Tag Archives: Causeway Hospital Coleraine

10.06.25
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REASONS WHY DAISY HILL IN NEWRY CITY IS ENTITLED TO BE AN AREA HOSPITAL – EXPLAINED

Daisy Hill Newry entitled to be Area Hospital in Hospital network 2025


The Department of Health will soon announce the outcome of the Hospital Network Public Consultation to reveal if Daisy Hill Acute Hospital in Newry has been renamed as an Area Hospital.

Four evidence based reasons for Daisy Hill Hospital in Newry to be renamed as an Area Hospital are:

(1) Historical Basis

(2) Population size

(3) Large land area and

(4) Strategic location.

REASON 1: HISTORICAL BASIS -THE FACTS: DAISY HILL – A NHS HOSPITAL IN 1949 AND 1 OF 9 EQUAL ACUTE HOSPITALS DESIGNATED IN 2003

Daisy Hill in Newry was made an NHS Hospital in 1949, and was designated by Government as one of a REGIONAL Network of nine EQUAL status major Acute Hospitals in NI in 2003. These decisions were made then, because of the large Population and large land area size, after a DOH Regional Consultation, ‘Developing Better Services’.

In 2003 it was a Ministerial Decision by Minister Des Browne to designate Daisy Hill in Newry as one of the 9 Acute Hospitals of Equal standing. All of these nine hospitals are vital to ensure timely access to CONULTANT LED 24/7 Emergency Surgical and Emergency Medical AND MATERNITY Services WITHIN ONE HOUR, to the entire population of NI no matter where they choose to live. * (Ref 1)

REASON 2: POPULATION SIZE –FACT : NEWRY & MOURNE – THIRD HIGHEST POPULATION in NI

Using official NISRA 2026 Estimated population figures, NEWRY & MOURNE (FORMER LGD) IS RANKED THIRD HIGHEST POPULATION OF THE 26 FORMER COUNCILS IN NI.

Ranking out of 26 councils /Name of Council/ 2026 est. Population size

  • 1st out of 26: Belfast LGD -290,808 people
  • 2nd out of 26: Lisburn LGD – 136,843 people
  • 3rd out of 26: Newry & Mourne LGD – 111,508 people
  • 4th out of 26: Derry LGD – 110,577 people

This 3rd place ranking for Newry & Mourne shows its very high population across the NI Region of 26 councils.

NEWRY & MOURNE IN THE TOP FOUR in NI FOR OVER 5O YEARS

NISRA Statistics also show that SINCE 1971 NEWRY & MOURNE LGD HAS RANKED IN THE TOP 4 HIGHEST POPULATIONS IN NI FOR OVER 50 YEARS WITH BELFAST, LISBURN (GREATER BELFAST) AND DERRY. So Newry & Mourne is growing still further and is entitled to have an Area Hospital.

Important Note: NI Health Care Trusts are still officially organised under the 26 council model.**(Ref 2)

REASON 3: LAND MASS AREA – FACT: NEWRY & MOURNE – THIRD LARGEST IN NI

NEWRY & MOURNE (Former LGD) IS RANKED THIRD LARGEST OF THE LAND MASS areas of the 26 former councils in NI.

Using official NISRA Land Measurements, Fermanagh has the largest land measurement with 1699.3sq km. Omagh is second (1129.9sq km) and Newry & Mourne is third largest land measurement with 898.3 sq km ***(Ref3)

REASON 4: LOCATION– FACT: NEWRY’S STRATEGIC LOCATION

Newry city is the main Gateway to NI, strategically located on the Belfast-Dublin Trans European Network, Road, Rail, and Sea economic corridor where hundreds of thousands travel through yearly.
Newry is also the Gateway to the three Areas of Outstanding Natural Beauty which comprise the designated Mourne Gullion Strangford UNESCO Global Geopark which also attract many thousands of visitors travelling through the Newry area annually. Newry has excellent road and rail links, and is connected to the major Port of Warrenpoint. Daisy Hill ACUTE Hospital is located at this major population settlement in Newry.

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.

CONCLUSION – SOLUTIONS TO HOSPITAL NETWORK REFORM

Acute Hospital status, Population, Land mass and location are the 4 main factors to determine the entitlement for an Area Hospital for Daisy Hill, Hospital, Newry in the proposed regional network.

Daisy Hill Hospital is entitled to have a full range of specialist acute services and inpatient beds, along with 24/7 consultant led Accident & Emergency, with emergency surgery and consultant led maternity services just the same as the other named Area Hospitals, in the proposed new Network of Hospitals.****(Ref 4)

To ensure equality of timely access to Consultant Led 24/7 365 Regional inpatient acute Services like Accident and Emergency surgical and Medical services like Heart and Stroke, and consultant led maternity services all Area Hospitals should be selected based on where the people (population) actually live.

The choice of location of Area Hospitals should not be made on the size of the hospital but should take into account the size of the population at each of the former Local Government Districts. The figures should be standardised population sizes and the land mass area to be covered by the fire and rescue service and ambulance service at each former local government district level, not just at a Regional level.

Doing this will show that Daisy Hill Hospital in Newry city is entitled to be an Area Hospital. The facts speak for themselves.


REFERENCES / BACKGROUND

*Ref 1 Developing Better Services (The Department of Health, Social Services and Public Safety) Minister of State Desmond Browne, 2003.

** Ref 2 THE ORGANISATION OF NI HEALTH CARE IS STILL UNDER THE 26 COUNCIL MODEL

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

***Ref 3 Statistics on Population and Land Mass are from Northern Ireland Statistics and Research Agency (NISRA).

****Ref 4 Department of Health Consultation ‘Hospitals – Creating a Network for Better Outcomes’

For more from this website on this topic – See also : https://savedaisyhillhospital.com/2025/01/26/daisy-hill-newry-is-entitled-to-be-in-the-area-hospital-category-in-the-doh-hospital-network-public-consultation-2024-25/

Daisy Hill Hospital for Life

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

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Want to know how you can help? – please see: https://savedaisyhillhospital.com/how-you-can-help/

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2025.

01.26.25
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Daisy Hill, Newry is entitled to be in the ‘Area Hospital’ Category in the DOH Hospital Network Public Consultation 2024/25

YOU DID IT BEFORE – YOU CAN DO IT AGAIN –PEOPLE POWER NEEDED FOR DAISY HILL HOSPITAL , NEWRY.

Daisy Hill Hospital Newry is entitled to be an Area Hospital in the Department of Health Hospital Network Consultation 2024-2025.

In 2019, you did it – over 19, 500 people sent back Consultation Reponses disagreeing with Department of Health plans to cut the existing number of Stroke Units in NI and centralise stroke services to as few as sites as possible.

People power here worked after thousands filled in the Questionnaire with 95% rejecting the options, with concerns about longer travel times in an emergency. Following this consultation – the Health Minister Robin Swann MLA said stronger evidence was needed – so change can happen if we write in large numbers to these consultations.

In 2024/5 there is a new plan as the Department of Health now proposes to go way beyond centralising Stroke services and proposes changes to the whole Regional Hospital Network. This plan puts Hospitals in NI into four categories: Local, General, Area Hospitals and Specialist Regional Centres.

In the Department of Health Consultation document ‘Hospitals – Creating a Network for better outcomes’, the majority of Specialist Inpatient Services for example Stroke, Emergency Surgery etc are proposed to be centralised to 5 newly chosen Area Hospitals (at Antrim, Altnagelvin, Craigavon, Ulster and Belfast Group Hospitals) and Specialist Regional Centres (at Altnagelvin, Ulster Hospital and Belfast Hospitals) (*Ref1)

In these proposals Daisy Hill Hospital (Newry); South West (Enniskillen) and Causeway (Coleraine) are to be known as ‘General Hospitals’.  (Very different from the new proposed ‘Area Hospitals’)

The Government now wants to consult with the public who are paying for the service, to see if they agree with these new proposals. 

DAISY HILL HAS BEEN PUT IN THE WRONG CATEGORY OF ‘GENERAL’ HOSPITAL – BUT THIS CAN BE CHANGED IF ENOUGH PEOPLE DISAGREE WITH THE NEW CONSULTATION PROPOSALS

As mentioned before, only 5 places have been selected to be upgraded to be higher level ‘Area Hospitals’ – they are: Craigavon, Antrim, Altnagelvin, Ulster and Belfast Group Hospitals.  “These Area Hospitals will maintain a 24/7 emergency department, a 24/7 emergency surgery and anaesthetic rota and theatre, and be supported by a critical care unit.” (Consultation Doc p35/37pdf)  Annex D also states Area Hospitals will be expected to have 31 specialty services with inpatient beds. (Page 106/8)

What about the General Hospitals?

Information on the limited services expected to be available from ‘General hospitals’ can be read in the Consultation document ‘Hospitals – Creating a Network for better outcomes’ from the Department of Health’s website. (See pages 23, 34-36, and 113)

In the document’s very important Actions page (p113, See Action 4) –it is rather concerning that the words ‘Short to Medium Term’*(Ref 2) are used when referring to maintaining core services in the ‘General Hospital’ category. And it is the Hospital Trusts who will be in charge of this.

Are core services not going to be maintained for the Long Term in the General Hospitals then? No other Hospital Category is dealt with in this way in the Actions Page.

Daisy Hill Acute Hospital, Newry has been incorrectly put in the ‘General Hospital’ category in this new report which also falsely  describes the Newry area as a small ‘isolated’ geographical location and community (*(Ref 3) See pages 6,23, 34).

The Department of Health report fails to recognise the consistently large population size, recorded illness statistics needs and large land mass area in the Newry & District area. 

Daisy Hill Hospital, Newry must be given the long overdue investment and specialist inpatient services it and the rate-paying and tax paying population here deserves.

Your help is needed to answer the Consultation through the Questionnaire and let the Dept of Health know that they have put Daisy Hill Acute Hospital, Newry into the wrong category –due to the population size, need and land mass here.

We must challenge these unfair proposals. In Health and Wellbeing 2026 Delivering Together (p19) First Minister and former Health Minister Michelle O’Neill MLA stated “Our HSC system belongs to all of us and we all bring valuable insights in to how it can improve. We must work in partnership – patients, services users, families’ staff and politicians – in doing so we co-produce lasting change which benefits us all.”  *(Ref 4)

DAISY HILL HOSPITAL IS ENTITLED TO BE AN AREA HOSPITAL & NEEDS YOUR HELP – PLEASE DISAGREE WITH THE CONSULTATION PROPOSALS

We have a right to continue to challenge, at every opportunity, these vital healthcare decisions.  Please take part in the Consultation and Strongly disagree with the proposals, stating in the Questionnaire that Daisy Hill Acute Hospital, Newry is entitled to be and should be categorised as an ‘Area Hospital’ along with the other Area Hospitals.  

Please ask everyone in your house to take part take part in this public Consultation too and please ask your friends, family and community and Elected Representatives- councillors, MLAs and MPs to do the same.

IMPORTANT – See this Link below to Daisy Hill Hospital for life website for all links to Department of Health Consultation, Questionnaire and Suggested Answers (to read and/or use if you agree) with instructions and Source References.

https://savedaisyhillhospital.com/2025/01/05/dept-of-health-hospital-network-consultation-2024-2025-a-suggested-response/

Daisy Hill Hospital, Newry Saves Lives - People Power 2023

5 EVIDENCE BASED REASONS WHY DAISY HILL HOSPITAL IN NEWRY IS ENTITLED TO BE AN AREA HOSPITAL

>Reason 1 – Population fact 1: Out of 17 GP Federations in NI, Newry & District GP Federation has the Second highest number of patients (161,308) registered after only Derry GP Federation since 2017. (Source: DOH 2023/24).

Newry & District includes 36,018 children and young people aged U18, the 2nd highest of the 17 GP Federations after only Derry (Source: DOH 2023/24).

>Reason 2 – Population fact 2: Newry & Mourne Local Government District (One of 26 Former Councils) RANKED IN THE TOP FOUR HIGHEST POPULATION CENTRES In NI after only Belfast, Derry and Lisburn.  (From 1971 to 2014)

>Reason 3> Population fact 3: Newry & Mourne LGD has ALWAYS HAD THE HIGHEST POPULATION of the 5 LGDS in the operational area of Southern Trust. (Source NISRA).  The 5 LGDS are Newry & Mourne, Craigavon, Armagh, Dungannon and Banbridge.

>Reason 4 – Landmass fact : Newry & Mourne local government district area alone has the 3RD LARGEST LANDMASS in NI (898.3 Sq Km: Source NISRA).

>Reason 5: NEWRY CITY’S STRATEGIC LOCATION. Newry City could not be in a more pivotal position. NEWRY CITY is a Gateway and Main Hub in the Spatial Framework for NI to 2035. Newry is midway on the route from Belfast to Dublin on the TENS Key Transport Corridor.

It is also on the North Sea- Mediterranean Corridor: Cork> Dublin > NEWRY > BELFAST > Larne. The Eastern Seaboard Corridor is the Strategic Route linking Larne to the Border at Newry via Belfast facilitating onward travel to Dublin and the Port of Rosslare. Newry is a Gateway City to the Ring of Gullion and the Mournes (Areas of Outstanding Natural Beauty) and Gateway to the new Ring of Gullion Mourne and Sperrins UNESCO Heritage site.

Newry is so busy they are prepared to spend over £94 million on the Southern Traffic Relief Road but not on a Major hospital for potential road accidents, residents and visitors. Warrenpoint, close to Newry is the 2nd largest Port in NI.

Daisy Hill Acute Hospital, Newry is entitled to be an Area Hospital due to the consistently high population size, need and land mass area in Newry & District. in the Department of Health's new public Consultation ‘Hospitals – Creating a Network for better outcomes’ Daisy Hill Acute Hospital has been wrongly put into the wrong Hospital category of general Hospital. Public help is needed to answer through the Questionnaire and let the Department know this and make Daisy Hill an Area Hospital, like the other Area Hospitals.

BACKGROUND INFORMATION/ REFERENCES

*Ref. 1. Hospitals – Creating a Network for better outcomes.  Department of Health, (October 2024).  Main Consultation document, Hospital Categories (Pages – pdf pg no. p23-25)

*Ref. 2. Action 4 states that “Consideration to be given to how in the short to medium term HSC Trusts can work in collaboration to maintain these core General Hospital services.” Creating a Network for better outcomes.  Department of Health, October 2024.  Main Consultation document, (pdf pg no p113)

*Ref. 3 Description of General Hospitals in ‘Creating a Network for better outcomes’. (Department of Health, October 2024,) the word ‘isolated’ is used 3 times  describing the ‘location’ and ‘community’ of the 3 named proposed ‘General hospitals’: Causeway Hospital, Daisy Hill Hospital and South West Hospital (Pages 6, 23, 34).

P6/23 :  “General Hospitals, delivering defined secondary care services including unscheduled care, geared to a specific, more ISOLATED geographical location…”

P34/ “What and Where: General Hospitals” – …… These hospitals have a key role in ensuring our system can respond to the challenges of an aging population, delivering a range of acute and rehabilitation services, with the advantage that they are closer to an otherwise more ISOLATED community.”]

*Ref. 4. Health and Wellbeing 2026 – Delivering Together – Department of Health, (October 2016.) (p19)

*Definition –‘Centralise’  “concentrate under one control” (Collins English Dictionary)

Northern Ireland Ambulances Saves Lives - Daisy Hill Hospital Saves Lives

For Suggested Answers to the Questionnaire and more info on this current consultation please see : https://savedaisyhillhospital.com/2025/01/05/dept-of-health-hospital-network-consultation-2024-2025-a-suggested-response/

Want to know how else you can help? – please see: https://savedaisyhillhospital.com/how-you-can-help/

Further reading on population:

https://savedaisyhillhospital.com/2020/02/04/newry-mourne-local-government-district-lgd-ranks-in-the-top-4-lgds-in-all-northern-ireland-consistently-since-1971-so-where-is-the-matched-funding-for-daisy-hill-acute-hospital-newry/

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

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© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2025.

07.30.19
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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).

The Golden Hour in stroke is well supported by Clinical Evidence

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.
  • Act FAST Stroke - HyperAcute Stroke Unit for Newry 2019

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.

© 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!

07.20.19
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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

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.

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

05.05.19
by

NI Stroke Consultation 2019 – Overview

The NI Stroke Services Consultation, Reshaping Stroke Care 2019 aims to create Hyperacute stroke units attached to acute stroke units, while cutting existing stroke units “to as few as sites as possible” to consolidate staff.

This is a consultation like no other, where the Department of Health is inviting people all over Northern Ireland to decide which stroke units will be kept or closed.

If all acute stroke units in Northern Ireland had an equal chance – this would be fair consultation – but they do not.

Some entire Councils have been omitted completely. (E.g. Newry, Mourne & Down locality, and its population of 179,000 people).

A Clear vision for Daisy Hill Acute Hospital - Newry _Daisy Hill for Life

SIX OPTIONS WHICH EXCLUDE ENTIRE POPULATIONS

There are Six Options in the Questionnaire of preferred hospital sites to choose for Hyperacute/Acute Stroke Units in Northern Ireland.

In this NI Stroke Consultation the existing acute stroke units in Daisy Hill, Newry and Causeway in Coleraine are excluded and do not even get a chance to be selected, because they do not appear anywhere in the Six Options.

These excluded populations are not even given the Option to voice their discontent with being left out – as the Options Question does not have a neutral or ‘Disagree’ or ‘None of the above’ Option.

At the other end of the spectrum, appearing six times, in each available Option are the stroke units in Altnagelvin, Craigavon and Royal Victoria Hospitals. Their continuation has been pre-determined and recruitment for their foretold Hyperacute stroke Units may have already started.

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

WE PRE PAY FOR EMERGENCY SERVICES INCLUDING STROKE & HEART

Hospital services are paid for with public money –general taxation, national insurance contributions and rates (including business rates).

All adults in Northern Ireland prepay for their life saving emergency care and hospitals, but this consultation downgrades Stroke from a time dependant Emergency service (which includes immediate vital CT scanning to confirm if patients are eligible for Thrombectomy and for Thrombolysis.

The NI Stroke Consultation 2019 has stated various research to justify the choices that have been made, determining which hospitals will keep or lose their acute stroke units in Northern Ireland – but the very supporting research referred to, does not fully back up these configurations.

These research Topics are looked at in more detail in the next article: https://savedaisyhillhospital.com/2019/05/05/ni-consultation-document-does-not-fully-follow-the-research-evidence-referred-to/


We have a right to continue to challenge, at every opportunity, these vital healthcare decisions

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.

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© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2023. 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!

04.04.19
by

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

© 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!