Evidence – what Evidence?

The word ‘evidence’ is used a lot in the Bengoa Report and this word alone tries to justify taking acute Specialist Stroke Services from Daisy Hill to offer them only in Craigavon. But the actual ‘evidence’ is NOT PROVIDED in either the Bengoa Report, or the Criteria document, nor is there a list of References WHERE the evidence came from, at the back of either the Report or the Executive Summary, as you would expect in any piece of scholarly work. The Bengoa Report (Systems not Structures – Changing Health and Social Care – Full Report can be read here.

Re change in specialist stroke services in the Southern Trust, What is the evidence? Has it been validated? Who provided the evidence? These 3 Q'S need answers to verify the ‘evidence’ on outcomes for Criteria No 1 in the Consultation on criteria for reconfiguring HSC services

These 3 Q’S need answers to verify the ‘evidence’ on outcomes for Criteria No 1 on the consultation on criteria for reconfiguring HSC services

The Bengoa Report states the case for change must be “fully evidenced”. It also states how this must be done:

“Clinicians must identify the evidence for change, managers must ensure the correct processes are followed, and the Minister, supported by the executive, must act quickly to take the final decision. All three groups will need to be prepared to defend the decision publicly.”

Therefore – we think the Questions shown in the picture need to be asked and we are entitled to answers.

Without these answers – the use of the word evidence alone is NULL and VOID. Given the whole of the criteria are based on ‘evidence’ and must be addressed urgently (Recommendation 13) – The Public who are paying for the services need to know WHAT IS THIS EVIDENCE before such services changes by centralisation of services are made across N Ireland including specialist Stroke Services and A&E.

BE AWARE! – there is no doubt that agreeing to the criteria will be the first step in AGREEING to centralisation ( or otherwise known as “rationalization”) of many specialist services from Daisy Hill Hospital as shown below in the extracts from the Bengoa Expert Panel Report, 2016, page 75-76

Based on the evidence the panel has received, the specialties that are currently in most need of reform would seem to be:
Priority 1
EMERGENCY & URGENT CARE, STROKE SERVICES, PRIMARY CARE INCLUDING GP OUT OF HOURS, GENERAL SURGERY, PATHOLOGY, VASCULAR

Priority 2
PAEDIATRICS, PALLIATIVE CARE, OBSTETRICS, RADIOLOGY, NEONATAL SERVICES, TRAUMA,
UROLOGY, REHABILITATION, COMMUNITY BASED ELDERLY CARE, BREAST SERVICES

RECOMMENDATION 13
The Panel recommends that the Department should formally endorse the criteria and apply them to five services each year to set out the future configuration of services to be commissioned (or not) from the Accountable Care Systems. If applying the criteria leads to the conclusion that the service is vulnerable, plans for reconfiguration should be developed and actioned within this twelve month period.

(Source: Bengoa Expert Panel Report, 2016, page 75-76)

It should also be noted that the Dept. of Health was very clear at the first meeting on 16th January that they want us to ‘have our say’ on only the Criteria, but as this criteria comes directly from the Bengoa Report – it is NOT possible to separate the two even though it would be convenient for them for us to do so.

Health Minister Michelle O’Neill has extended the period of consultation on the criteria for reconfiguring health and social care services by a further two weeks at the request of the public. Speaking about the decision to extend the period of consultation the Minister Michelle O’Neill said:

“The views of the public are vital in bringing forward change and I want to ensure that as many as possible get the opportunity to put their views forward. The meetings provide a real opportunity for the public to engage directly with senior professional medical, nursing and policy staff from the Department of Health.  These criteria will be instrumental in shaping change across HSC and it is critical we get it right.

“I would like to assure the public that full consideration will be given to the views expressed as part of this process in determining the way forward.”

As we have been invited to ask Q’s at the second Dept of Health meeting on Monday 30th January, Newry, Canal Court Hotel,  7 pm – 9 pm, it is VITAL we use this opportunity to ask the 3 Q’S as stated in the picture – as the answers are needed to verify the ‘evidence’ on outcomes for Criteria No 1.

Thank-you to all who continue to speak up and show support for Daisy Hill Hospital to keep it for future generations.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2017. Excerpts and links may be used, 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.

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Speak up for Daisy Hill Hospital – 2017

Speak up for Daisy Hill and submit your views to the consultation by 20th Jan 2017

This meeting on Mon 16th Jan in Newry hosted by the Department of Health is the last chance to find out info on the criteria from the Bengoa Report for changing the Health service in NI and its effects on people in Newry & Mourne, before the consultation period closes, 4 days later on 20th January 2017. We should ask for the Consultation period to be extended further than the deadline of 20th January, 2017.

Speak up and Take part in the Dept. of Health consultation to keep specialist services at Daisy Hill Hospital

Speak up and take part in the Dept. of Health meeting and consultation. Consultation closes 20th January 2017

At the Meeting we will hear the Department of Health’s reasons for proposed Centralisation of services. There are proposals to look at the centralisation of the following specialist services: Stroke services, Emergency and Urgent Care (A&E), GP out of hours, general surgery, paediatrics, neo natal services,  obstetrics, rehabilitation, community based elderly care, etc., (see Bengoa Report pg 76)

The decision on the proposed withdrawal of specialist acute stroke and rehabilitation services from Level 6 Daisy Hill Acute Hospital, Newry –  used as the only local case study in the Bengoa Panel was and still is very controversial and should be examined before final approval is given for removal of stroke services . The Department/Health Minister can intervene if a decision to withdraw services is controversial. This can be shown by the following quote showing the Department of Health’s position on change or withdrawal of Services issued November 2014:                                                                                                             

DEPARTMENT OF HEALTH POLICY GUIDANCE CIRCULAR :
Change or withdrawal of services– Guidance on Roles and Responsibilities, Intro 2:

“This means there are likely to be occasions when decisions about services, properly arrived at by the relevant Arms Length Body (ALB), will need the final approval of the Department/Minister because they are major or controversial in nature”.

(Annex 1 ,page 23 Health & Wellbeing 2026 Consultation on Criteria for Reconfiguring Health & Social Care Services)

Therefore -they can look again at decisions made by the Southern Trust and Commissioners and see if the information is accurate and then make the final decision.

The Bengoa Panel Report itself, which selected the criteria – highlights the proposed centralisation of stroke services from Daisy Hill hospital to Craigavon as a major Local Case Study of best practice – to be up-scaled throughout NI.  The Bengoa Report Criteria will be used as a guideline for future plans and this is why it is so important for the people of Newry & Mourne to attend this meeting and ask questions. If we do not question it and give our views, at the meeting and in writing- these criteria will be used to centralise services in Newry & Mourne to Craigavon.  This consultation is different to previous ones, as it is the actual Department of Health, led by Health Minister Michelle O’Neill MLA- so we are optimistic that they may actually listen if enough people answer.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2017. Excerpts and links may be used, 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.

Bengoa Report uses the London Stroke Model – does it give N.Ireland the full picture?

The Bengoa Report uses the London Stroke Model as an example of international good practice, but by only mentioning the 8 Hyper acute stroke units and ignoring the rest of the local stroke services network in London – is N.Ireland getting the full picture?

The diagram shows there are 31 Stroke Units in London including 8 ‘Hyper acute’ stroke units (HASUs) following reconfiguration of stroke services.

The diagram shows there are 31 Stroke Units in London including 8 ‘Hyper acute’ stroke units (HASUs) following reconfiguration of stroke services.

The International Level Case Study in the Bengoa Panel Report (pg 72) would seem to imply that all the 30 stroke units in London were centralised to only 8 hyper acute stroke units.  As the diagram shows- there is a network of 31 Stroke Units remaining in London including 8 ‘Hyper acute’ stroke units (HASUs) following reconfiguration of stroke services.

It was never intended that ‘Hyper Acute’ Stroke Units in London should work in isolation from the other 23 existing dedicated local stroke units providing stroke services. The Sentinel Stroke National Audit Programme for 2016 shows there is a total of 628 stroke beds in all 31 stroke units in London.

According to the London Stroke Model HYPER ACUTE STROKE UNITS (HASUs) ARE ONLY FOR THE FIRST 72 HOURS OF STROKE CARE – that is why a network of dedicated local stroke units as well as the 8 Hyper Acute stroke units were needed in London.

Confirmation the Southern Trust have proposed the creation of a’ hyper-acute’ stroke unit can be seen in the following extract from a 27th October 2014 press statement:

“The Trust’s proposals are:

  1. The modernisation of in-patient acute and rehabilitation Stroke Services, which are currently provided at Lurgan, Loane House (South Tyrone Hospital) Daisy Hill and Craigavon Area Hospitals. The Trust is proposing the development of a ‘hyper-acute’ stroke unit at Craigavon Area Hospital…..”*.

The Southern Trust’s proposal to have only one ‘Hyper Acute’ Stroke Unit in Craigavon locality with no network of dedicated local stroke units in Newry or Dungannon is in COMPLETE CONTRAST to the London Stroke Model.

If the London Stroke Model is followed correctly by the Southern Trust for safe stroke care –TWO ‘hyper acute’ stroke units – one in Newry City’s Daisy Hill Acute Hospital, and one in Craigavon Hospital – attached to the already existing stroke units are needed. Only this proposal would give ALL THE POPULATION of the Southern Trust the same EQUALITY OF ACCESS to a network of stroke services (both ‘hyper acute’ and dedicated local acute rehabilitation stroke services) as there exists in London.

The criteria evolving from this Bengoa Report is the subject being addressed by the Department of Health in a series of public meetings around Northern Ireland before the current health Consultation on the criteria closes on 20th January 2017.  The meeting in Newry will take place on Monday 16th January in the Newry Conferencing and Banqueting Centre, 39-41 The Mall Newry from 7 -9 pm.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2017. Excerpts and links may be used, 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!

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Bengoa Report – Shock link to Daisy Hill Hospital

Shock as Bengoa Report proposes Daisy Hill Hospital Stroke Services Removal as Way Forward for NI,

People campaigning to save stroke services in Daisy Hill acute Hospital, Newry now face a new challenge with the Bengoa panel report.

This report that addresses Health and Social Care Reform in Northern Ireland,  uses the controversial proposed removal of Stroke services from Daisy Hill Hospital in Newry as the prime local Case Study for Centralising Services.  It states it is an example of how “services can be changed in ways that benefit patients.” No associated Clinical evidence or References are provided in the Case Study to back up the claims and the theory. (Ref: Page 72-3 Bengoa Expert Panel Report ‘Systems not Structures, 2016’)

The criteria evolving from this Bengoa Report is the subject being addressed by the Department of Health in a series of public meetings around Northern Ireland before the current health Consultation on the criteria closes on 20th January 2017.  The meeting in Newry will take place on Monday 16th January in the Newry Conferencing and Banqueting Centre, 39-41 The Mall Newry from 7 -9 pm.

Michelle O’Neill, MLA, is the first Health Minister who has held a public meeting in Newry City – this is an encouraging sign of inclusion for local people and an ideal opportunity for Newry & Mourne people to have a platform for their views on the “rationalisation” or proposed centralisation of health services from Daisy Hill acute hospital and from their area.

As published on the Department of Health’s website  “Speaking about the events, Minister O’Neill said: “They allow the public to engage face to face with senior professional medical, nursing and policy staff  from my Department and the views expressed will be reported back to me.”

Background info

The proposed removal of the Stroke services from Daisy Hill Acute Hospital, Newry to Craigavon Hospital by the Southern Trust has warranted a continuous long-running community campaign, ignored by the Southern Trust.  An estimated 10,000 people marched under the banner ‘Save Daisy Hill Stroke Services’ in a Public Rally and march organised by Newry & Mourne Council in March 2015.  The Lord Mayor of the former Newry & Mourne Council, Daire Hughes, handed in a letter to Daisy Hill, from the Council for the attention of the Southern Trust regarding the removal of stroke services from Daisy Hill Hospital, Newry City to Craigavon hospital.

The Bengoa Report panel members include: Professor Rafael Bengoa (Chair), Dr Alan Stout, Bronagh Scott, Mairead McAlinden, Mark A Taylor

One of the local experts who made up The Bengoa Expert Panel Mairead McAlinden was previous Chief Executive of the Southern Trust (until March 2015.)  She has subsequently been appointed as a member of the Transformation Advisory Board to help implement the Department of Health’s follow on Report: ‘Health and Wellbeing 2026: Delivering Together’ which will include a public consultation on Stroke services in February 2017.

All interested in attending the Department of Health meeting on Monday 16th January 2017 from 7-9 pm should come to Newry Conferencing and Banqueting Centre, 39-41 The Mall Newry BT34 1AT, Tel 028 3025 5790.

You can also link to the Daisy Hill hospital for life campaign at Daisy Hill for Life on Facebook

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Bengoa Report Public Meeting in Newry Mon 16th Jan: 7 – 9 pm

dec-27th-bengoa-meeting-1_3

Click here for meeting info from the Department of Health’s website.

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GOOD NEWS FOR DAISY HILL HOSPITAL?

“We have just recently secured 16 doctors to come and work in the Southern Trust.”  announced Southern Trust interim Chief Executive Francis Rice to the NI Assembly Health Committee on 16 June 2016.

The full minutes of the Health Committee meeting are available at Committee for Health, meeting on Thursday, 16 June 2016 Official Report minutes of evidence

The document can also be downloaded as a PDF from the NI Assembly Hansard Health Committee meeting minutes page (Thursday 16 June 2016) Briefing by Health and Social Care Trusts, Quote on page 10 of pdf).http://aims.niassembly.gov.uk/officialreport/minutesofevidence.aspx?&cid=10

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3 Ways to use the sample Response letter to respond to the Strategic Plan

Show your support again for Daisy Hill Hospital

Rally for Daisy Hill Hospital

Every person in the house can send a separate letter or email, the more the better to get the message through loud and clear to The Southern Trust that we don’t agree with their Strategic Plan to centralise services from Daisy Hill to Craigavon. Please write to them with your views but if you’re not sure what to write – you can use the sample wording, if you wish. It’s available to view and download as a word document ‘Response Letter’ from this link. RESPONSE LETTER suggested wording -to download

THREE DIFFERENT WAYS TO RESPOND

(We’ve included some hints for those not familiar with using computers or emails)


1. PRINT out the letter,

  • and write your name and address in PEN on the letter and post it with a first class stamp.
  • Postal address to: Mrs Paula Clarke, Interim Chief Executive, C/O Corporate Planning Department, The Brackens, Craigavon Area Hospital, 68 Lurgan Road, Portadown, BT63 5QQ (Last day to post 1st class Wed 9th Sept)

OR
2. EMAIL your Response by adding the text as email message text only.

  • by Sending a New Message from your email address to strategic.plan@southerntrust.hscni.net and Copy and Paste all the word document ‘Response letter’ (Use Edit – Select All and Paste into the blank message field of your email. (Its usually a large white box)
  • Then add a cc copy to: Enquiry.hscb@hscni.net (the all over Health board.)
  • Add your Name and Address within the Email text in the message field
  • Click Send!

OR
3. EMAIL Response by sending the word document ‘Response letter’ as a separate ATTACHMENT.

  • (How – Save this word document ‘Response letter’ onto your computer, then type your name and address at the bottom of the letter, and Save a new copy to your computer.
  • Compose a new email and add strategic.plan@southerntrust.hscni.net to the To field and Attach the New signed response letter as an attachment (using the paperclip Icon)
  • Then add a cc copy to Enquiry.hscb@hscni.net (the all-over Health board).
  • Click Send!

Note: Emails must be sent by this Fri. 11th Sept, If you have problems with email sending. Check the Email address and make sure it’s not a hyperlink (These are blue and underlined) If it IS, remove the hyperlink (by Right clicking mouse and selecting remove hyperlink) or try typing the email address in again and retrying the message.

Thank you all for supporting Daisy Hill.  As a community we are strong.

Save daisy Hill Hospital for life

Please Speak up for Daisy Hill and tell the Southern Trust you do not agree with their Strategic Plan to centralise hospital services from Daisy Hill, Newry city to Craigavon.

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Speak out to save children’s and older people services at Daisy Hill Hospital, Newry

peak out for childrens and older peoples services at Daisy Hill

Speak out for children’s and older peoples services at Daisy Hill Hospital, Newry

Childrens services must be kept at Daisy Hill Acute hospital, New Older peoples services must be kept at Daisy Hill acute hospital, Newry

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2017. We welcome sharing 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!

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Background info on why Daisy Hill is an Acute Hospital.

Daisy Hill Hospital is an acute hospital to provide a Seamless web of care with the NI hospital network

Graphic by Daisy Hill for life

DAISY HILL Acute Hospital, Newry was 1 of the 9 acute hospitals chosen, with EQUAL status to provide ACUTE hospital services in the “South” of Northern Ireland* in 2003 when a new pattern of Acute Hospital Services was established. (‘Developing Better Services’) This configuration of 9 Acute hospitals was made in order to give choice and equity of access ”in a seamless web of Acute hospital care” to the whole population of Northern Ireland. It was a direct result of a very detailed and thorough investigation (initiated by Health Minister Barbara de Brun), & finalised by Direct Rule Minister Des Browne.
The Southern Trust is NOT entitled to re-designate Daisy Hill Acute Hospital Newry to the status of a “support” hospital to Craigavon Hospital as they did in their Outline Business Case for Daisy Hill Hospital approved in March 2010.
The importance of ‘Developing Better Services’ designation of Acute Hospitals is still used successfully as a lever to get funding for redevelopment of Craigavon Hospital by the Southern Trust. (eg CAH Business case for Redevelopment of Theatres 1-4, etc).
*source pg 14, Ministerial statement, Developing Better Services 2003

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2017. We welcome the sharing and using 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.

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Access to hospital services

Land mass area of Southern Health and social services Trust. Infographic by Daisy Hill for life 2015

Infographic by Daisy Hill for Life

Every hospital service the Southern Trust centralises to Craigavon from Daisy Hill Acute hospital, Newry makes it nearly impossible for the Ambulance Service to respond within acceptable time limits. The Southern Trust state in their Delivery Plan (Draft) 2015/16 it is not applicable to them that 72.5% of Category A ( Life Threatening) calls are responded to within 8 minutes by ambulances.

The Southern Trust’s attitude of get there whatever way you can to access hospital services both to the population of Newry and the Greater Newry and Mourne, Area of Banbridge and Armagh, and to Ambulance Personnel must be questioned. The Southern Trust need to address this urgently. They take no responsibility that every hospital service the Southern Trust centralises to Craigavon from Daisy Hill Acute hospital, Newry makes it nearly impossible for the Ambulance Service to respond within acceptable time limits.The diagram shows the vast area the Ambulance Service must cover to bring patients to only one acute Hospital in Craigavon, in the most Northern Area of the Southern Trust.

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