BROKEN TRUST – CALL FOR NEWRY, MOURNE & DOWN COUNCIL EMERGENCY MEETING AND MARCH FOR DAISY HILL HOSPITAL

The Southern Health and Social Care Trust came down to Newry on Wednesday 22nd March 2023 to dictate to the people that they had decided, to withdraw timely, life-saving emergency general surgery permanently, from Newry City’s Area Acute Hospital Daisy Hill.

Because of this unjust decision there is a Major public health crisis in Newry & Mourne right now, especially with this new threat to Daisy Hill of permanent removal of Emergency Surgery so that Daisy Hill can be made an Elective Care Centre, as confirmed at the public meeting on 22 March 2023

Dr O’Kane, the Southern Trust’s Chief Executive confirmed at this meeting that ‘plans to turn the hospital into an elective overnight stay centre were progressing.’  Note how they have removed the name Hospital.

The Daisy Hill Future Group Chairman Dr Conor Patterson also stated that plans were imminent to pass over the Monaghan Row Council Offices over to the Southern Trust. He also spoke of Southern Trust intentions to transfer acute services from Daisy Hill into a Community Treatment Centre in Newry. (This will be a privately built building which will be rented by the Southern Trust for 27 years, so not HSC owned).

TIME FOR ACTION – EMERGENCY COUNCIL MEETING AND MARCH NEEDED

Now it is time again, that the people asked Newry Mourne & Down Council for their concentrated support to organise to call for action and proper treatment of Daisy Hill Acute Hospital, the Area Hospital for Newry & Mourne and South Armagh.

In 2014 when the Southern Trust announced they wanted to centralise all Acute Stroke Services from Newry to Craigavon, the former Newry & Mourne Council unanimously supported the people’s campaign against this unfair and unjust decision. 

Daisy Hill Acute Hospital - enhance stroke services in Newry Public Rally 2015

Newry & Mourne Council did an excellent job of organising a large Rally and March in Newry, wrote to the Southern Trust with their objections and ran a successful united Save Our Stroke Services Campaign. This Save Our Stroke services at Daisy Hill, Newry Rally was 8 years ago this weekend on Saturday 28th March 2015.

We need Newry, Mourne and Down Council to support the people in a similar way with a united campaign to support Daisy Hill Acute Hospital and the proposed loss of another Specialist Service – this time, Emergency Surgery from the Newry city hospital.

We need Newry Mourne & Down Council’s support and for them to organise another March in Newry on a Saturday as soon as possible.

Daisy Hill for life is calling on all citizens of Newry & Mourne and Down to please contact, talk to, and write to our District Councillors for help today on the Southern trust’s plan to withdraw permanently, timely, life saving emergency general surgery from Newry City’s Area Acute Hospital Daisy Hill.

DAISY HILL HOSPITAL, NEWRY CITY IS NOT BEING TREATED FAIRLY

The Newry Mourne & Down District Council should be aware that this isn’t the first time since 2014 that Daisy Hill was under threat of permanent removal of timely life saving Acute Stroke or Acute Emergency services under the direction of the Southern Trust, especially since the publication of the advice given by: 

1. The Bengoa Report 2016 – where they used Stroke Services in the Southern Trust as a Local Case Study and canvassed for Craigavon to be the only hospital to have Acute Stroke services in the Southern Trust.

2. Regional Acute Stroke Services Consultation 2019 : Daisy Hill was in none of the 5 options in the 2019 consultation for Regional Acute Stroke Services and Craigavon was named as one of only three sure to have a hyper acute and acute stroke unit.

3. In March 2020 at a key time for the world, the Southern Trust showed complete indifference on how people of Newry & Mourne and South Armagh were supposed to access Emergency Care. All Acute Services including Emergency Medical and Surgical Services, Respiratory, Direct Assessment, Children’s ED, and Acute Clinical Staff, were removed from Daisy Hill for six months.  Again making sure that Craigavon could have two adult and 1 new Children’s Emergency Department.

4. HSC Rebuilding Plans 2020 -2021 : The Southern Trust refused to put Daisy Hill Emergency Department in the Department of Health Rebuilding Plans from March to October 2020 and Daisy Hill was excluded from the NI Critical Care Network.

5. Review of Emergency Surgery Workstreams March 2022: Daisy Hill was used as a Case Study not to have Emergency Surgery in Review of Emergency Surgery Workstreams because the Southern Trust has removed Emergency Surgery from Daisy Hill in February 2022.

6. Review of General Surgery 2022: The Southern Trust decision to permanently remove emergency surgery from Daisy Hill used as evidence  in the findings and advice of the Workstreams of the Review of General Surgery (which never went to public consultation to the NI Assembly for approval) and the advice given by Dr Mark Taylor to Minister Swann to decide on which hospitals would have Emergency Surgery services, or decide that Daisy Hill and South West Acute Hospitals should be changed permanently from major specialist acute hospitals into Regional Elective care centres

Daisy Hill in Newry City is the only Acute hospital serving the 2 Constituencies of Newry & Armagh & South Down, with Population of 235,877, including 60,327 under-18s; NISRA 2020
Daisy Hill in Newry City is the only Acute hospital serving the 2 Constituencies of Newry & Armagh & South Down, with Population of 235,877, including 60,327 under-18s; NISRA 2020

Newry, Mourne and Down is the 3rd highest Local Government District population in NI and its only Acute Area hospital at Daisy Hill, Newry must be prioritised for  funding and investment as a Major Specialist acute Hospital not just as an elective centre. The population here have no other timely access to an acute hospital in an emergency.

 Now is the time for positive action. Please contact your councillors and ask for an Emergency Council Meeting and a Public Rally/March to be organised to take place on a Saturday in Newry in support of Daisy Hill Acute Hospital, Newry. This must happen before the Councillors break for council elections.

Contact info for your councillors available here: https://www.newrymournedown.org/your-councillors

The Consultation on Provision of Emergency Surgery in the Southern Trust closes on Friday 21st April 2023. It is also important that the people of Newry Mourne & Down take part in this consultation. More information on how you can take part in the Southern Trust Emergency Surgery Consultation 2023 will soon be provided here and on Daisy Hill for Life face book page. https://www.facebook.com/daisyhillforlife Thank you.

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

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

Excerpts and links may be used, provided that full and clear credit is given to http://www.savedaisyhillhospital.com (Daisy Hill Hospital for Life) and Daisy Hill for Life on Facebook with appropriate and specific direction to the original content. Thank-you! We welcome sharing.

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2 Days to go! You need to Know! Daisy Hill Acute Hospital, Newry and the DoH NI Urgent and Emergency Care Services Consultation 2022

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.

Link to the Online Consultation – below:

https://consultations2.nidirect.gov.uk/doh-1/review-of-urgent-and-emergency-care-services-in-no/

Main Department of Health NI Consultation Documents are available to read here:

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

WAYS TO RESPOND to the DoH Urgent and Emergency Care Services Consultation 2022: 

 By Email > Send your completed Consultation Form
by Email to :  UECS@health-ni.gov.uk

By Online Questionnaire > Using :

https://consultations2.nidirect.gov.uk/doh-1/review-of-urgent-and-emergency-care-services-in-no/

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

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

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!

BACKGROUND:

NO MORE SILOS ACTION PLAN LINK
https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-no-more-silos.pdf

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.


© 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 on Facebook with appropriate and specific direction to the original content. Thank-you.

Additional articles on this Consultation and other ways to respond using the longer questionnaire help is available from : IT’S 2022 AND DAISY HILL NEEDS YOU! in the Dept. of Health Urgent and Emergency Care Consultation (Closes 1st July 2022) – Daisy Hill Hospital for Life (savedaisyhillhospital.com)

and

Consultation on changes to Access to Urgent & Emergency Care Services 2022 (Department of Health NI) – Daisy Hill Hospital for Life (savedaisyhillhospital.com)

IT’S 2022 AND DAISY HILL NEEDS YOU! in the Dept. of Health Urgent and Emergency Care Consultation (Closes 1st July 2022)

WANT TO HELP DAISY HILL ACUTE HOSPITAL IN NEWRY & HELP ENSURE WE STILL HAVE LIFE-SAVING 24/7 EMERGENCY SURGICAL & MEDICAL SERVICES THERE IN THE FUTURE?

Yes, YOU CAN HELP make a difference to our future Hospital services in Newry City by answering the Dept of Health (DOH) consultation on Changes to Urgent and Emergency Services 2022 by Friday 1 July 2022 @ 5pm.

Support Daisy Hill Acute Hospital in the Reshaping stroke services Department of Health NI 2017 consultation. stroke services. Newry and Mourne is the right place for a hyperacute stroke unit.

WHY IT IS IMPORTANT TO TAKE PART IN THIS CONSULTATION

This Consultation proposes future Changes to How and Where we can access Emergency and Urgent Care services, and will soon involve changes to our existing services.  We all need to be involved in this or the new changes will be made without our input. 

This Consultation is about proposed Changes to Urgent and Emergency Care Services, and gives us a direct opportunity, while answering the Qs, to show the Department of Health how important it is to provide Emergency & Urgent Care services in Daisy Hill Hospital.

The Provider of Services in this area, the Southern Trust withdrew Emergency Surgery from Daisy Hill Acute Hospital in March 2022 – and we would like this life-saving Emergency Care to be re-instated to Newry city.

This Department of Health Consultation places huge importance on an Action Plan called ‘No More Silos’ for future planning of Emergency services – but this No More Silos Plan was in place when the Southern Trust closed Daisy Hill’s ED during the pandemic to provide 3 EDs in Craigavon– so this is not the model of care best suited to our area. There is a real population-based need in the area and future Emergency & Urgent Care services must be commissioned for the Newry South Down and South Armagh Area Hospital -Daisy Hill, in Newry City.

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

 If you would like to help by Submitting a Response to the Urgent and Emergency Care Services Consultation, or are short on time and would like some ideas – please read the Daisy Hill for Life on Facebook and this website

All Responses must be submitted before Friday 1st July 2022 @5pm.

HOW TO RETURN YOUR COMPLETED QUESTIONNAIRE TO THE CONSULTATION BY EMAIL

When you have finished the form – check and save your answers, then log into your email account.

Select New Email, Add the Questionnaire File as an Attachment to your new email message (using either the Paperclip icon or Add Attachment)

The Email Address to send your completed Questionnaire is UECS@health-ni.gov.uk ,

Type UECS@health-ni.gov.uk into the To box of your New Email

Write your message and finally click Send

 DEPARTMENT OF HEALTH NI CONSULTATION DOCUMENTS LINK

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

Closing Date:  Friday 1st July 2022 at 5pm

WAYS TO RESPOND: 

 By Email > Send your completed Consultation Form by Email to :  UECS@health-ni.gov.uk

By Online Questionnaire > Using :

https://consultations2.nidirect.gov.uk/doh-1/review-of-urgent-and-emergency-care-services-in-no/

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

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

Why Emergency & Urgent Care services must be provided in Daisy Hill Acute Hospital in Newry

  1. DEMOGRAPHICS

Latest May 2022 figures* show Newry & District has the 2nd highest number of patients in NI registered with GP practices, (159,599) many suffering with serious illnesses who need Emergency & Urgent Care and specialist hospital services.   (Newry & District also has the 2nd highest number of Children U18 in NI). Without Daisy Hill ED there is no nearby alternative for Emergency or Urgent treatment for accidents which can happen on the road, work, home or school or during sport and leisure.   (* Background information at the end)

2. COST OF LIVING

Fuel prices are increasing – people cannot afford to drive or get taxis to Craigavon hospital if services are moved there.

3. ECONOMY & JOBS

We want to keep Jobs in our Newry South Down South Armagh Area Hospital and keep our skills-base and economy strong (Fair treatment and Employment Act).

4. CLIMATE CHANGE

Centralisation of services is bad for the Environment – puts extra cars on the road and increases carbon footprint. We are told to Shop Local to protect Economy and the Environment – why should hospital services be any different?

5. RURAL PROOFING

In 2009 the NI Executive committed to strive for a fair and inclusive rural society where rural dwellers enjoy the same quality of life as all others in the region.  There is a duty on public authorities to have due regard to rural needs ( Rural Needs Act 2016) – this must be shown by the DOH in how they commission Emergency and Urgent care services.

>Newry city needs a fully functioning acute hospital with a Type 1 ED providing Time Critical Emergency and Urgent care for its citizens.  Rates, taxes and national insurance contributions all go towards these services and you and your family are entitled to have a say where the services are provided.

*BACKGROUND 1

According to the GP Federation Register May 2022 (Source BSO)

>Newry & District has the Highest number of patients in NI with Heart Failure

>Newry & District has the 2nd Highest number of Patients in NI (after only Derry/L’Derry) with Cardiovascular Disease Primary Prevention, Osteoporosis and Depression

>Newry & District has the 3rd Highest number of Patients in NI (after Derry/L’Derry and Antrim) with Cancer, Coronary Heart Disease, Asthma, Hypertension (which can lead to heart and stroke), Chronic Obstructive Pulmonary Disease, Diabetes, and needing Palliative Care.

>Newry & District also has the 4th highest no of Patients in NI with Stroke, while Craigavon is 10th. This must inform where stroke services are provided in NI.

(GP Registers are the main reliable source of info you can look at for actual illness present in a local or general area to find out if there is need to provide health services there and to what extent.). 

In 2020 Newry Mourne and Down (NMD) had the highest number of Fatal collisions, Serious collisions and Number of Seriously injured according to Recorded Injury Road Traffic Collisions (RTC) statistics.

BACKGROUND 2

ROAD ACCIDENTS:

In 2020 Newry Mourne and Down (NMD) had the HIGHEST number of 

(1) Fatal collisions ,

(2) Serious collisions and

(3) Number of Seriously injured

according to Recorded Injury Road Traffic Collisions (RTC) statistics. Similar high statistics were recorded in previous years.

ROAD ACCIDENTS – CHILD CASUALITIES

U16 Child casualties following Road Traffic Collisions (Newry Mourne and Down):

In 2020/21 : NMD had the highest number of children seriously injured  and

highest number of children in NI KSI (killed or seriously injured) .

In 2019/20 NMD had joint highest no of children in NI killed,

2nd highest no of road collisions in NI resulting in child injuries or deaths and

2nd highest no of children in NI seriously injured after Belfast.

Similar high statistics were recorded since 2016/17. (Source: Recorded Injury Road Traffic Collisions statistics).

The evidence is all there – please take part in the Department of Health NI Urgent and Emergency Care Consultation 2022 and ask for Urgent and Emergency care services to be commissioned in the Newry South Down South Armagh Area Hospital, Daisy Hill in Newry city for us, our families and our future generations.  

You can keep making a difference for Daisy Hill!

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.

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 2nd 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.

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 – 2022

© 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.

TIME TO OPEN DAISY HILL HOSPITAL ED NOW!

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.

Reinstate Daisy Hill Newry into NI regional Network -infographic 5 localities in Southern Trust. Newry&Mourne locality is the largest land area with the highest population in the Southern Trust and is still waiting for its ED to be restored.


“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).

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

Reinstate Daisy Hill Newry into NI regional Network -infographic 5 localities in Southern Trust. Newry&Mourne locality is the largest land area with the highest population in the Southern Trust and is still waiting for its ED to be restored.

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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Put Daisy Hill acute Hospital, Newry & Mourne and its Type 1 ED for children and adults back on the map!

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).

Put Daisy Hill acute hospital Newry & its Type 1 ED for children and adults back on the map! 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.

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

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.

Focus on Newry and Mourne -Drivetime to nearest Type 1 ED when Daisy Hill ED is excluded

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:

7:  Spelga  8 : Kilbroney 9 : Seaview  10 : Clonallan 11:  Crossmaglen 12 : Creggan  13 :Silverbridge 14: Forkhill

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.  

Time for Investment for Newry +Mourne LGD 2020

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.

The Golden Hour in stroke is well supported by Clinical Evidence

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.

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

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.

Southern Trust Rebuild Phase 2 Plan available here: https://www.health-ni.gov.uk/sites/default/files/publications/health/shsct-plan-2.pdf

Links to all Trust Rebuild Plans 2020 here:

 https://www.health-ni.gov.uk/publications/rebuilding-hsc-services

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

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

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

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

NI Stroke Consultation -Call for Dept. of Health to Assess for population health and Rural Needs

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.

Act FAST Stroke - HyperAcute Stroke Unit for Newry 2019

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

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

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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!

Another Call to Action for the Specialist Stroke Unit in Newry: Write for your rights!

Suggested Answers to the RSC Consultation NOW AVAILABLE – including the Extra 5 Equality, Human Rights & Rural impact Questions

As the 2019 Stroke Consultation Deadline is Fri 30th August, Daisy Hill’s campaign for Hyperacute Stroke Unit status continues, with a renewed call for action for the people of Newry & Mourne, South Armagh,  South Down and surrounding areas.

Based on demographics Daisy Hill Acute Hospital, Newry should be confirmed as a location for a Hyperacute and Acute Stroke Unit – so Suggested Answers to Reshaping Stroke Care are now ready to Download for sending back to the Department.

If you want to help but haven’t submitted any Response to the Consultation, OR if you have already signed a Support Our Stroke Services Questionnaire and need to answer the Equality Questions, both documents are available below.

1. For those YET TO REPLY to Re-shaping Stroke Care 2019 Consultation

ALL Questions Suggested Answers Version 1 (Complete Questionnaire)  is available to download and save as a new filename from this Link: All Qs Answers Reshaping Stroke Care questionnaire

OR

2. For Those who have Responded to the first Questions but not the EQUALITY\ RURAL IMPACT QUESTIONS in Reshaping Stroke Care 2019

5 EQUALITY Q’s ONLY Questionnaire is available to download and save as a new Filename from this link: 5 Equality Qs answers Reshaping Stroke Care Questionnaire

These Suggested answers are already typed onto the RSC Questionnaire in Word Format for easy access for you to download and read.  

The Answers are only intended to be a Guide for your own Answers – but if you agree with these and find it useful and time-saving– you can use all or part of the content.  You can type changes directly onto the Questionnaire, (adding or delete as you wish!) It is recommended that you do make some changes so they are not all identical. Please remember to add your name/address/email address too.

After Downloading, please remember to ‘Save As’ and Give the document a new filename – perhaps adding your Initials or Surname. For e.g. RSC_Questionaire_All_JSmith_2019

The Original RSC blank Questionnaire is available from the Department of Health NI website :  https://www.health-ni.gov.uk/reshaping-stroke-care . Click on ‘Reshaping Stroke Questionnaire’(Word doc) and save.

DIFFERENT WAYS TO RESPOND  

(1) EMAIL: Email your Questionnaire \answers to the Department of Health at:  StrokeConsultation@health-ni.gov.uk

(2) ONLINE: You can copy and paste some or all the Reshaping Stroke Care ‘suggested answers’ plus add your own comments onto the online questionnaire at:

https://consultations.nidirect.gov.uk/doh-healthcare-policy-group/reshaping-stroke-care-saving-lives-reducing-disabi/consultation/intro/

(3) BY POST (using First Class Stamp) post (before 4.30pm Wednesday 28th August 2019 at the latest) to:                

Reshaping Stroke Care, Hospital Services Reform, Department of Health, Annexe 3, Castle Buildings, Stormont Estate, Belfast BT4 3SQ    

If you know people that would like to respond to the Consultation, that do not have a computer or do not wish to respond online, forms are available from the Department of Health.

To get a form posted to you: Phone (028) 9076 5643 and ask for a RESHAPING STROKE CARE Consultation Questionnaire. It is advisable to do this as soon as possible as All Responses must be received by the DOH before the Deadline of Friday 30th August 2019 @5pm.

All the Consultation Documents (including the Questionnaire Form are available online at   https://www.health-ni.gov.uk/reshaping-stroke-care

IMPORTANT INFORMATION

THIS ACTION IS TO FURTHER SUPPLEMENT THE EXCELLENT WORK ALREADY DONE BY SUPPORT OUR STROKE SERVICES COMMITTEE

As you know, another Campaign Group, Support Our Stroke Services Committee organised Community Outreach events over the summer in Shops, Shopping Centres and local places to encourage people to sign Questions from the Online Questionnaire.  These Questionnaires supported the community goal to ensure that Daisy Hill Acute Hospital both retains its acute specialist Stroke Unit and is elevated to a Specialist Centre with Hyperacute Stroke Unit.

Many thousands signed these Consultation Questions up to the Alternative Option Question, but answering the remaining Equality & Human Rights Questions is an absolutely vital part of this whole process.

The flawed Department of Health Consultation Questionnaire prevented access to the Equality Questions previously, as these Questions could only be reached once you had selected one of the Options and every one of them excludes Daisy Hill Hospital.

Now with the Extended deadline – we have the opportunity to supplement the ‘Support Our Stroke Services’ Committee facilitated Questionnaires by submitting the rest of the 5 Equality Questions to support the need for a Hyperacute Stroke Unit in Daisy Hill, Newry.

The people from Newry & Mourne, South Armagh,  South Down and surrounding areas, still stand together to challenge the flawed Consultation document which deliberately excluded Daisy Hill’s specialist combined Acute Stroke Rehabilitation Unit from the proposed Options in Reshaping Stroke Care, but every-one of us need to continue to put the case in writing.

STILL NEED CONVINCING?

Time is Brain - Urban and Rural -None of the Options in the NI Stroke Consultattion are best for all of NI. Every minute matters during a stroke says London Stroke Strategy.

The DoH states that the proposals will have MINOR IMPACT in NI. This is not the case in Newry & Mourne, Down and South Armagh area where there will be MAJOR IMPACT on the lives of stroke patients.

There will be removal of scanning, administration of the crucially time dependant clot-busting drug Alteplase and removal of direct access into a specialist acute stroke rehabilitation unit from Daisy Hill acute Hospital as if it never existed.

This includes losing existing direct access to the Royal for Thrombectomy from Daisy Hill Hospital.

Your life could depend on it.

We must challenge the Department of Health by answering this Consultation – The more the better to get the message through loud and clear. We can do it with YOUR help.

WE CAN DO THIS TOGETHER !

Thank you.

Daisy-Hill-still-needs-you!-call-to-action-for-the-specialist-stroke-unit-in-Newry

For background information on the 2019 NI stroke Consultation document – please see the following post:

https://savedaisyhillhospital.com/2019/05/05/ni-stroke-consultation-2019-overview/

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

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2019. Thank-you!

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.

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!

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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!

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.

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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