by Admin 4

Consultation on changes to Access to Urgent & Emergency Care Services 2022 (Department of Health NI)

Department of Health NI proposals to radically change HOW and WHERE the public can ACCESS Accident and Emergency Care, are out for consultation, so the people can agree or disagree to this permanent Change or Withdrawal of Services.

The Urgent and Emergency Care Services Review Consultation 2022* proposes plans to re-organise the current system of ACCESS to Urgent and Emergency Care Services (including Hospitals). It also deals with “how older people and others will be offered treatment in the community to avoid admission or delays in hospital.” The Consultation says changes are needed to help with issues like over-crowded EDS, too many patients waiting over 12 hours.

What will these proposals mean for you and the people of Newry & Mourne, South Down and South Armagh, Banbridge, Armagh etc?

Future services and investment for all Hospitals in NI including Newry’s Area Hospital, Daisy Hill will depend on these new changes.

Department of Health NI Urgent and Emergency Care Services Review Consultation 2022

The Urgent and Emergency Care Consultation Report suggests that future Emergency/ Urgent Care Services should use the “experience gained locally” during the pandemic.
The people will remember that during pandemic THERE WAS NO EMERGENCY SERVICE IN NEWRY under the Southern Trust from 28th March 2020 to 19th October 2020.

The local experience / service was, the Southern Trust CLOSED the Emergency Surgery & Emergency Medical services at Daisy Hill Hospital Type 1 ED in Newry, and Daisy Hill staff were re-deployed –to provide 3 EDs including a children’s ED in Craigavon hospital.

Daisy Hill Acute Hospital in Newry was designated to be one of the 9 Major Acute Hospitals with 24/7 consultant -led Emergency Surgery and Emergency Medical Services necessary to provide Acute hospital services fairly to everyone no matter where they choose to live in NI in 2003.

However, at the beginning of the pandemic, the Southern Trust was the only Health and Social Care Trust in NI to close an acute hospital Type 1 ED.

Daisy Hill Acute Hospital has also been left out of the NI Critical Care Network, and the Southern Trust Stage 1 and Stage 2 Rebuilding plans, showing little regard for the unscheduled care needs of the large populations Daisy Hill was designated as an Acute Hospital for.

Time for Investment for Newry +Mourne LGD 2020

The Southern Trust consistently LEAVES DAISY HILL HOSPITAL, NEWRY OUT of their necessary Capital Priorities Business plans submitted to the Department of Health. Because of this -Daisy Hill in Newry City is the only Acute hospital in all of NI waiting on finance for future Redevelopment, especially the NEW hospital building, which was agreed by the Secretary of State in 2005.

PROPOSED LOCATIONS FOR URGENT AND EMERGENCY CARE SERVICES

The Department of Health Review and Consultation does not give Names of Locations for Future Urgent and Emergency services, but instead state they will provide them in the “RIGHT PLACE”.

Newry & District with 159,600 patients has the 2^nd highest number of patients on GP Federation Registers in NI. We need to tell the Department of Health in this Consultation that based on POPULATION size, DAISY HILL ACUTE HOSPITAL, NEWRY IS THE RIGHT PLACE for Type 1 Consultant-Led Emergency Department with and Emergency Surgery and Emergency Medicine.

The Department of Health NI wants us to tell them if they have left anything out of the Urgent and Emergency Services Consultation Proposals before they finalise the plan. All views put forward to the Consultation will go directly to the decision makers at the Department of Health; whose responsibility it is to assess the health needs of the population, and to then commission services, based on this.

STROKE IS A MAJOR 999 EMERGENCY

Stroke Services are being consulted on again in this consultation, as it is a major Emergency service which we are still told to ring 999 for. The Bengoa Report inappropriately recommended the Centralisation of Stroke services from Daisy Hill, Newry City to Craigavon. The result of which was shown in the Department of Health NI Consultation on Reshaping Stroke Services in 2019 when Daisy Hill’s Stroke Unit was unfairly LEFT OUT of all the Options for Location of Acute and Hyper-acute Stroke units. Craigavon, because of the Bengoa Recommendation as a local Case Study was in ALL of the Options for both Hyper-acute and Acute stroke Units, while Newry’s Daisy Hill was in NONE.

Act FAST Stroke - HyperAcute Stroke Unit for Newry 2019

No reply was ever given to any of the 19,000 people in NI who responded to the ‘Reshaping Stroke Services’ Consultation and many objected or gave alternatives to the proposals. This needs to be cleared up NOW as this consultation is in provision of Emergency/Urgent Care for the future.

If you want to make sure you can still access Emergency services at Daisy Hill Acute Hospital in Newry, in the future – This is how we tell them -We are ENTITLED TO IMMEDIATE ACCESS TO 24/7 CONSULTANT-LED EMERGENCY SURGICAL AND EMERGENCY MEDICAL SERVICES IN DAISY HILL ACUTE HOSPITAL, NEWRY CITY. You can reply to the Consultation questionnaire online and in writing until 01 July 2022. (Link below)

People power through Consultations -Based on demographics Daisy Hill Acute Hospital, Newry should be confirmed as a location for a Hyperacute and Acute Stroke Unit

More information on this Dept. Of Health NI Consultation will follow shortly on Daisy Hill for Life Facebook page and on this blog Daisy Hill Hospital for life

Daisy Hill Acute Hospital Emergency Department serves the entire area of Newry and Mourne and South Armagh the largest popultation in the Southern Trust

LINKS
https://www.health-ni.gov.uk/consultations/consultation-review-urgent-and-emergency-care-services-northern-ireland Consultation Documents links

REFERENCE
*Review of Urgent and Emergency Care Services in Northern Ireland – Consultation Report & Strategic Priorities Department of Health Northern Ireland, 2022.

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© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2022. 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.

11.25.19

by Admin 4

NI Stroke Consultation: Call for Dept. of Health to Assess for Population Health and Rural Needs as Next phase of Work

Dept.of Health NI have stated in Hospital Reconfiguration Update Nov 2019 that 19,000 responses were submitted to NI ‘Reshaping Stroke Care’ Centralisation proposals and 4,500 responses received on proposed centralisation of NI Reshaping Breast Assessment Services.

The Department’s plans to proceed after these two consultations differ radically with a plan to carry out a Population Health Needs Assessment for BREAST ASSESSMENT but NOT FOR STROKE SERVICES.

The two statements on (1) Stroke and (2) Breast Assessment services appear below.
(1) Statement on ‘Reshaping Stroke Care’ services:

“A consultation on improving stroke services to improve outcomes launched in March 2019. The consultation document set out seven commitments to improve stroke care across the stroke pathway, alongside six potential options for the establishment of a hyperacute stroke network in Northern Ireland.
19,000 consultation responses were received. The Department is currently analysing consultation responses to inform the development of a preferred model for stroke care.”
Dept. of Health NI (DoH) 2019 Hospital Reconfiguration Update

(2) Statement on ‘Reshaping Breast Assessment Services’ :
“A consultation on proposals to improve breast assessment services ran from 25 March to 30 August 2019.
Over 4,500 responses have been received. The Department is currently analysing all responses. This will help to inform the next phase of work to review breast cancer treatment services which is commencing with a Population Needs Assessment. Further details will be announced in the weeks ahead.
Dept. of Health NI (DoH) 2019 Hospital Reconfiguration Update

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

POPULATION HEALTH NEEDS ASSESSMENT VITAL FOR BOTH STROKE SERVICES AND BREAST CANCER SERVICES.

The Department’s plan to carry out a “Population Health Needs Assessment” for Breast Cancer services as a next phase of work is a good proposal, but where is the plan to carry out a Population Health Needs Assessment for specialist emergency, inpatient, outpatient and rehabilitation treatment for Stroke Services covering the complete stroke pathway – across NI? THERE HAS NEVER BEEN ONE.

A failure to carry out accurate Population Needs Assessments for health services is a recurring theme in the Southern Trust area – NO NEEDS ASSESSMENT WAS UNDERTAKEN as part of the SOUTHERN TRUST STROKE CONSULTATION in 2014.

Despite this, the 2016 Full Bengoa Expert Panel Report used the controversial proposed removal of Specialist Acute Stroke services, and its specialist Acute Stroke staff, from Daisy Hill acute Hospital in Newry as the prime local Case Study for Centralising Stroke Services in NI.

The full Bengoa Report inappropriately promoted (quote below) the choice of Craigavon Hospital for a Specialist Stroke Unit, singled out ahead of all other NI hospitals, and WITH NO NEEDS ASSESSMENT.

This was proposed to make sure that Craigavon could have a 24/7 specialist Stroke Centre leaving Daisy Hill Newry without its existing life saving combined specialist Acute Rehabilitation Stroke Unit and its valuable specialist stroke staff.

“In 2014…, a decision was taken to create a single specialist stroke inpatient unit within the Southern Health and Social Care Trust, at Craigavon Area Hospital. The Trust is proposing to provide a consistent and specialist service 24/7 in one centre rather than spreading the specialist team of staff across four sites. Daisy Hill Hospital will continue to provide ongoing rehabilitation and support through community stroke teams working to a regionally agreed care model.”
Bengoa Expert Panel 2016 (Full Report) (pg 72/ 73).

WHY ASSESS NEED?

Population Needs Assessments are widely recognised as a statutory requirement for health commissioning across the UK to ensure fairness and to reduce inequalities. A Needs Assessment is absolutely vital to ensure that immediate access to stroke services is available for all NI stroke patients – not just those attending hospitals confirmed in all six options in the urban areas of in and around Belfast namely the Royal, Craigavon and Altnagelvin.

POPULATION NEEDS ASSESSMENT DATA MUST USE OFFICIAL NISRA STATISTICS

This Needs Assessment must be undertaken using accurate NISRA Local Government Districts Demographics – not by using (1) imaginary theoretical demand of 600 stroke patients to certain hospitals or (2) Integrated Care Partnerships (which vary across local government districts).

Neither is an accurate statistical representation of the POPULATION health needs of an area.

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.

DEPT. OF HEALTH N.I. ARE FAILING TO ADDRESS THE HEALTH NEEDS OF NEWRY & MOURNE POPULATION

(1) Newry & Mourne LGD is consistently the HIGHEST POPULATION IN THE SOUTHERN TRUST OPERATIONAL AREA

(2) Newry & Mourne LGD is consistently the 4TH HIGHEST POPULATION IN NI -SINCE c1972

Newry and Mourne locality has always been the largest population of the 5 localities (LGDs) in the Southern Trust and must have investment for a Specialist Acute Hospital.

The DOH, PHA, HSCB and Commissioners need to take action to assess Population Health Needs and provide services for Newry & Mourne former LGD , (which includes South Armagh) both as:

(1) Newry & Mourne has been the consistently largest local government district that remains in the operational area of the Southern Trust since its inception in 2007. NISRA demographics confirm this.

Latest official population stats for the 5 LGDs in the operational area of the Southern Trust

(1)Newry & Mourne ( 105,693*); (2) Craigavon ( 101,489*); (3)Armagh(62,976*) (4) Dungannon (62,666*) and (5) Banbridge (50,717*) [ [2018* NISRA]. This has been consistently ignored by the Southern Trust since they came into operation in 2007.

(2) Newry &Mourne LGD has always been the 4th highest LGD population in NI since 1972 (for nearly 50 years) after only Belfast, Lisburn (Greater Belfast ) and Derry.

(3) NISRA demographics confirm the Newry & Mourne population is projected to be the 3rd HIGHEST LGD POPULATION IN THE WHOLE OF NI BY 2023 with 110,090 population after only (1st)Belfast (289,130) and (2nd) Lisburn (Greater Belfast): 133,106. Derry is projected to be the 4th highest population in NI with 110,028 (NISRA).

These demographics were not considered in the ‘Reshaping Stroke Care’ Consultation or by the Southern Trust. A population Health Needs Assessment using accurate statistics will show the DoH the population health needs within Newry & Mourne, including needs for specialist stroke services.

A Population Health Needs Assessment (at local Government District Level) using accurate NISRA demographics will show quite clearly the continued need for specialist Stroke staff in Daisy Hill acute Hospital combined Stroke Unit, in order to provide time crucial emergency, acute and rehabilitation stroke care for the Newry & Mourne population and further afield within the same time frame as in urban areas in NI.

Centralisation of stroke services to one area in Craigavon will not provide safe stroke care in Newry & Mourne and will cost lives.

PHASE OF WORK REQUESTED:

CALL FOR THE DOH, PHA, HSCB and COMMISSIONERS TO:

1. Conduct a Full Population Health Needs Assessment at individual Local Government District level (not at Trust level) using official NISRA Statistics – not Administrative stats such as Integrated Care Partnerships or theoretical modelled hospital demand.
2. Carry out Full Rural Impact Assessment (Rural Needs Act 2016)
3. Carry out an Environmental Impact Assessment to assess the Carbon Footprint implications of Centralisation
Then
4. Rewrite the Stroke Consultation and Stroke Options following these assessments, based on population needs, along with the Consultation Responses.

WHY THE STROKE OPTIONS NEED TO BE RE-WRITTEN

Under “Change or Withdrawal of services” – ALL 8 existing specialist Acute Stroke Units (including Daisy Hill, Newry combined specialist Acute Stroke Rehabilitation Unit) , NOT JUST 6 STROKE UNITS are entitled to be included in an NI wide consultation questionnaire options for upgrading to Hyperacute stroke units and retained as Acute Stroke Units.

The finally selected options must ensure immediate access to Emergency and inpatient specialist stroke Care in a fair and regionally balanced way across NI

>>>>>BACKGROUND

Dept. of Health NI latest Update to NI 2019 ‘Reshaping Stroke Care’ Consultation can be seen at the following link:
https://www.health-ni.gov.uk/hrn-newsletter-edition1

For Bengoa Report: Systems not Structures: Changing Health & Social Care (FULL REPORT) (link Below) See pages 72/73
https://www.health-ni.gov.uk/topics/health-policy/systems-not-structures-changing-health-and-social-care

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© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2021. We welcome sharing of this info and the use of excerpts and links, provided that full and clear credit is given to http://www.savedaisyhillhospital.com and Daisy Hill for Life with appropriate and specific direction to the original content. Thank-you!

07.30.19

by Admin 4

Clinical evidence proves the importance of ‘Golden Hour’ in Emergency Stroke care

The effectiveness of stroke treament within the ‘Golden Hour’ is well documented in clinical research and in the stroke treatment community. (Hussain, M.S.(2018); Fassbender, K.et al (2013); Saver, J.(2006,2010)

Clinical evidence proves the importance of the ‘GOLDEN HOUR’ in Emergency Stroke care, but ‘Golden Hour’ is not recognised by Department of Health (DoH).

It is well known that STROKE is a 999 EMERGENCY where every second counts for the patient receiving acute stroke care and the critically time dependant clot-busting drug Alteplase used in Thrombolysis.

The options given in the 2019 Stroke consultation show clearly that the Department of Health NI are IGNORING the fact that every stroke patient, no matter where they live, needs to be seen and treated as an Acute Stroke Care 999 Emergency ideally within the ‘Golden Hour’. This means making pre hospital travel times as SHORT AS POSSIBLE, so that the patient can ideally be treated within the ‘Golden Hour ‘from onset of stroke to needle time.
Rather than make pre-hospital travel times SHORTER, the DoH are proposing to make pre hospital travel times LONGER for patients living in Newry Mourne & Down and other areas in NI.

Stroke patients who presently are scanned in Daisy Hill (and if eligible) given Thrombolysis are already immediately transferred to the Royal for Thrombectomy if suitable.

If 2019 Reshaping Stroke Care proposals go ahead, dying stroke patients WILL BE DENIED IMMEDIATE TREATMENT and have to be transferred to Craigavon, 45 minutes away (to see if they are even suitable for Thrombolysis, never mind Thrombectomy) and will have much worse outcomes due to the delay in transfer and will be denied the best chance for survival.

TIME DELAY IN GETTING 999 EMERGENCY CARE IS NOT ACCEPTABLE

It is not acceptable that people from the Rural Areas of NI who will already have travelled long distances to access existing specialist Stroke Units, (using up precious minutes of the ‘Golden Hour’ already) will have to travel even FURTHER, losing vital brain cells and causing untold brain damage on the journey. It also means that patients who suffer a stroke when in hospital or ED will be denied access to the existing specialist Acute Stroke/Rehab Unit in Newry and denied immediate treatment.

WHY IS THE FIRST HOUR TERMED ‘GOLDEN’?

The Golden Hour in stroke is well supported by Clinical Evidence

The effectiveness of treatment in the GOLDEN HOUR is well documented in the emergency medicine and stroke treatment community, even if our DoH refuse to recognise the term ‘Golden Hour’ in the recent FAQ/ Frequently asked Questions supplement to the consultation document (see FAQ5).

It is well known that patients receiving treatment within the first 60 minutes of symptom onset, (termed the Golden Hour,) have the greatest opportunity to benefit from restoration of blood flow therapy with respect to disability and living independently. This time-frame is when the volume of salvageable brain and the patient’s capacity to benefit from clot-busting therapy are greatest.
The reason the first hour of stroke is called ‘golden’ is because stroke patients have a much greater chance of SURVIVING and avoiding long-term brain damage if they arrive at the hospital and receive treatment with a clot-busting drug called TPA (Altepalse) within that first hour from onset of stroke:

“Therapeutic benefit is maximal in the first minutes after symptom onset and declines rapidly during the next 4.5 hours.” (Saver MD)

DoH DO NOT RECOGNISE THE TERM ‘GOLDEN HOUR.’

The DoH try to justify selectively making Stroke patients travel further for immediate Emergency Stroke Care during the ‘Golden Hour’ from onset of stroke in Newry Mourne & Down by stating that: “the Golden Hour is not a recognised term in Stroke Care. In our healthcare system we work to the National Clinical Guidelines for stroke, which is the definitive source of how stroke care should be delivered in the UK.”

It is the DoH’s opinion that: “The most important factor in stroke care is not the time to hospital. It is the time to expert assessment, brain scanning and treatment that is critical.” (See FAQ 5:Taken from Questions and Answers Supplement to 2019 Stroke Consultation).

CLINICAL EVIDENCE SUPPORTING IMPORTANCE OF ‘GOLDEN HOUR’

At the International Stroke Conference 2018 in Los Angeles M. Shazam Hussain, MD, Director of Cleveland Clinic Cerebrovascular Center presented significant findings that the “golden hour” is proving to live up to its name, even for patients with one of the most serious forms of ischemic stroke.

According to this study, 52 percent of individuals suffering an ischemic stroke had better long-term outcomes if they received Thrombolysis medication (Alteplase) within 60 minutes of symptom onset. This compares to only 27 percent of patients showing good long-term outcomes – with respect to disability and living independently — if administered Alteplase beyond the golden hour.

A summary of The Lancet article (2013): ‘Streamlining of pre-hospital stroke management: the golden hour’ reinforces the importance of the narrow time-frame or ‘Golden Hour’:

“Thrombolysis with Alteplase administered within a narrow therapeutic window provides an effective therapy for acute ischaemic stroke. However, mainly because of prehospital delay, patients often arrive too late for treatment, and no more than 1–8% of patients with stroke obtain this treatment.
We recommend that ALL LINKS in the PREHOSPITAL STROKE RESCUE CHAIN must be optimised so that in the future more than a small minority of patients can profit from time-sensitive acute stroke therapy.”
The Lancet article (2013)

Therefore pre-hospital travel time for the Newry Mourne and Down population should also be shortened, not lengthened, in receiving 999 Emergency Stroke Care to save lives with better outcomes.

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, NEWRY IS THE RIGHT PLACE FOR A HYPERACUTE STROKE UNIT – A VITAL OMISSION FROM THE 6 PROPOSED 2019 STROKE CONSULTATION OPTIONS

Newry Mourne and Down – with a population of 180,000 is the third largest Local Government District population in NI. Daisy Hill Acute Hospital, Newry City with its STRATEGIC LOCATION – is the right place, entitled to have a hyperacute stroke unit co-located with an acute stroke unit.

This option will give a fair and equitable chance of survival with better outcomes for dying stroke patients in this LGD, like the population attending the Royal, Altnagelvin and Craigavon.

‘TIME LOST IS BRAIN LOST.’

The Emergency Stroke Care “Golden Hour” is already a very narrow time-frame. Additional delay in pre-hospital travel times which the DoH are selectively imposing on the Rural Catchment population of Newry Mourne and Down will cost lives, not save saves and cannot be condoned.

The population is entitled to fair and equitable treatment, so this proposal to withdraw emergency and specialist acute stroke care from the combined Specialist Acute Stroke/Rehab Unit, which has existed since pre-2003 in Daisy Hill Acute Hospital, Newry, must be challenged!

You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

07.20.19

by Admin 4

Largest rural population in NI: Newry, Mourne and Down Local Gov. District must have immediate access to life saving 999 Emergency Stroke Care

Withdrawal of immediate access to life saving 999 Emergency Stroke Care, including direct admission into the existing specialist Acute Stroke Unit from Newry, Mourne & Down Locality is not fair and equitable treatment. Under the Rural Needs Act (NI) 2016 due regard must be given by Public Authorities to the needs of rural populations to fairly access key public services. This includes immediate, not delayed access to hospital stroke care. The largest rural population is in Northern Ireland is in Newry, Mourne & Down Local Government District which includes South Armagh.

Under the Rural Needs Act (NI) 2016 due regard must be given by Public Authorities to the needs of rural populations to fairly access key public services. This includes immediate, not delayed access to hospital stroke care.

The largest rural population is in Northern Ireland is in Newry, Mourne & Down Local Government District which includes South Armagh.

Since 2018, the Rural Needs Act 2016 (NI), which aims to deliver fairer and more equitable treatment in Rural areas, must be adhered to by all Public bodies in NI. Because of this, the Dept. of Health filled in a Rural Needs Assessment Form to accompany the 2019 NI Stroke Consultation.

Definition of Rural in Rural Needs Assessment Form

On this form, the definition of “Rural” which according to the DOH “is better able to distinguish between those who will be MOST IMPACTED by additional travel times caused by proposed changes to services is:
“Populations outside of a 30 minute drive time of Derry/Londonderry or Belfast”

Using the above definition confirms that the 5 Urban hospitals in the Stroke Consultation 2019 are:
Altnagelvin, Royal Victoria, Craigavon, Antrim and Ulster hospitals,
while there are only three Rural Acute hospitals:–
Daisy Hill, Newry, Causeway Hospital, Coleraine and South West Hospital, Enniskillen.

The DoH’s reply to Question 2B in the Rural Needs Assessment states:

“The key impact that differently affects rural dwellers is likely to relate to travel times to hospital etc.” They continue:
“ALL OF THE OPTIONS outlined in the consultation document INCLUDE the provision of hospital care” at “Altnagelvin, Craigavon and Royal Victoria Hospital” (all URBAN Sites.) “Therefore people living in the catchment areas for these three sites WILL NOT experience any increase in respect of travel times. Under the potential options, people living in the catchment areas for Causeway Hospital and Daisy Hill Hospital, WOULD experience an INCREASE in journey times if taken to hospital after a suspected stroke.”

INCREASE IN JOURNEY TIMES AFTER A SUSPECTED STROKE FOR RURAL CATCHMENT AREAS

From research by Werner Hacke, MD It is known that the drug “Alteplase” used in Thrombolysis, is nearly twice as effective when administered WITHIN the first 1.5 hours after stroke as it is when administered 1.5 to 3 hours after stroke.

Yet, The DoH have admitted, above, that there WILL BE AN INCREASE IN JOURNEY TIMES for people living in the Rural Catchment areas of Causeway and Daisy Hill hospitals, and that people living in the Urban catchment areas of Altnagelvin, Craigavon, and Royal Victoria hospitals WILL NOT experience any increase in respect of travel times.

They have decided also to WITHDRAW COMPLETELY the existing stroke units in the Rural Locations of Daisy Hill Acute Hospital, Newry and Causeway Hospital, Coleraine. This proposal means dying stroke patients from these Rural localities will have to TRAVEL FURTHER for the CRITICALLY TIME DEPENDENT, LIFE-SAVING drug Alteplase used in Thrombolysis, and direct access from ED into the existing combined Specialist Acute/Rehabilitation Stroke Units in Daisy Hill, Newry, and Causeway Hospital, Coleraine, essential to save lives.

Daisy Hill Hospital Emergency Department is vital for stroke and life threatening emergencies

The 3 Urban Hospitals Altnagelvin, Craigavon, and Royal Victoria will never experience an increase in travel times because they feature in all 6 Options in the 2019 Stroke Questionnaire to be upgraded to Hyperacute stroke units with co-located Acute Stroke Units.

RURAL HOSPITALS OF DAISY HILL AND CAUSEWAY OMITTED FROM ALL SIX OPTIONS

However the two Rural hospitals of Daisy Hill and Causeway have been omitted altogether from all six options, confirming they will be shut down as if they never existed as part of the network providing 999 Emergency Stroke care to the population of NI.

THERE ARE NO RURAL HOSPITALS INCLUDED IN ALL 6 OPTIONS FOR HYPERACUTE AND ACUTE STROKE UNITS.

The DOH forget that Rurality is a factor in allocating Health and Social Care Funding which means that there is extra money to provide services in Rural areas which should be taken into account in deciding where stroke Units will be provided.

*********RURAL NEEDS ACT (2016)*************

To have Three Hyperacute stroke units for Urban Areas of NI in all 6 Options and NO Option for a Hyperacute Stroke Unit for the Catchment population for the LARGEST RURAL POPULATION in NI namely Newry, Mourne & Down (which includes S.Armagh) Local Government District is NOT FAIR AND EQUITABLE TREATMENT in revising policies, strategies and plans, and designing and delivering public services such as Acute Stroke Care under the 2016 Rural Needs Act.

The Rural Needs Act NI 2016, (which is not a devolved matter) is there to PROTECT the Rural Population from this unfair treatment and “can relate to the ability to access key public services such as health, the ability to access suitable employment opportunities, and the ability to enjoy a healthy lifestyle”.

NEWRY MOURNE & DOWN LOCALITY SHOULD ALREADY HAVE A MAJOR ACUTE HOSPITAL

There is no doubt that Newry Mourne and Down LGD with the largest Rural population in NI with 179,000 people, SHOULD ALREADY have a major acute hospital, in Newry as proposed by Secretary of State Peter Hain in 2005.

This Stroke consultation shows that the Department of Health are not even prepared to give dying stroke patients from the largest rural Population in NI, the basic essential need of immediate access to Emergency Stroke Care.

The Rural catchment population for Daisy Hill Acute Hospital, Newry, is not being treated fairly and equitability in the same way as the catchment population of the Urban Stroke Units in Altnagelvin, Craigavon and Royal Victoria Hospitals who will have immediate access, as they should, to life saving stroke care, in Hyperacute and Acute Stroke Units without having to travel further than at present.

This deliberate plan to exclude the Rural populations need for IMMEDIATE, not delayed, access to life saving Emergency Stroke Care, including CT scanning and Thrombolysis, followed by direct access into a specialist Hyperacute Stroke Unit /Acute Stroke Unit will COST LIVES, not save lives of Stroke patients and should not be condoned.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BACKGROUND INFO
Link to Rural Needs Act 2016
https://www.legislation.gov.uk/…/19/pdfs/nia_20160019_en.pdf

“RURAL NEEDS ACT (NORTHERN IRELAND) 2016
Duty of public authorities to have due regard to rural needs
1.(1) A public authority must have due regard to rural needs when— (a) developing, adopting, implementing or revising policies, strategies and plans, and (b) designing and delivering public services.
6. In this Act— “the Department” means the Department of Agriculture and Rural Development; “rural needs” means the social and economic needs of persons in rural areas.”
‘PUBLIC AUTHORITIES’ include:
A Northern Ireland department
A district council
A Health and Social Care Trust
Invest Northern Ireland
The Regional Agency for Public Health and Social Well-Being
The Regional Health and Social Care Board

04.14.19

by Admin 4

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

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

04.04.19

by Admin 4

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 3^rd 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

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2021. We welcome sharing of excerpts & links, provided that full and clear credit is given to http://www.savedaisyhillhospital.com and Daisy Hill for Life with appropriate and specific direction to the original content. Thank-you!

Daisy Hill Hospital for Life

Campaign to enhance Daisy Hill Acute Hospital, Newry for future generations

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