rd Highest number of Patients in NI (after Derry and Antrim) with Cancer, Coronary Heart Disease, Asthma, Atrial Fibrillation, Chronic Obstructive Pulmonary Disease, Diabetes, Palliative Care and Hypertension (which can lead to heart disease and Stroke).
4th Highest number of Patients with Stroke: South West is 3rd: Causeway 7th: Craigavon 10th. This must inform where stroke services are provided in NI.
WHAT CAN WE DO ABOUT REMOVAL OF ACUTE SERVICES FROM DAISY HILL ACUTE HOSPITAL, NEWRY?
Whether it’s the Type 1 ED, Specialist Stroke Unit and even vital CT scanners – it’s a Tug of War with the Southern Trust. FINALLY NOW – here’s something we can do. We have an address and an opportunity to air our views as part of a Department of Health Framework Consultation. So we MUST USE THIS OPPORTUNITY –as Daisy Hill needs us!
During the Covid pandemic, at a days notice, (without providing a nearby alternative) the Southern Trust removed Daisy Hill Acute Hospital’s 24/7 Type 1 ED services and staff to provide 3 EDs in Craigavon Hospital – one Covid 19, one non Covid 19 and a new Children’s ED.
YOU CAN HELP shape the future, and ensure Daisy Hill isn’t missing from the Regional network as Northern Ireland Rebuilds during and after covid-19 by replying to the ‘Temporary Amendments to the HSC Framework Document’ Consultation, by this Friday 4th December 2020, 5pm.
The Consultation Documents along with info on how to respond can be read in full at: www.health-ni.gov.uk/consultations/HSCframework (Additionally Consultation Links are available at the end of this article.)
IMPORTANT ASPECTS DIGESTED
The Department of Health (NI) has made temporary changes to the 2011 Health and Social Care (HSC) Framework Document where it describes the Role and Responsibilities of HSC bodies .So, the Consultation asks :
If we agree with ‘temporary’amendments needed to change these roles and responsibilities. Although they frame it as an “administrative” change it will mean HSC Trusts will have MORE POWER than before.
2. If we agree with their decision to establish a ‘new’ Management Board for Rebuilding HSC Services in NI (which has been in operation since June 2020 without consultation, until now).
TRUSTS HAVE BEEN GIVEN THE GO AHEAD TO REBUILD AND EXPAND SERVICES WHERE THEY WANT.
The only function of Trusts before was as a ‘provider’ of hospital and community services. But as part of these amendments to the 2011 Framework Document in this Consultation – the role of Trusts is now elevated. Trusts are now responsible for assessing their population needs, planning to meet those needs and delivering ‘appropriate’ services in whatever location or hospital they deem appropriate.
If these changes to the 2011 HSC Framework Document go through according to this current Consultation, the Southern Trust will have the loudest voice influencing the future of Daisy Hill.
This will have a huge impact on all ED and specialist inpatient acute hospital services (including children’s services) in Daisy Hill Hospital, Newry as well as Capital investment shaping the future of Daisy Hill acute Hospital for good. Can you help?
PLEASE ENSURE DAISY HILL PART OF NI REBUILDING PLANS NOW – REPLY TO THE CONSULTATION
Nearly £7 billion has been allocated to the Department of Health and the Southern Trust handle over £800 million – we are entitled to our share of this. If we lose services in these Rebuilding Plans for two years to May 2022 we will not get them back. You can Reply to the Consultation to give your views and ensure Daisy Hill, Newry is part of the NI Health and Social Care Rebuilding Plans at both a Regional and local level.
As Health Minister Robin Swann MLA rightly stated at the 10th Annual Nicon Conference 2020
“Whilst we must face the challenges that lie ahead, we must also continue to rebuild; to transform our services in a way that ensures they are here for those who need them today, tomorrow, and for generations to come.”
Robin Swann MLA (10th Annual Nicon Conference 2020)
Newry & Mourne is projected to be the 3rd highest population in NI by 2025 and presently has the 3rd highest population of children in the whole of NI after only Belfast and greater Belfast.
We are entitled to the same investment as Altnagelvin. We must speak up for ourselves as we have seen that the Southern Trust priorities are not with Daisy Hill
We have to respond to this Consultation and speak up for ourselves, our children and their children to ensure retention and expansion of acute specialist acute services (including children’s services) in Daisy Hill acute Hospital in NI HSC Rebuilding plans NOW.
Ways to Respond
Dont forget the deadline is this Friday 4th December 2020, 5pm.
Which ever you prefer. But please do take part – do it for your family, the future of Daisy Hill, for those who cant take part themselves and for generations to come. Full instructions for responding to this Consultation are available on the Department of Health’s website at: www.health-ni.gov.uk/consultations/HSCframework
Nearly £7 billion has been allocated to the Department of Health and the Southern Trust handle over £800 million – we are entitled to our share of this. If we lose services in these Rebuilding Plans for two years to May 2022 we will not get them back. There has been a hospital in Newry for 175 years – NO ONE IS ENTITLED TO TAKE IT AWAY.
EXTERNAL LINKS TO CONSULTATION
Consultation on Temporary Amendments to the Health and Social Care Framework Document for the period June 2020 to May 2022
Rebuilding HSC Services Programme Coordination Office, Department of Health, Annexe 3, Castle Buildings, Stormont Estate, Belfast, BT4 3SQ
Email: RebuildingHSC.Services@health-ni.gov.uk
Telephone: 028 9052 3231
The Department of Health is inviting us all to tell them what we think about the new Amendments. If we DON’T respond we are letting the DoH and Southern Trust Rebuild (or not) for us and future generations – without us.
Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ – Thank you. Please Follow or Like the Page to receive updates.
MAKE SURE DAISY HILL ISN’T MISSING FROM THE NI REGIONAL NETWORK AS NORTHERN IRELAND REBUILDS DURING/ AFTER COVID-19– AND HELP SHAPE THE FUTURE, by replying to the ‘Temporary Amendments to the HSC Framework Document’ Consultation, by this Friday 4th December 2020, 5pm. The Consultation Documents and info on how to reply can be read in full at: www.health-ni.gov.uk/consultations/HSCframework
You can tell the Department of Health how you feel. It’s your Health service.
You can also use the Online Consultation form. Which ever you prefer. By the deadline of this Friday 4th December 2020, 5pm. But please do take part – do it for your family, the future of Daisy Hill, for those who cant take part themselves and for generations to come. There has been a hospital in Newry for 175 years – NO ONE IS ENTITLED TO TAKE IT AWAY.
EXTERNAL LINKS TO CONSULTATION
Consultation on Temporary Amendments to the Health and Social Care Framework Document for the period June 2020 to May 2022
Rebuilding HSC Services Programme Coordination Office, Department of Health, Annexe 3, Castle Buildings, Stormont Estate, Belfast, BT4 3SQ
Email: RebuildingHSC.Services@health-ni.gov.uk
Telephone: 028 9052 3231
The Department of Health is inviting us all to tell them what we think about the new Amendments. If we DON’T respond we are letting the DoH and Southern Trust Rebuild (or not) for us and future generations – without us.
Nearly £7 billion has been allocated to the Department of Health and the Southern Trust handle over £800 million – we are entitled to our share of this. If we lose services in these Rebuilding Plans for two years to May 2022 we will not get them back. DAISY HILL NEEDS YOU!
Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ – Thank you. Please Follow or Like the Page to receive updates.
The Southern Trust must fast track their plans to open Daisy Hill Hospital ED at once, now that Craigavon Hospital has unfortunately fallen victim to COVID-19 clusters, which were reported on BBC NI News 01.09.2020.
Time is now opportune for the Southern Trust and Southern Local Commissioning Group to prove the truth of the rhetoric to the Southern Trust population how much an essential part of the hospital network, Daisy Hill in Newry is, by reopening the Emergency Department (ED) at once.
“Daisy Hill Hospital is based in the city of Newry and is an essential part of the hospital network provided by the Southern Trust and has been ranked as a CHKS Top 40 Hospital.” (Southern Trust 2017).
Daisy Hill Acute Hospital, Newry City
END OF SEPTEMBER NOT SOON ENOUGH TO OPEN ED
The Southern Trust stated on 24.08.2020 that work is progressing to reopen Daisy Hill ED on a 24/7 basis by the end of September. The Southern Trust Chief Executive has been asked repeatedly to open the ED and the end of September is not soon enough. It is vital to save lives that this date is brought forward to show how effectively they can manage their hospital network.
Daisy Hill 24/7 Type 1 ED was closed on 28th March 2020 – with little warning – so after 6 months to prepare – it is well past time it is reopened, especially given the current circumstance of several covid-19 clusters in Craigavon Hospital.
Mr Shane Devlin praised “The dedication and flexibility of staff during this time has been remarkable” (Southern Trust statement 24.08.2020). This is true of all Southern Trust staff, and especially of Daisy Hill staff who showed immense flexibility by also changing their workplace to Craigavon – but now given the changing circumstances and given the sheer population of Newry & Mourne and beyond – it makes sense that the Southern Trust uses the resources, facilities and staff available in the most sensible way now.
The Diagram and map shows the size of the Southern Trust and the 2 acute hospitals which operate in this Network. It should be noted that Daisy Hill Hospital, Newry is in Newry & Mourne with the largest population (106,499) and largest land mass (898.3 square Km) of all the 5 localities in the Southern Trust area.
Craigavon covers only 281.5 sq Km with less of a population of (102,566) in 2019. (All stats from NISRA) .The map shows the 5 localities / (former) local government districts/LGDs that still remain in the operational area of the Southern Trust, according to its founding legislation.
ED IS A REGIONAL SERVICE
The 106,499 population of Newry & Mourne are being denied time critical access to a Type 1 Emergency Department in a functioning acute hospital, since 28th March 2020 in Newry City.
As they have paid for Regional and Local Urgent and Emergency and acute services through their Regional Rates and Taxes, the population of Newry & Mourne (as well as all of the rest of the population across NI) are entitled to avail of the 24/7 Regional ED Services being provided by the Royal Group of Hospitals including the Royal Belfast Hospital for Sick Children, who have shorter waiting times.
The Southern Trust have a duty of care (under their founding legislation) to provide hospital services in Daisy Hill, Newry – not repeatedly take them away to Craigavon.
Daisy Hill’s Emergency Department has been a vital part of the Northern Ireland Network of Type 1 Emergency Departments for the past 17 years.
The Southern Trust have to end the uncertainty and anxiety caused to the population of Newry & Mourne by the removal of vital ED Services and return Daisy Hills ED and Specialist Staff back to Newry as a matter of urgency.
Sources: Population Stats NISRA 2019 Land Mass Figures – NISRA Southern Trust Statement 24th August 2020 Craigavon Area Hospital: Third Covid-19 outbreak confirmed, Louise Cullen BBC News NI, 01.09.2020 https://www.bbc.co.uk/news/uk-northern-ireland-53989892
PATIENTS ON DOCTORS REGISTERS (NISRA 2018) Derry: 122,280 under 5’s: 8,943 Newry & Mourne: 116,378: under 5’s: 9,481 Craigavon: 105,295 under 5’s: 8,504 Dungannon: 66,848 under 5’s: 5,746 Armagh: 67,930 under 5’s: 5,487 Banbridge: 51,494 under 5’s: 3,927
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Newry, the main Gateway City to NI now, and after we leave the EU, is being denied its rightful place in the Rebuilding of Health and Social Care Services, by the people who are paid to include them.
The graphics which follow show THERE IS NO OTHER Type 1 ED Department in NI that can be accessed within one hour by a third of the population of Newry & Mourne/South Armagh – 38,000 people.
That is why Newry City’s Acute Hospital, Daisy Hill’s ED department was designated in 2003 with 8 other EDs across NI to form a Regional network of 9 Type1 EDs , vital to ensure equality of access within one hour 24/7 to Consultant-led urgent and emergency Care to everyone in NI , no matter where they live – urban and rural.
The Southern Trust needs to take its responsibilities to the Newry & Mourne/South Armagh population seriously and be accountable for their actions. The function of the Southern Trust is to provide hospital accommodation and services in Newry City in Newry & Mourne – the largest administrative area in the Southern Trust.
Their function DOES NOT include the removal of Daisy Hill’s Emergency Department (ED) from the long established Designated Regional network of the nine 24/7 Type 1 ED Departments of Daisy Hill, Royal Group , Antrim, Ulster, Causeway, Mater, Altnagelvin, Craigavon, and S.W. Acute Hospitals, which provided a seamless web of ED care to all of the people of NI over the past 17 years.
The Southern Trust shut down Daisy Hill’s Type 1 ED, at a days notice, without consultation, or any adherence to Equality, Rural Needs, Human Rights, Disability legislation. This Type 1 ED in Daisy Hill Hospital is the only one serving the population of the Southern part of NI one hour drive-time ED Network.
GRAPHICS/MAPS
The accompanying Graphics ‘Drive Times to Nearest Type 1 ED’ show the effect the removal of Daisy Hill ED from the existing network of Nine Type1 EDs across NI has on the Population of Newry & Mourne.
The Department of Health/Public Health Agency and Southern Trust are aware of the importance of this Drive Time information as it was previously analysed and published in the Department’s Pathfinder Project Report and Appendices in 2017. The map in the graphic is a scaled drawn reproduction of the report’s map*(See end for source).
GRAPHIC 1: Drive Time shows approx Drive time to a Type 1 ED across the Southern Trust and wider area when Daisy Hill ED is excluded. It shows that people living in Armagh, Craigavon, Lisburn, and all across the greater Belfast Area are all within a 30 minute car drive time of a Type1 ED. This is as well as being only 30 min Drive time to all other Type 1 EDs in acute hospitals in Belfast). It also shows that Newry & Mourne is most badly affected by removal of Daisy Type 1 Hill ED.
GRAPHIC 2: Focus on Newry & Mourne – Drive Time – focuses in detail at the map showing the area of Newry and Mourne. The Rural areas of the Mournes and South Armagh are most affected without Daisy Hill ED.
Nearly 38,000 people in Newry & Mourne denied right to access a Type 1 ED within 1 hour
Nearly 38,000 people in Newry & Mourne denied right to access a Type 1 ED within 1 hour
Graphic 2 shows the area of Newry & Mourne affected with added reference to Electoral Ward populations. Without DHH ED the population of the following electoral wards have to travel 75 to 90 minutes+ to get to a 24/7 TYPE 1 ED in an emergency situation.
OVER 75 MINUTES DRIVETIME TO GET TO A 24/7 TYPE 1 ED (coloured dark orange on maps): see key
1 : Annalong: 2. Binnion 3 : Kilkeel Central 4 : Kilkeel South 5 : Lisnacree 6 : Rostrevor
60 TO 75 MINUTES+ DRIVE TIME TO GET TO A 24/7 TYPE 1 ED. (coloured dark yellow on maps): see key:
These times are only estimates. Only those of us who have had to make the journey to the nearest ED know exactly how long the journey takes.
The Southern Trust’s has a centralisation policy of provision of all medical and surgical Urgent and Emergency Services. Because of this Southern Trust policy – approximately 38,000 people in Newry & Mourne (including South Armagh) since 28th March 2020, have been potentially denied their right to access immediate life saving care in a Type 1 ED within one hour Drive time from their homes. This includes 8,403 children and 5,914 aged 65+. (Population data from latest NISRA estimated 2019 stats).
REBUILDING PLANS:
Southern Trust made an agreement with other Health Trusts and the Department of Health NI that they will:
(1) Ensure Equity of Access for the treatment of patients across Northern Ireland (2) Minimise transmission of Covid-19; and (3) Protect access to the most urgent services for our population.
By shutting down and refusing to reopen Newry City’s Type 1 ED department the Southern Trust have not ensured “Equity of Access” for the treatment of patients across NI and have denied approx 38,000 men, women and children in Newry and Mourne access to time critical immediate Urgent and Emergency Car within an hour.
They have also destroyed the existing 17 years Regional network of 9 Type1 EDs being provided by all the other Trusts.
JUST LIKE NEWRY AND DAISY HILL WAS LEFT OUT OF THE STROKE CONSULTATION OPTIONS
Like with the Stroke consultation (where all Stroke care was centralised to Craigavon from Newry), the Southern Trust has again wrongly left Daisy Hill out – this time out of the Regional Plans for Urgent and Emergency and other services in their Rebuilding Health and Social Care services plans.
STAND YOUR GROUND
It is on record that there has been a hospital in Newry caring for anyone in need of immediate life saving services for the past 175 years, through famine, wars and the Cholera epidemic.
It took the Southern Trust, to remove its caring specialist staff at a days notice, from Newry to Craigavon, when they were needed most in Newry, during the Covid 19 pandemic, leaving the entire population of Newry & Mourne without a lifeline in Newry city to time critical Urgent and Emergency Care.
All Politicians, Unions, community representatives and individuals. Please stand your ground to get what is rightfully ours because we have paid for it.
The Department of Health get £5 billion to improve the health and social Care of all of the people of NI who need healthcare no matter where they live. Together we will stand our ground to get Newry, the Gateway City to NI and Newry & Mourne/South Armagh firmly back on the map.
Background:
*Map – (Source: Appendices – Daisy Hill Hospital Pathfinder Project – Development of an Unscheduled Care Model through a Co-Production Approach, 20th December 2017. Appendix 2 – Population Needs Assessment – Report of the Needs Assessment Figure 6-2: Drivetime Analysis for NI – DHH ED excluded. Pg 87/88.)
TYPE 1 Emergency Departments are defined as those with a consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services on a round the clock basis.
Daisy Hill Acute Hospital with 24/7 Type 1 ED in Newry is in the Southern Health and Social Care Trust area.
RELEVANT RESEARCH
Extensive research by ‘Developing Better Services’ Report 2003 found that only a total of 9 EDs would ensure the entire population of NI had access WITHIN ONE HOUR to immediate urgent and emergency care no matter where they lived in both urban or rural areas.
Newry & Mourne is the largest locality of the 5 localities in the operational area of the Southern Trust. The five localities in consistent order of population size since the establishment of the Southern Trust in 2007 are: (1) Newry & Mourne (2) Craigavon (3) Armagh (4) Dungannon and (5) Banbridge.
GOVERNMENT CONSTITUENCY INFO
Newry & Mourne Locality is in Two Westminster and NI Assembly constituencies: Newry Armagh and South Down. 17 Wards are in the Newry Armagh Constituency and 13 Wards from Newry & Mourne are in South Down Constituency.
NEWRY & ARMAGH CONSTITUENCY: Daisy Hill, Drumalane, St Marys, St Patrick’s, Windsor Hill, Drumgullion, Ballybot, Newtownhamilton, Camlough, Derrymore, Bessbrook, Tullyhappy, Crossmaglen, Creggan, Silverbridge, Forkhill, Fathom.
SOUTH DOWN CONSTITUENCY: 13 electoral wards of Newry & Mourne are in South Down Constituency.
Spelga, Rostrevor, Sea View, Clonallan, Burren & Kilbroney, Mayobridge, Derryleckagh, Annalong, Binnion, Kilkeel Central, Kilkeel South, Lisnacree, and Donaghmore: 49,000 of the Newry & Mourne population are in the South Down Constituency.
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Southern Trust Rebuild Plans Phase 2 (July to 30 Sept 2020) now published show the Southern Trust have not committed to the permanent re-opening of Children’s and Adults ED Department in Daisy Hill Acute Hospital. Newry. (See Plan page 6, link at end)
Six months with no emergency department through the dark days of the continuing covid-19 pandemic and no commitment to reopen the Consultant Led-24/7 ED – is a public health failure.
The Southern Trust will go down in history as the Health Trust who denied access to Daisy Hill hospital for immediate life saving care to the men, women and children of the largest locality in their care- Newry & Mourne. (106,500 population: NISRA)
Both Phase 2 and Phase 1 Rebuild Plans by Southern Trust show they have not responded to calls by elected representatives and individuals who have campaigned for the return of the Type 1 24/7 ED in Daisy Hill, Newry.
LAW AND STANDARDS THE SOUTHERN TRUST MUST ADHERE TO
1. Establishment Order
The Southern Trust function under their founding legislation is to PROVIDE hospital accommodation and services, not to TAKE AWAY accommodation and Services in Daisy Hill acute hospital, Newry. Their function is not to centralise all services including immediate life saving services like ED from Newry to Craigavon. They have a duty to keep the doors of Daisy Hill acute hospital open to anyone in need of immediate life saving care.
The Southern Trust’s function is to provide health and social care services paid for with public money from Regional Rates and Taxes. They have almost 1,600 admin staff and were given nearly £700 million in 2019/20 from the HSCB for provision of services across ALL of the Southern Trust, not just in some of the 5 geographical areas under their care.
2. Rural Needs Act 2016
Trusts also have obligations under the Rural Needs Act. Every other health trust in NI continued to provide Covid and Non Covid Care in their Rural and Urban Acute Hospitals, except the Southern Trust. The Southern Trust decided to deny access to Daisy Hill Acute Hospital which provided life saving Urgent and Emergency services for children and adults to the largest Rural catchment population in their care. Daisy Hill had ED attendances of 58,277 people in 2018/19.
3. Quality Standards for Health and Social care
Quality Standards for Health and Social care take into account Equality and Human Rights legislation where everyone has to be treated equally and humanely.
To refuse access to immediate life saving care to children and adults alike in Daisy Hill hospital by closing the only Accident and Emergency Department they have access to for immediate life saving services is inhumane treatment and should not be condoned.
The Centralisation of Acute Hospital Services to Craigavon Agenda of the Southern Trust evident in their planning policies is unfair and inhumane – and does not take into account the legislation.
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These letters ask for the Return and Enhancement of all Acute and Emergency services and valuable staff transferred to Craigavon Hospital to be restored to Newry IMMEDIATELY, without delay. If you agree, please contact your local representatives, including Councillors, MLA’s and MP’s, Contact Details Follow Below
After downloading (Just Click on the Blue Links, Select Save and then OK to save to your own device.) The contents of these draft Letters can be used as they are or as a guide to copy and paste from to write your own message/letter to send to MPs, MLAs, Councillors and/other organisations like Health Authorities (e.g. Department of Health) and other Stakeholders regarding the Southern Trust – June 2020 Rebuild Plan.
Please add your name and address to the letter if you are attaching it to an Email so the recipient knows it is genuine and also remember to ‘Save As’ with a New Filename or your choice e.g. Daisy Hill Hospital-2020 or whatever you like maybe using your initials to make it unique.
Tips on attaching the Email-Letter Doc to an Email are at the end of this piece, should you need them.
Dept. of Health ‘Rebuilding Health and Social Care’ Framework docs show services provided during COVID by each of the 5 Health Trusts, and more importantly Plans on how the Health Trusts propose to both Restore and scale back services following the easing of COVID 19.
The Plans each Trust have for Rebuilding HSC Services can be found at:
This letter is to support the view that all Acute and Emergency services and valuable staff transferred to Craigavon Hospital should be restored to Newry IMMEDIATELY, without delay.
If you agree please contact all your local representatives, Councillors, MLA’s and MP’s. They are all in a position as stakeholders to represent our views in relation to the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
MORE CONTACT INFO & LINKS
Contact List for MLAs & MPs for Constituencies of Newry & Armagh/ South Down (14.06.2020)
They are all in a position as stakeholders to represent our views regarding the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
This contact list is based on information as listed on the NI Assembly Portal page and other sources such as MLA’s Facebook pages or political party websites. Despite attempts to be as accurate as possible, if there is any information which is not up-to-date – apologies. (MLAs are listed in alphabetical order.)
Contact List already downloaded from data.gov.uk also directly available here: nmddc-councillors-12nov19
Step by Step Instructions how to Use the Draft Email Letter
Download the Document to your device and ‘Save As’ to give the File a new name of your choice .
Edit the document as you please, either delete or add your own info.
Add your NAME and ADDRESS at the end (or Email Address) so the recipient knows it is a genuine letter.
Click ‘Save’ to Save your new Changes
Compose New Message and Select the Paperclip Icon and select your File to Attach it to your Email message. (You will see the Filename attached to your Email when it has uploaded)
Type the email address of the person you want to send an email to in the To Field.
DAISY HILL HOSPITAL, NEWRY NEEDS YOUR SUPPORT LIKE NEVER BEFORE
3 Reasons why it is so important to Email your Representatives.
>REASON 1: THESE HSC REBUILD PLANS WILL DICTATE WHAT ACUTE SPECIALIST SERVICES WILL BE CENTRALISED TO CRAIGAVON FOR NOW AND THE FUTURE.
The Southern Trust Plan for June to September shows that although they promised to return the urgent and Emergency Care Services and staff to Daisy Hill as soon as the immediate threat of Covid- 19 was over – they have refused to do so. The Southern Trusts function, under the 2006 Establishment Order, is to provide hospital services, in Daisy Hill, Newry for the consistently largest population of the five localities in the admin area of the Southern Trust in Newry & Mourne – (their function is NOT to move them to Craigavon).
These Rebuilding Plans are LONG TERM future plans to decide location of all urgent and emergency care services, diagnostics, cancer, stroke, heart, and will decide which hospitals will shut in the future. This will dramatically affect provision of ED and inpatient hospital services in Newry & Mourne and NI FOR THE FUTURE.
>REASON 2: NEWRY & MOURNE HAS NO OTHER NEARBY ALTERNATIVE FOR URGENT AND EMERGENCY CARE AND INPATIENT CARE SERVICES:
In 2019 THERE WERE 60,000 ATTENDANCES TO DHH ED. When all ED services and ED staff were suddenly stripped from Daisy Hill Hospital and centralised to Craigavon Hospital at the height of the Covid Pandemic, the people of Newry & Mourne and surrounding areas unacceptably had no nearby alternative ED to go to for either Covid or non-Covid Emergencies. Adults and children alike, requiring any emergency care which needs immediate attention are now having their LIVES PUT IN DANGER because the Southern Trust are refusing to provide treatment in Daisy Hill ED now or in the future.
TAKE YOUR PICK
In direct comparison, Craigavon population has many alternative EDs to go WITHIN HALF HOURS MOTORWAY JOURNEY AWAY .They are as follows: The Royal (NI Regional Hospital), Royal Hospital for Sick Children, The Mater (NI Covid Centre), the Ulster, the City (formerly Covid Nightingale Hospital), Antrim Hospital, and Lisburn Hospital.
>REASON 3: POPULATION STATS: Newry & Mourne has been 4th highest locality population in NI since pre 1972 and is projected to be 3rd highest population in NI by 2023. Since the Southern Trust was established in 2007 Newry & Mourne has always been the largest of the 5 localities in the Southern Trust – with greatest need and THIS CAN BE IGNORED NO LONGER. In 2019 Newry & Mourne has the 3rd highest number of births in NI. This all can be confirmed by official NISRA stats.
>WHO CAN I EMAIL?
1. Representatives (Councillors, MLA’s and MPs).
2. Public Authorities (Public servants – Dept of Health, Health Trusts)
3. Others in your area who you may think of yourself e.g. Charities, community groups, business leaders etc
Two Draft Letter/Emails re Restoration of Daisy Hill ED June 2020 for those who wish to write to their MP, MLAs or Councillor or other Stakeholders regarding the Southern Trust – June 2020 Rebuild Plan is available by clicking on the blue links below:
for you to download and type on (or print off if you want to post it). After downloading save the File with a new name if you intend to attach it to an Email. Edit as you please and remember to add your NAME and ADDRESS (or Email Address) so they know it is a genuine letter.
Dept. of Health ‘Rebuilding Health and Social Care’ Framework docs show services provided during COVID by each of the 5 Health Trusts, and more importantly Plans on how the Health Trusts propose to both Restore and scale back services following the easing of COVID 19.
The Plans each Trust have for Rebuilding HSC Services can be found at:
This letter is to support the view that all Acute and Emergency services and valuable staff transferred to Craigavon Hospital should be restored to Newry IMMEDIATELY, without delay.
If you agree please contact all your local representatives, Councillors, MLA’s and MP’s. They are all in a position as stakeholders to represent our views in relation to the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
MORE CONTACT INFO & LINKS
Contact List for MLAs & MPs for Constituencies of Newry & Armagh/ South Down (14.06.2020)
This contact list is based on information as listed on the NI Assembly Portal page and other sources such as MLA’s Facebook pages or political party websites. Despite attempts to be as accurate as possible, if there is any information which is not up-to-date – apologies. (MLAs are listed in alphabetical order.)
Newry & Armagh MLAs
Cathal Boylan (Sinn Féin)
William Irwin (DUP)
Liz Kimmins (Sinn Féin)
Justin McNulty (SDLP)
Conor Murphy (Sinn Féin)
Cathal Boylan MLA(Sinn Féin);
Email: cathal.boylan@mla.niassembly.gov.uk
Constituency Address: Thomas Street, Armagh, BT61 7QB;
Phone: 02837511797
William Irwin MLA (DUP)
Email: william.irwin@mla.niassembly.gov.uk
Constituency Address: 18 Main Street, Rich Hill, BT61 9PW; Phone: 028 38870500;
Liz Kimmins MLA (Sinn Féin)
Try Email as listed on MLA’s facebook profile, Email: lizkimminssf@gmail.com or Newry & Armagh Sinn Fein Email address: sfcrossmaglen@gmail.com
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
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.
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.
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*)
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’
Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ – Thank you. Please Follow or Like the Page to receive updates.
Daisy Hill Hospital for Life 