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.
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.
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.
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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
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 effectiveness of treatment in the GOLDEN HOUR is well documented in
the emergency medicine and stroke treatment community, even if our DoH
refuse to recognise the term ‘Golden Hour’ in the recent FAQ/ Frequently
asked Questions supplement to the consultation document (see FAQ5).
It is well known that patients receiving treatment within the first 60
minutes of symptom onset, (termed the Golden Hour,) have the greatest
opportunity to benefit from restoration of blood flow therapy with
respect to disability and living independently. This time-frame is when
the volume of salvageable brain and the patient’s capacity to benefit
from clot-busting therapy are greatest.
The reason the first hour of stroke is called ‘golden’ is because
stroke patients have a much greater chance of SURVIVING and avoiding
long-term brain damage if they arrive at the hospital and receive
treatment with a clot-busting drug called TPA (Altepalse) within that
first hour from onset of stroke:
“Therapeutic benefit is maximal in the first minutes after symptom onset and declines rapidly during the next 4.5 hours.” (Saver MD)
DoH DO NOT RECOGNISE THE TERM ‘GOLDEN HOUR.’
The DoH try to justify selectively making Stroke patients travel further for immediate Emergency Stroke Care during the ‘Golden Hour’ from onset of stroke in Newry Mourne & Down by stating that: “the Golden Hour is not a recognised term in Stroke Care. In our healthcare system we work to the National Clinical Guidelines for stroke, which is the definitive source of how stroke care should be delivered in the UK.”
It is the DoH’s opinion that: “The most important factor in stroke care is not the time to hospital. It is the time to expert assessment, brain scanning and treatment that is critical.” (See FAQ 5:Taken from Questions and Answers Supplement to 2019 Stroke Consultation).
CLINICAL EVIDENCE SUPPORTING IMPORTANCE OF ‘GOLDEN HOUR’
At the International Stroke Conference 2018 in Los Angeles M. Shazam Hussain, MD, Director of Cleveland Clinic Cerebrovascular Center presented significant findings that the “golden hour” is proving to live up to its name, even for patients with one of the most serious forms of ischemic stroke.
According to this study, 52 percent of individuals suffering an ischemic stroke had better long-term outcomes if they received Thrombolysis medication (Alteplase) within 60 minutes of symptom onset. This compares to only 27 percent of patients showing good long-term outcomes – with respect to disability and living independently — if administered Alteplase beyond the golden hour.
A summary of The Lancet article (2013): ‘Streamlining of pre-hospital stroke management: the golden hour’ reinforces the importance of the narrow time-frame or ‘Golden Hour’:
“Thrombolysis with Alteplase administered within a narrow therapeutic window provides an effective therapy for acute ischaemic stroke. However, mainly because of prehospital delay, patients often arrive too late for treatment, and no more than 1–8% of patients with stroke obtain this treatment.
We recommend that ALL LINKS in the PREHOSPITAL STROKE RESCUE CHAIN must be optimised so that in the future more than a small minority of patients can profit from time-sensitive acute stroke therapy.”
The Lancet article (2013)
Therefore pre-hospital travel time for the Newry Mourne and Down population should also be shortened, not lengthened, in receiving 999 Emergency Stroke Care to save lives with better outcomes.
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 fromthe combined Specialist Acute Stroke/Rehab Unit, which has existed since pre-2003in Daisy Hill Acute Hospital, Newry, must be challenged!
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.
The 3
Urban Hospitals Altnagelvin, Craigavon, and Royal Victoria will never
experience an increase in travel times because they feature in all 6
Options in the 2019 Stroke Questionnaire to be upgraded to Hyperacute
stroke units with co-located Acute Stroke Units.
RURAL HOSPITALS OF DAISY HILL AND CAUSEWAY OMITTED FROM ALL SIX OPTIONS
However the two Rural hospitals of Daisy Hill and Causeway have been omitted altogether from all six options, confirming they will be shut down as if they never existed as part of the network providing 999 Emergency Stroke care to the population of NI.
THERE ARE NO RURAL HOSPITALS INCLUDED IN ALL 6 OPTIONS FOR HYPERACUTE AND ACUTE STROKE UNITS.
The DOH forget that Rurality is a factor in allocating Health and
Social Care Funding which means that there is extra money to provide
services in Rural areas which should be taken into account in deciding
where stroke Units will be provided.
*********RURAL NEEDS ACT (2016)*************
To have Three Hyperacute stroke units for Urban Areas of NI in all 6 Options and NO Option for a Hyperacute Stroke Unit for the Catchment population for the LARGEST RURAL POPULATION in NI namely Newry, Mourne & Down (which includes S.Armagh) Local Government District is NOT FAIR AND EQUITABLE TREATMENT in revising policies, strategies and plans, and designing and delivering public services such as Acute Stroke Care under the 2016 Rural Needs Act.
The Rural Needs Act NI 2016, (which is not a devolved matter) is there to PROTECT the Rural Population from this unfair treatment and “can relate to the ability to access key public services such as health, the ability to access suitable employment opportunities, and the ability to enjoy a healthy lifestyle”.
NEWRY MOURNE & DOWN LOCALITY SHOULD ALREADY HAVE A MAJOR ACUTE HOSPITAL
There is no doubt that Newry Mourne and Down LGD with the largest Rural
population in NI with 179,000 people, SHOULD ALREADY have a major acute
hospital, in Newry as proposed by Secretary of State Peter Hain in
2005.
This Stroke consultation shows that the Department of
Health are not even prepared to give dying stroke patients from the
largest rural Population in NI, the basic essential need of immediate
access to Emergency Stroke Care.
The Rural catchment population for Daisy Hill Acute Hospital, Newry, is not being treated fairly and equitability in the same way as the catchment population of the Urban Stroke Units in Altnagelvin, Craigavon and Royal Victoria Hospitals who will have immediate access, as they should, to life saving stroke care, in Hyperacute and Acute Stroke Units without having to travel further than at present.
This deliberate plan to exclude the Rural populations need for IMMEDIATE, not delayed, access to life saving Emergency Stroke Care, including CT scanning and Thrombolysis, followed by direct access into a specialist Hyperacute Stroke Unit /Acute Stroke Unit will COST LIVES, not save lives of Stroke patients and should not be condoned.
“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
One of the Functions of the Southern Health and Social Care Trust under the 2006 Establishment Order is to PROVIDE SERVICES – (not take away existing services) to the population of the five former Local Government Districts (LGD)s or Localities of (1) Newry & Mourne LGD (105,161); (2)Craigavon LGD (100,310); (3)Armagh LGD (62,427); (4) Dungannon LGD (62,149) and (5) Banbridge LGD (50,265).
The Southern Trust have a duty of care to plan provision of services in equal measure to all 380,312* people under their care.
Proof that the future configuration of Hyperacute and Acute stroke Units in the Northern Ireland Stroke Consultation Document 2019 was decided not only by the Department of Health, but also by all of the Health Trusts in NI, can be seen from the Western Trust website which states:-
‘Speaking ahead of the meeting of the Western Trust Board this week, Dr Anne Kilgallen, Western Trust Chief Executive said:
“The Department of Health is leading on the Stroke Consultation and all Health and Social Care Trusts have been actively involved in the discussions in preparation. We in the Western Trust are very pleased that both the South West Acute and Altnagelvin Hospitals are part of the options being considered.”‘
If only it could be said that the Southern Trust were also actively involved in discussions and preparations to make sure that the existing Specialist combined Acute Stroke /Rehabilitation Unit in Daisy Hill, Newry City (in the largest locality in the Southern Trust) was being put forward as a vital Hyperacute Stroke Unit, co-located with an Acute Stroke in the future network of specialist Stroke Units in NI.
Compare how inclusively the Western Health and Social Care Trust have reassured their staff and population of 301,448*, that they are doing their best to retain and enhance their TWO ACUTE STROKE UNITS in Altnagelvin Hospital in Derry and the South West hospital in Enniskillen, with the Southern Trust’s approach.
The Southern Trust (SHSCT), has consistently pushed forward at every opportunity, removal of vital life saving stroke services from Daisy Hill, out of reach to Craigavon in their Centralisation Programme of all specialist services to Craigavon. (Even the 2016 Bengoa Report’s only Local Case Study promoted SHSCTs proposal to centralise all Stroke services to Craigavon and remove them forever from Daisy Hill, Newry City).
Because of this, Daisy Hill Acute Hospital, Newry City specialist combined Acute/Rehabilitation Stroke Unit, (in the largest of the five Local Government Districts in the Southern Trust), does not even warrant a mention on the list of options given in the Northern Ireland Stroke Consultation 2019.
A HASU and ASU is proposed for Craigavon, not on one, but on ALL SIX OPTIONS. It is clear from this, that nobody seems to have spoken out for provision of Stroke services in NEWRY CITY.
It also shows that the SHSCT are proposing to continue with their plans to withdraw existing life saving specialist Acute Stroke and Stroke Rehabilitation Services from Daisy Hill Acute Hospital, without making any provision of a NEARBY alternative Specialist Stroke Unit. They are required to do this under equality of access to provide EMERGENCY timely life saving specialist services e.g. CT scanning, thrombolysis, etc and acute Stroke Rehabilitation.
CONCLUSION
Just as in the Western Trust (with a total population of 301,448*) there is need for TWO Specialist Acute Stroke Units – so too, the Southern Trust (with a LARGER population of 380,312*) is also entitled to TWO Specialist Stroke Units (HASUs and Acute Stroke Units).
This would ensure that everyone in the Southern Trust has, as they have at present, immediate access to CT scanning and life saving thrombolysis, followed by direct access into a stroke unit – the stroke pathway recommended by The Royal College of Physicians for better outcomes.
>The Southern Trust need at this stage to speak up for ALL the population they are duty bound to provide specialist stroke services for in the future stroke network in Northern Ireland, in the same inclusive manner as the Western Trust.
*NISRA 2017
Southern Trust population 380,312 : Western Trust population 301,448 : NISRA 2017
The NI Stroke Consultation: Reshaping Stroke Care – Saving Lives, Reducing Disability 2019 asks for the public’s agreement to choose an option between 6 possible options of future configuration of both hyperacute and acute stroke units in Northern Ireland (NI) even though many local Government Districts are excluded.
In these proposals, two existing stroke units in acute hospitals at Daisy Hill Hospital in Newry City and Causeway Hospital in Coleraine have been completely EXCLUDED from ALL possible Options to choose in the Consultation Questionnaire, and isolated from the process completely.
ALTNAGELVIN, CRAIGAVON AND ROYAL VICTORIA HOSPITALS SELECTED IN ALL OPTIONS
Altnagelvin, Craigavon and Royal Victoria Hospitals are proposed in every one of the 6 Options, which means the future of these three stroke units is perceived as definitely secure whatever happens.
These three stroke units may be recruiting on the strength of this, while other units and their staff are left out in the cold, despite actively participating in the Pre-Stroke Consultation in 2017, where they were assured that no decisions had been made.
RESEARCH BIAS
The approach in the Questionnaire is considered bad practice in Research as the occurrence of the same 3 hospitals in all 6 Options shows bias and favouritism and employment unions may be alerted that this is a failure to follow due process in Employment Law.
This bias renders the whole Consultation invalid as the topic deals with the Change and Withdrawal of existing public services in hospitals, which are paid for using Public Money.
TIMING OF CONSULTATION
The timing of this Consultation is also called into question as it was timed at the same time as the recess for forthcoming Council Elections. This leaves populations without access to advice from full sitting Councils and Council reps on local Health Boards. Therefore the Consultation must be extended beyond the statutory 3 months consultation period to allow Newry, Mourne and Down Council Representatives and other Councils in other areas to make a response on behalf of their electorate.
NEWRY, MOURNE & DOWN COUNCIL – NEEDS A HYPER ACUTE STROKE UNIT & AN ACUTE STROKE UNIT IN DAISY HILL HOSPITAL, NEWRY
>Newry Mourne and Down Council – has the 3rd highest council population in NI of 179,000 people (of which 105,300 residents live in rural areas ). If any of the Six pre-selected Options in the Consultation are chosen – this entire local government district will be left with NO Hyperacute or acute stroke /Rehabilitation Units and no timely access to Thrombolysis.
This deliberate plan to remove without a trace the existing designated Daisy Hill Acute Hospital combined Specialist Acute + Rehabilitation Stroke Unit is deplorable, and a public health injustice which cannot be condoned. (Stroke services are assured in Derry City and Strabane Council with a population of 150,500 with only 49,900 people living in a rural area.)
OPPORTUNITY & HOPE
Despite all these issues – there is STILL an opportunity for our excluded populations to put the best case forward for their existing Stroke Units. The only positive aspect of the Reshaping Stroke Consultation 2019 is that we have been given the opportunity to answer Q.6 with additional options
PRESENTING A NEW OPTION TO INCLUDE ALL N.I.
The answer as shown in the graphic is suggested for public consideration. In the Consultation Questionnaire Q. 6 asks: “Are there additional options that we have not considered?”
Q6 SUGGESTED ANSWER : 5 Hyperacute Stroke Units (HASUs) and 5 Acute Stroke Units (ASUs) at 5 acute hospitals in NI at: (1)Royal Victoria, Belfast; (2) Daisy Hill Hospital, Newry; (3) South West, Enniskillen; (4) Altnagelvin, Derry and (5) Causeway Hospital, Coleraine.
This option is based on existing acute stroke units that already give specialist CT scanning and Thrombolysis. This option offers timely equality of access to these necessary specialist stroke services more evenly distributed across NI and to include the rural population – ignored in the consultation.
In this option Antrim, Craigavon (a satellite town of Belfast) and Ulster Hospital, Dundonald – are all within 30 minutes motorway journey of Belfast and can advantageously avail of both Thrombolysis + Thrombectomy in the Royal Victoria Regional Hospital (already confirmed as having a HASU and an ASU).
Daisy Hill Acute Hospital (DHH) Newry City is in a strategic location where patients from Banbridge (approx 15mins travel from Newry City) and South Armagh and Down can avail of timely access to specialist stroke services (scanning and Thrombolysis ) in Daisy Hill (DHH) Hyperacute Stroke Unit + Rehabilitation in DHH Acute Stroke unit.
CONCLUSION YOUR LAST CHANCE to air your views in support of Daisy Hill specialist stroke unit.
The most meaningful way we can put the best case forward for the existing Daisy Hill combined Specialist Acute Stroke/ Rehabilitation unit and its dedicated staff in the Reshaping Stroke Consultation is by taking our time to respond to the questionnaire (including answering Q6).
Don’t give any rushed answers – the closing date is not until June 2019, and you can only submit one response each.
It should also be noted that the Complete Online Form’ button, and online form is set up to force people to choose one of those six options – which all mean the end for the stroke units in Daisy Hill Hospital and in Causeway Hospital.
WE CAN and have the right to CHALLENGE these decisions and the options given and put the best case forward for RETENTION and ENHANCEMENT of Daisy Hill existing acute stroke rehab unit and its specialist services to ensure its rightful place in the network of stroke services in NI for the LONG TERM FUTURE.
The Reshaping Stroke Care Consultation was launched on 26th March 2019 by the Permanent Secretary for Health in Northern Ireland. The Consultation documents reveal what Stroke Services are proposed for The Newry & Mourne/South Armagh Area Hospital – Daisy Hill and for the rest of Northern Ireland.
It is vitally important for the Northern Ireland population that acute Stroke Services are accessible in the Newry & Mourne/South Armagh area at Daisy Hill, Newry to ‘save lives’ of the current population and those of future generations.
The renamed ‘Reshaping Stroke Care – Saving Lives, Reducing Disability’ Consultation and associated docs are available to view and download from the Department of Health NI website: https://www.health-ni.gov.uk/rehaping-stroke-care
‘Every minute matters during a stroke.’ London Stroke Strategy
Daisy Hill Hospital for Life 