MAKE SURE DAISY HILL ISN’T MISSING FROM THE NI REGIONAL NETWORK AS NORTHERN IRELAND REBUILDS DURING/ AFTER COVID-19– AND HELP SHAPE THE FUTURE, by replying to the ‘Temporary Amendments to the HSC Framework Document’ Consultation, by this Friday 4th December 2020, 5pm. The Consultation Documents and info on how to reply can be read in full at: www.health-ni.gov.uk/consultations/HSCframework
You can tell the Department of Health how you feel. It’s your Health service.
You can also use the Online Consultation form. Which ever you prefer. By the deadline of this Friday 4th December 2020, 5pm. But please do take part – do it for your family, the future of Daisy Hill, for those who cant take part themselves and for generations to come. There has been a hospital in Newry for 175 years – NO ONE IS ENTITLED TO TAKE IT AWAY.
EXTERNAL LINKS TO CONSULTATION
Consultation on Temporary Amendments to the Health and Social Care Framework Document for the period June 2020 to May 2022
Rebuilding HSC Services Programme Coordination Office, Department of Health, Annexe 3, Castle Buildings, Stormont Estate, Belfast, BT4 3SQ
Email: RebuildingHSC.Services@health-ni.gov.uk
Telephone: 028 9052 3231
The Department of Health is inviting us all to tell them what we think about the new Amendments. If we DON’T respond we are letting the DoH and Southern Trust Rebuild (or not) for us and future generations – without us.
Nearly £7 billion has been allocated to the Department of Health and the Southern Trust handle over £800 million – we are entitled to our share of this. If we lose services in these Rebuilding Plans for two years to May 2022 we will not get them back. DAISY HILL NEEDS YOU!
Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ – Thank you. Please Follow or Like the Page to receive updates.
The Southern Trust must fast track their plans to open Daisy Hill Hospital ED at once, now that Craigavon Hospital has unfortunately fallen victim to COVID-19 clusters, which were reported on BBC NI News 01.09.2020.
Time is now opportune for the Southern Trust and Southern Local Commissioning Group to prove the truth of the rhetoric to the Southern Trust population how much an essential part of the hospital network, Daisy Hill in Newry is, by reopening the Emergency Department (ED) at once.
“Daisy Hill Hospital is based in the city of Newry and is an essential part of the hospital network provided by the Southern Trust and has been ranked as a CHKS Top 40 Hospital.” (Southern Trust 2017).
Daisy Hill Acute Hospital, Newry City
END OF SEPTEMBER NOT SOON ENOUGH TO OPEN ED
The Southern Trust stated on 24.08.2020 that work is progressing to reopen Daisy Hill ED on a 24/7 basis by the end of September. The Southern Trust Chief Executive has been asked repeatedly to open the ED and the end of September is not soon enough. It is vital to save lives that this date is brought forward to show how effectively they can manage their hospital network.
Daisy Hill 24/7 Type 1 ED was closed on 28th March 2020 – with little warning – so after 6 months to prepare – it is well past time it is reopened, especially given the current circumstance of several covid-19 clusters in Craigavon Hospital.
Mr Shane Devlin praised “The dedication and flexibility of staff during this time has been remarkable” (Southern Trust statement 24.08.2020). This is true of all Southern Trust staff, and especially of Daisy Hill staff who showed immense flexibility by also changing their workplace to Craigavon – but now given the changing circumstances and given the sheer population of Newry & Mourne and beyond – it makes sense that the Southern Trust uses the resources, facilities and staff available in the most sensible way now.
The Diagram and map shows the size of the Southern Trust and the 2 acute hospitals which operate in this Network. It should be noted that Daisy Hill Hospital, Newry is in Newry & Mourne with the largest population (106,499) and largest land mass (898.3 square Km) of all the 5 localities in the Southern Trust area.
Craigavon covers only 281.5 sq Km with less of a population of (102,566) in 2019. (All stats from NISRA) .The map shows the 5 localities / (former) local government districts/LGDs that still remain in the operational area of the Southern Trust, according to its founding legislation.
ED IS A REGIONAL SERVICE
The 106,499 population of Newry & Mourne are being denied time critical access to a Type 1 Emergency Department in a functioning acute hospital, since 28th March 2020 in Newry City.
As they have paid for Regional and Local Urgent and Emergency and acute services through their Regional Rates and Taxes, the population of Newry & Mourne (as well as all of the rest of the population across NI) are entitled to avail of the 24/7 Regional ED Services being provided by the Royal Group of Hospitals including the Royal Belfast Hospital for Sick Children, who have shorter waiting times.
The Southern Trust have a duty of care (under their founding legislation) to provide hospital services in Daisy Hill, Newry – not repeatedly take them away to Craigavon.
Daisy Hill’s Emergency Department has been a vital part of the Northern Ireland Network of Type 1 Emergency Departments for the past 17 years.
The Southern Trust have to end the uncertainty and anxiety caused to the population of Newry & Mourne by the removal of vital ED Services and return Daisy Hills ED and Specialist Staff back to Newry as a matter of urgency.
Sources: Population Stats NISRA 2019 Land Mass Figures – NISRA Southern Trust Statement 24th August 2020 Craigavon Area Hospital: Third Covid-19 outbreak confirmed, Louise Cullen BBC News NI, 01.09.2020 https://www.bbc.co.uk/news/uk-northern-ireland-53989892
PATIENTS ON DOCTORS REGISTERS (NISRA 2018) Derry: 122,280 under 5’s: 8,943 Newry & Mourne: 116,378: under 5’s: 9,481 Craigavon: 105,295 under 5’s: 8,504 Dungannon: 66,848 under 5’s: 5,746 Armagh: 67,930 under 5’s: 5,487 Banbridge: 51,494 under 5’s: 3,927
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Newry, the main Gateway City to NI now, and after we leave the EU, is being denied its rightful place in the Rebuilding of Health and Social Care Services, by the people who are paid to include them.
The graphics which follow show THERE IS NO OTHER Type 1 ED Department in NI that can be accessed within one hour by a third of the population of Newry & Mourne/South Armagh – 38,000 people.
That is why Newry City’s Acute Hospital, Daisy Hill’s ED department was designated in 2003 with 8 other EDs across NI to form a Regional network of 9 Type1 EDs , vital to ensure equality of access within one hour 24/7 to Consultant-led urgent and emergency Care to everyone in NI , no matter where they live – urban and rural.
The Southern Trust needs to take its responsibilities to the Newry & Mourne/South Armagh population seriously and be accountable for their actions. The function of the Southern Trust is to provide hospital accommodation and services in Newry City in Newry & Mourne – the largest administrative area in the Southern Trust.
Their function DOES NOT include the removal of Daisy Hill’s Emergency Department (ED) from the long established Designated Regional network of the nine 24/7 Type 1 ED Departments of Daisy Hill, Royal Group , Antrim, Ulster, Causeway, Mater, Altnagelvin, Craigavon, and S.W. Acute Hospitals, which provided a seamless web of ED care to all of the people of NI over the past 17 years.
The Southern Trust shut down Daisy Hill’s Type 1 ED, at a days notice, without consultation, or any adherence to Equality, Rural Needs, Human Rights, Disability legislation. This Type 1 ED in Daisy Hill Hospital is the only one serving the population of the Southern part of NI one hour drive-time ED Network.
GRAPHICS/MAPS
The accompanying Graphics ‘Drive Times to Nearest Type 1 ED’ show the effect the removal of Daisy Hill ED from the existing network of Nine Type1 EDs across NI has on the Population of Newry & Mourne.
The Department of Health/Public Health Agency and Southern Trust are aware of the importance of this Drive Time information as it was previously analysed and published in the Department’s Pathfinder Project Report and Appendices in 2017. The map in the graphic is a scaled drawn reproduction of the report’s map*(See end for source).
GRAPHIC 1: Drive Time shows approx Drive time to a Type 1 ED across the Southern Trust and wider area when Daisy Hill ED is excluded. It shows that people living in Armagh, Craigavon, Lisburn, and all across the greater Belfast Area are all within a 30 minute car drive time of a Type1 ED. This is as well as being only 30 min Drive time to all other Type 1 EDs in acute hospitals in Belfast). It also shows that Newry & Mourne is most badly affected by removal of Daisy Type 1 Hill ED.
GRAPHIC 2: Focus on Newry & Mourne – Drive Time – focuses in detail at the map showing the area of Newry and Mourne. The Rural areas of the Mournes and South Armagh are most affected without Daisy Hill ED.
Nearly 38,000 people in Newry & Mourne denied right to access a Type 1 ED within 1 hour
Nearly 38,000 people in Newry & Mourne denied right to access a Type 1 ED within 1 hour
Graphic 2 shows the area of Newry & Mourne affected with added reference to Electoral Ward populations. Without DHH ED the population of the following electoral wards have to travel 75 to 90 minutes+ to get to a 24/7 TYPE 1 ED in an emergency situation.
OVER 75 MINUTES DRIVETIME TO GET TO A 24/7 TYPE 1 ED (coloured dark orange on maps): see key
1 : Annalong: 2. Binnion 3 : Kilkeel Central 4 : Kilkeel South 5 : Lisnacree 6 : Rostrevor
60 TO 75 MINUTES+ DRIVE TIME TO GET TO A 24/7 TYPE 1 ED. (coloured dark yellow on maps): see key:
These times are only estimates. Only those of us who have had to make the journey to the nearest ED know exactly how long the journey takes.
The Southern Trust’s has a centralisation policy of provision of all medical and surgical Urgent and Emergency Services. Because of this Southern Trust policy – approximately 38,000 people in Newry & Mourne (including South Armagh) since 28th March 2020, have been potentially denied their right to access immediate life saving care in a Type 1 ED within one hour Drive time from their homes. This includes 8,403 children and 5,914 aged 65+. (Population data from latest NISRA estimated 2019 stats).
REBUILDING PLANS:
Southern Trust made an agreement with other Health Trusts and the Department of Health NI that they will:
(1) Ensure Equity of Access for the treatment of patients across Northern Ireland (2) Minimise transmission of Covid-19; and (3) Protect access to the most urgent services for our population.
By shutting down and refusing to reopen Newry City’s Type 1 ED department the Southern Trust have not ensured “Equity of Access” for the treatment of patients across NI and have denied approx 38,000 men, women and children in Newry and Mourne access to time critical immediate Urgent and Emergency Car within an hour.
They have also destroyed the existing 17 years Regional network of 9 Type1 EDs being provided by all the other Trusts.
JUST LIKE NEWRY AND DAISY HILL WAS LEFT OUT OF THE STROKE CONSULTATION OPTIONS
Like with the Stroke consultation (where all Stroke care was centralised to Craigavon from Newry), the Southern Trust has again wrongly left Daisy Hill out – this time out of the Regional Plans for Urgent and Emergency and other services in their Rebuilding Health and Social Care services plans.
STAND YOUR GROUND
It is on record that there has been a hospital in Newry caring for anyone in need of immediate life saving services for the past 175 years, through famine, wars and the Cholera epidemic.
It took the Southern Trust, to remove its caring specialist staff at a days notice, from Newry to Craigavon, when they were needed most in Newry, during the Covid 19 pandemic, leaving the entire population of Newry & Mourne without a lifeline in Newry city to time critical Urgent and Emergency Care.
All Politicians, Unions, community representatives and individuals. Please stand your ground to get what is rightfully ours because we have paid for it.
The Department of Health get £5 billion to improve the health and social Care of all of the people of NI who need healthcare no matter where they live. Together we will stand our ground to get Newry, the Gateway City to NI and Newry & Mourne/South Armagh firmly back on the map.
Background:
*Map – (Source: Appendices – Daisy Hill Hospital Pathfinder Project – Development of an Unscheduled Care Model through a Co-Production Approach, 20th December 2017. Appendix 2 – Population Needs Assessment – Report of the Needs Assessment Figure 6-2: Drivetime Analysis for NI – DHH ED excluded. Pg 87/88.)
TYPE 1 Emergency Departments are defined as those with a consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services on a round the clock basis.
Daisy Hill Acute Hospital with 24/7 Type 1 ED in Newry is in the Southern Health and Social Care Trust area.
RELEVANT RESEARCH
Extensive research by ‘Developing Better Services’ Report 2003 found that only a total of 9 EDs would ensure the entire population of NI had access WITHIN ONE HOUR to immediate urgent and emergency care no matter where they lived in both urban or rural areas.
Newry & Mourne is the largest locality of the 5 localities in the operational area of the Southern Trust. The five localities in consistent order of population size since the establishment of the Southern Trust in 2007 are: (1) Newry & Mourne (2) Craigavon (3) Armagh (4) Dungannon and (5) Banbridge.
GOVERNMENT CONSTITUENCY INFO
Newry & Mourne Locality is in Two Westminster and NI Assembly constituencies: Newry Armagh and South Down. 17 Wards are in the Newry Armagh Constituency and 13 Wards from Newry & Mourne are in South Down Constituency.
NEWRY & ARMAGH CONSTITUENCY: Daisy Hill, Drumalane, St Marys, St Patrick’s, Windsor Hill, Drumgullion, Ballybot, Newtownhamilton, Camlough, Derrymore, Bessbrook, Tullyhappy, Crossmaglen, Creggan, Silverbridge, Forkhill, Fathom.
SOUTH DOWN CONSTITUENCY: 13 electoral wards of Newry & Mourne are in South Down Constituency.
Spelga, Rostrevor, Sea View, Clonallan, Burren & Kilbroney, Mayobridge, Derryleckagh, Annalong, Binnion, Kilkeel Central, Kilkeel South, Lisnacree, and Donaghmore: 49,000 of the Newry & Mourne population are in the South Down Constituency.
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Southern Trust Rebuild Plans Phase 2 (July to 30 Sept 2020) now published show the Southern Trust have not committed to the permanent re-opening of Children’s and Adults ED Department in Daisy Hill Acute Hospital. Newry. (See Plan page 6, link at end)
Six months with no emergency department through the dark days of the continuing covid-19 pandemic and no commitment to reopen the Consultant Led-24/7 ED – is a public health failure.
The Southern Trust will go down in history as the Health Trust who denied access to Daisy Hill hospital for immediate life saving care to the men, women and children of the largest locality in their care- Newry & Mourne. (106,500 population: NISRA)
Both Phase 2 and Phase 1 Rebuild Plans by Southern Trust show they have not responded to calls by elected representatives and individuals who have campaigned for the return of the Type 1 24/7 ED in Daisy Hill, Newry.
LAW AND STANDARDS THE SOUTHERN TRUST MUST ADHERE TO
1. Establishment Order
The Southern Trust function under their founding legislation is to PROVIDE hospital accommodation and services, not to TAKE AWAY accommodation and Services in Daisy Hill acute hospital, Newry. Their function is not to centralise all services including immediate life saving services like ED from Newry to Craigavon. They have a duty to keep the doors of Daisy Hill acute hospital open to anyone in need of immediate life saving care.
The Southern Trust’s function is to provide health and social care services paid for with public money from Regional Rates and Taxes. They have almost 1,600 admin staff and were given nearly £700 million in 2019/20 from the HSCB for provision of services across ALL of the Southern Trust, not just in some of the 5 geographical areas under their care.
2. Rural Needs Act 2016
Trusts also have obligations under the Rural Needs Act. Every other health trust in NI continued to provide Covid and Non Covid Care in their Rural and Urban Acute Hospitals, except the Southern Trust. The Southern Trust decided to deny access to Daisy Hill Acute Hospital which provided life saving Urgent and Emergency services for children and adults to the largest Rural catchment population in their care. Daisy Hill had ED attendances of 58,277 people in 2018/19.
3. Quality Standards for Health and Social care
Quality Standards for Health and Social care take into account Equality and Human Rights legislation where everyone has to be treated equally and humanely.
To refuse access to immediate life saving care to children and adults alike in Daisy Hill hospital by closing the only Accident and Emergency Department they have access to for immediate life saving services is inhumane treatment and should not be condoned.
The Centralisation of Acute Hospital Services to Craigavon Agenda of the Southern Trust evident in their planning policies is unfair and inhumane – and does not take into account the legislation.
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These letters ask for the Return and Enhancement of all Acute and Emergency services and valuable staff transferred to Craigavon Hospital to be restored to Newry IMMEDIATELY, without delay. If you agree, please contact your local representatives, including Councillors, MLA’s and MP’s, Contact Details Follow Below
After downloading (Just Click on the Blue Links, Select Save and then OK to save to your own device.) The contents of these draft Letters can be used as they are or as a guide to copy and paste from to write your own message/letter to send to MPs, MLAs, Councillors and/other organisations like Health Authorities (e.g. Department of Health) and other Stakeholders regarding the Southern Trust – June 2020 Rebuild Plan.
Please add your name and address to the letter if you are attaching it to an Email so the recipient knows it is genuine and also remember to ‘Save As’ with a New Filename or your choice e.g. Daisy Hill Hospital-2020 or whatever you like maybe using your initials to make it unique.
Tips on attaching the Email-Letter Doc to an Email are at the end of this piece, should you need them.
Dept. of Health ‘Rebuilding Health and Social Care’ Framework docs show services provided during COVID by each of the 5 Health Trusts, and more importantly Plans on how the Health Trusts propose to both Restore and scale back services following the easing of COVID 19.
The Plans each Trust have for Rebuilding HSC Services can be found at:
This letter is to support the view that all Acute and Emergency services and valuable staff transferred to Craigavon Hospital should be restored to Newry IMMEDIATELY, without delay.
If you agree please contact all your local representatives, Councillors, MLA’s and MP’s. They are all in a position as stakeholders to represent our views in relation to the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
MORE CONTACT INFO & LINKS
Contact List for MLAs & MPs for Constituencies of Newry & Armagh/ South Down (14.06.2020)
They are all in a position as stakeholders to represent our views regarding the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
This contact list is based on information as listed on the NI Assembly Portal page and other sources such as MLA’s Facebook pages or political party websites. Despite attempts to be as accurate as possible, if there is any information which is not up-to-date – apologies. (MLAs are listed in alphabetical order.)
Contact List already downloaded from data.gov.uk also directly available here: nmddc-councillors-12nov19
Step by Step Instructions how to Use the Draft Email Letter
Download the Document to your device and ‘Save As’ to give the File a new name of your choice .
Edit the document as you please, either delete or add your own info.
Add your NAME and ADDRESS at the end (or Email Address) so the recipient knows it is a genuine letter.
Click ‘Save’ to Save your new Changes
Compose New Message and Select the Paperclip Icon and select your File to Attach it to your Email message. (You will see the Filename attached to your Email when it has uploaded)
Type the email address of the person you want to send an email to in the To Field.
DAISY HILL HOSPITAL, NEWRY NEEDS YOUR SUPPORT LIKE NEVER BEFORE
3 Reasons why it is so important to Email your Representatives.
>REASON 1: THESE HSC REBUILD PLANS WILL DICTATE WHAT ACUTE SPECIALIST SERVICES WILL BE CENTRALISED TO CRAIGAVON FOR NOW AND THE FUTURE.
The Southern Trust Plan for June to September shows that although they promised to return the urgent and Emergency Care Services and staff to Daisy Hill as soon as the immediate threat of Covid- 19 was over – they have refused to do so. The Southern Trusts function, under the 2006 Establishment Order, is to provide hospital services, in Daisy Hill, Newry for the consistently largest population of the five localities in the admin area of the Southern Trust in Newry & Mourne – (their function is NOT to move them to Craigavon).
These Rebuilding Plans are LONG TERM future plans to decide location of all urgent and emergency care services, diagnostics, cancer, stroke, heart, and will decide which hospitals will shut in the future. This will dramatically affect provision of ED and inpatient hospital services in Newry & Mourne and NI FOR THE FUTURE.
>REASON 2: NEWRY & MOURNE HAS NO OTHER NEARBY ALTERNATIVE FOR URGENT AND EMERGENCY CARE AND INPATIENT CARE SERVICES:
In 2019 THERE WERE 60,000 ATTENDANCES TO DHH ED. When all ED services and ED staff were suddenly stripped from Daisy Hill Hospital and centralised to Craigavon Hospital at the height of the Covid Pandemic, the people of Newry & Mourne and surrounding areas unacceptably had no nearby alternative ED to go to for either Covid or non-Covid Emergencies. Adults and children alike, requiring any emergency care which needs immediate attention are now having their LIVES PUT IN DANGER because the Southern Trust are refusing to provide treatment in Daisy Hill ED now or in the future.
TAKE YOUR PICK
In direct comparison, Craigavon population has many alternative EDs to go WITHIN HALF HOURS MOTORWAY JOURNEY AWAY .They are as follows: The Royal (NI Regional Hospital), Royal Hospital for Sick Children, The Mater (NI Covid Centre), the Ulster, the City (formerly Covid Nightingale Hospital), Antrim Hospital, and Lisburn Hospital.
>REASON 3: POPULATION STATS: Newry & Mourne has been 4th highest locality population in NI since pre 1972 and is projected to be 3rd highest population in NI by 2023. Since the Southern Trust was established in 2007 Newry & Mourne has always been the largest of the 5 localities in the Southern Trust – with greatest need and THIS CAN BE IGNORED NO LONGER. In 2019 Newry & Mourne has the 3rd highest number of births in NI. This all can be confirmed by official NISRA stats.
>WHO CAN I EMAIL?
1. Representatives (Councillors, MLA’s and MPs).
2. Public Authorities (Public servants – Dept of Health, Health Trusts)
3. Others in your area who you may think of yourself e.g. Charities, community groups, business leaders etc
Two Draft Letter/Emails re Restoration of Daisy Hill ED June 2020 for those who wish to write to their MP, MLAs or Councillor or other Stakeholders regarding the Southern Trust – June 2020 Rebuild Plan is available by clicking on the blue links below:
for you to download and type on (or print off if you want to post it). After downloading save the File with a new name if you intend to attach it to an Email. Edit as you please and remember to add your NAME and ADDRESS (or Email Address) so they know it is a genuine letter.
Links to Contact Lists:
What is the Southern Trust Rebuild Plan? (June 2020)
Dept. of Health ‘Rebuilding Health and Social Care’ Framework docs show services provided during COVID by each of the 5 Health Trusts, and more importantly Plans on how the Health Trusts propose to both Restore and scale back services following the easing of COVID 19.
The Plans each Trust have for Rebuilding HSC Services can be found at:
This letter is to support the view that all Acute and Emergency services and valuable staff transferred to Craigavon Hospital should be restored to Newry IMMEDIATELY, without delay.
If you agree please contact all your local representatives, Councillors, MLA’s and MP’s. They are all in a position as stakeholders to represent our views in relation to the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
MORE CONTACT INFO & LINKS
Contact List for MLAs & MPs for Constituencies of Newry & Armagh/ South Down (14.06.2020)
This contact list is based on information as listed on the NI Assembly Portal page and other sources such as MLA’s Facebook pages or political party websites. Despite attempts to be as accurate as possible, if there is any information which is not up-to-date – apologies. (MLAs are listed in alphabetical order.)
Newry & Armagh MLAs
Cathal Boylan (Sinn Féin)
William Irwin (DUP)
Liz Kimmins (Sinn Féin)
Justin McNulty (SDLP)
Conor Murphy (Sinn Féin)
Cathal Boylan MLA(Sinn Féin);
Email: cathal.boylan@mla.niassembly.gov.uk
Constituency Address: Thomas Street, Armagh, BT61 7QB;
Phone: 02837511797
William Irwin MLA (DUP)
Email: william.irwin@mla.niassembly.gov.uk
Constituency Address: 18 Main Street, Rich Hill, BT61 9PW; Phone: 028 38870500;
Liz Kimmins MLA (Sinn Féin)
Try Email as listed on MLA’s facebook profile, Email: lizkimminssf@gmail.com or Newry & Armagh Sinn Fein Email address: sfcrossmaglen@gmail.com
2019 ended with Northern Ireland’s Health Care in crisis: Patient Waiting lists at record highs, healthcare workers on strike over pay and staffing levels, Nurses from the Royal College of Nursing on strike for the first time in its 103 year history. This ‘crisis’ is recognised by the Royal College of Surgeons, the Royal College of Nursing and Health Unions
Health Care workers on strike here have been short changed in comparison with the rest of the UK, on pay and staffing levels. But in terms of Acute Hospital Care, are people in Northern Ireland being treated fairly in the number and location of specialist acute hospitals?
Before NI can start to fix the current Health Care Crisis –some background is necessary to find out how it got to this point.
There were 19 Acute hospitals in NI in 1995 as the map below, reproduced from The Department of Health’s Regional Strategy (1997 – 2002) shows.
According to the Department of Health:
“If the ratio of acute hospitals to population which currently obtains in England were applied to Northern Ireland (1,649,131 in 1995) there would be no more than 10 acute hospitals in NI. Thus many acute hospitals in NI serve much smaller populations than acute hospitals in England.”
Dept. of Health for Northern Ireland Regional Strategy (1997 – 2002)
Direct Rule Health Minister Mr Moss stated in a Hansard Report 5 March 1997:
“The Department’s Regional Strategy for 1997 to 2002 was published last year and envisaged specialised acute hospital services being built around the cornerstone of Northern Ireland’s six major hospitals- the Royal Victoria hospital, the Belfast City hospital, Craigavon, Antrim, Altnagelvin and the Ulster.”
It clearly states also that:
“While investment where appropriate will be made in other hospitals, it is expected that those SIX HOSPITALS will provide the main focus for FUTURE INVESTMENT in INPATIENT FACILITIES.”
Dept. of Health for Northern Ireland Regional Strategy (1997 – 2002) p65
These 6 hospitals out of 19 hospitals were envisaged as specialist acute hospitals, because of hospital size, NOT based on where the largest settlements of population lived, compared to England who the strategy stated would have 10 hospitals for a population the size of NI (1,649,131). The mid-year 1995 NISRA populations (Table) prove this.
They show that Daisy Hill acute Hospital, Newry & Mourne LGD – the FOURTH largest population (84,035) in NI, and Lisburn LGD (106,583), the SECOND Largest population in NI were COMPLETELY IGNORED for consideration as one of 6 major acute hospitals, while 3 other acute hospitals serving SMALLER populations in the local Government Districts of Craigavon, (population 77,689) Antrim (48,489), and Castlereagh (64,616) were listed for preservation.
Accurate population demographics, as provided by NISRA must inform health planning and future investment in inpatient facilities across NI
This trend of ignoring population size has continued into the present (as the next post will show), so to truly combat the Northern Ireland wide health crisis – ACCURATE DEMOGRAPHICS provided by NI Statistics and Research Agency (NISRA) must inform health planning. This includes using these official statistics, as presented by NISRA to determine WHERE Specialist acute Hospitals and specialist inpatient and outpatient acute services are located.
Acute Hospital accommodation and services are paid for through Rates and Taxes by everyone, irrespective of where they live in NI – Urban or Rural, everyone is entitled to equality of access to Hospital Care.
Further posts will look at the present and future NI Demographics in relation to location of acute hospital provision.
BACKGROUND A Short History – Pre Centralisation – In 1995 there were 19 ACUTE HOSPITALS in Northern Ireland. (See Map or Full List at End of post.)
1995: All NI population: 1,649,131*
1995: 15 LARGEST POPULATION SETTLEMENTS IN NORTHERN IRELAND (Statistics from NISRA*)
19 ACUTE HOSPITALS IN 1995 NI (Alphabetical order) Altnagelvin (Derry); Antrim; Ards; Banbridge; Causeway (Coleraine); City (Belfast); Craigavon; Daisy Hill (Newry); Downe; Erne (Enniskillen); Lagan Valley (Lisburn) ; Mater (Belfast); Mid-Ulster(Magherafelt); Route (Ballymoney); Royal Group (Belfast); South Tyrone; Tyrone County (Omagh); Ulster (Castlereagh); Whiteabbey (Newtownabbey).
Sources: NI Regional Strategy for Health and Social Wellbeing (1997- 2002) ‘Health and Wellbeing into the Next Millennium’
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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
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.”
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.
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
The DOH, PHA, HSCB and Commissioners need to take action to assess Population Health Needs and provide services for Newry & Mourne former LGD , (which includes South Armagh) both as:
(1) Newry & Mourne has been the consistently largest local government district that remains in the operational area of the Southern Trust since its inception in 2007. NISRA demographics confirm this.
Latest official population stats for the 5 LGDs in the operational area of the Southern Trust
(1)Newry & Mourne ( 105,693*); (2) Craigavon ( 101,489*); (3)Armagh(62,976*) (4) Dungannon (62,666*) and (5) Banbridge (50,717*) [ [2018* NISRA]. This has been consistently ignored by the Southern Trust since they came into operation in 2007.
(2) Newry &Mourne LGD has always been the 4th highest LGD population in NI since 1972 (for nearly 50 years) after only Belfast, Lisburn (Greater Belfast ) and Derry.
(3) NISRA demographics confirm the Newry & Mourne population is projected to be the 3rd HIGHEST LGD POPULATION IN THE WHOLE OF NI BY 2023 with 110,090 population after only (1st)Belfast (289,130) and (2nd) Lisburn (Greater Belfast): 133,106. Derry is projected to be the 4th highest population in NI with 110,028 (NISRA).
These demographics were not considered in the ‘Reshaping Stroke Care’ Consultation or by the Southern Trust. A population Health Needs Assessment using accurate statistics will show the DoH the population health needs within Newry & Mourne, including needs for specialist stroke services.
A Population Health Needs Assessment (at local Government District Level) using accurate NISRA demographics will show quite clearly the continued need for specialist Stroke staff in Daisy Hill acute Hospital combined Stroke Unit, in order to provide time crucial emergency, acute and rehabilitation stroke care for the Newry & Mourne population and further afield within the same time frame as in urban areas in NI.
Centralisation of stroke services to one area in Craigavon will not provide safe stroke care in Newry & Mourne and will cost lives.
PHASE OF WORK REQUESTED:
CALL FOR THE DOH, PHA, HSCB and COMMISSIONERS TO:
1. Conduct a Full Population Health Needs Assessment at individual Local Government District level (not at Trust level) using official NISRA Statistics – not Administrative stats such as Integrated Care Partnerships or theoretical modelled hospital demand. 2. Carry out Full Rural Impact Assessment (Rural Needs Act 2016) 3. Carry out an Environmental Impact Assessment to assess the Carbon Footprint implications of Centralisation Then 4. Rewrite the Stroke Consultation and Stroke Options following these assessments, based on population needs, along with the Consultation Responses.
WHY THE STROKE OPTIONS NEED TO BE RE-WRITTEN
Under “Change or Withdrawal of services” – ALL 8 existing specialist Acute Stroke Units (including Daisy Hill, Newry combined specialist Acute Stroke Rehabilitation Unit) , NOT JUST 6 STROKE UNITS are entitled to be included in an NI wide consultation questionnaire options for upgrading to Hyperacute stroke units and retained as Acute Stroke Units.
The finally selected options must ensure immediate access to Emergency and inpatient specialist stroke Care in a fair and regionally balanced way across NI
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.
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 wantto 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
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:
(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.
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?
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 includeslosing 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.
For background information on the 2019 NI stroke Consultation document – please see the following post:
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.
The urgent need for MRI and CT scanning equipment in Daisy Hill Acute Hospital, Newry for now and the future, was pointed out by many people in responses to the Draft Consultation called ‘Strategic Framework for Imaging Services in Health and Social Care’, (which closed in January 2018.)
The Department of Health NI has published the Final Framework and Summary of Responses documents on their website. (Links are available below)
WAITING LISTS GROW IN THE SOUTHERN TRUST
As demand for diagnostic MRI and CT scans in the Southern Trust area increases, this need for more imaging equipment becomes more urgent.
Of the 5 Health Trusts in Northern Ireland – the Southern Trust had the HIGHEST number of people (26,383) on the URGENT Waiting list in need of CT diagnostic scanning, out of 34,137 people waiting for CT scans in the Southern Trust. (for the period 31st July 2017 – 30th June 2018).
The Southern Trust also had the 2nd highest number of people in NI on the URGENT waiting list for diagnostic MRI scans during the same period (9,419 people).
Providing extra CT and MRI scanners in Daisy Hill Acute Hospital, Newry – in the largest locality in the Southern Trust would improve these waiting lists.
However there is NO CAPITAL INVESTMENT PROPOSED as a PRIORITY for the replacement of the eight year old CT Scanner, or new MRI and CT scanners in DAISY HILL ACUTE HOSPITAL (for 2014 to 2022).
Extracts from this document show plans for proposed CT/MRI Scanning Equipment Investment (2014 – 2022) and the level of priority the Trust assigns it.
New/Replacement equipment is NOT a TRUST PRIORITY for DAISY HILL Acute Hospital, Newry City.
Trust Priority EQUIPMENT £ Est. Cost
NOT A PRIORITY; MRI SCANNER Daisy Hill £500k for 2016/17
NOT A PRIORITY; CT SCANNER Daisy Hill £500k for 2016/17
In the same period, the Trust assigns Priority 1, 2, 3 (2014 – 2022) for CT/MRI equipment for CRAIGAVON Hospital at a TOTAL COST of nearly £4.5 MILLION
Trust Priority EQUIPMENT £ Est. Cost
PRIORITY 1; 2ND NEW CT Scanner £2 million for 2015 /16
PRIORITY 2; 2ND MRI Scanner £1.5 million for 2014/15
PRIORITY 3; UPGRADE CT Scanner £495K for 2015/16
PRIORITY 3; UPGRADE CT Scanner £500K for 2021/22
Trust priority 1, 2, 3 (2014 – 2022) for CRAIGAVON > TOTAL COST nearly £4.5 MILLION
(Source: Imaging Review Equipment Management Document, see pg 31/32 table)
£62.8 MILLION PROPOSED INVESTMENT FUNDING 2014/15 – 2022 FOR IMAGING EQUIPMENT IN NI
Under the ‘Proposed Major Equipment Investment Programme’ (see Annex D Equipment Management Document) – all five Health Trusts in NI have asked for a total of £62.8 million from the Department of Health for New and Replacement of major imaging equipment (from 2014/15 to 2022) under Royal College of Radiologists guidelines.
The Trust have asked for nearly £4.5 million of this proposed Investment as a Trust Priority for CT and MRI scanning equipment for Craigavon only between 2014 to 2022.
One proposed new CT scanner in Craigavon Hospital for 2015/16 (Trust Priority 1) was itemised to cost £2million, this is enough money to pay for one Necessary MRI scanner as well as 1 Vital CT scanner in Daisy Hill Acute Hospital, Newry City.
Daisy Hill Hospital is not even down as a Trust Priority to get a REPLACEMENT CT scanner (to replace the CT scanner which was installed in 2010) even though the Royal College of Radiologist guidelines should be adhered to.
DEMOGRAPHICS (population)
Using the latest population estimates (June 2017), Newry & Mourne Locality has the largest Local population (105,161) of the five former Local Government Districts of Newry & Mourne, Banbridge, Dungannon, Armagh and Craigavon in the operational area of the Southern Trust.
Daisy Hill Acute Hospital, Newry city should currently have at least TWO NEW diagnostic MRI and 2 NEW CT scanners, plus a NEW MOBILE SCANNER and NEW SCREENING ROOMS, as in Craigavon Local Government District (which always had a smaller Local Government District or Locality population.)
Do you agree? If so, please continue to speak up for Daisy Hill. Continued support from the Community, Politicians, Individuals, Trade Unions and businesses on this issue is URGENTLY NEEDED NOW.
BACKGROUND INFO & LINKS
Links to the Strategic Framework for Imaging Services in Health and Social Care Consultation documents referred to in this article are below:
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