PLAYING WITH NUMBERS, PLAYING WITH PEOPLE’S LIVES

In a crucially important Population Plan Table*, created in 2013 for the influential ‘Transforming Your Care’ Health Review – Newry & Mourne Local Government District was made to look like the smallest population in Southern Trust area when it was really the largest.

This misinformation was used to plan future Acute Hospital services for the Southern Trust area and the rest of NI and is still being used today – so this error is why Newry & Mourne LGD and Daisy Hill Acute Hospital have been placed at the back of the queue for hospital buildings and specialist acute inpatient services for years, despite Newry & Mourne LGD being the HIGHEST LGD population in the Southern Trust area since it was formed in 2007.

WHAT IS WRONG WITH THIS TABLE?

This population plan table (shown in the graphic) implies that Newry & Mourne local government district (LGD) has the smallest Locality population in the Southern Trust area.  But this is wrong because Newry & Mourne was NOT the smallest population – it was the LARGEST (and still is).

Whoever compiled this Southern Locality Population Plan Table* incorrectly displayed the standardised NISRA population figures of the Southern Trust area and by doing this –masked the true population sizes of the five Localities / LGDs in the Southern Trust area. The effects of this misinformation are still being felt today.

WHERE DID THIS TABLE COME FROM? 

In 2011/12 as Part of the Transforming Your Care (TYC) Health Review and Consultation, the Health Minister asked the 5 NI Local Commissioning Groups for Draft Population Plans for each of their areas to assess the population in each Local Government District (LGD or locality) across NI to reflect local needs. “Population planning and local commissioning to be the central approach for organising services and delivering change.” (p8 TYC).

This Table is reproduced from the Southern Local Commissioning Group Locality -Population Plan ‘Changing For A Better Future’ 2013 Report on p18.* (A copy is available to download from the References section at the end of the article)

The Southern Local Commissioning Group (SLCG) created this Population Plan Report in conjunction with the Southern Trust which outlined how they jointly intended to commission and provide health and social care services in the Southern Trust area.

This information in this Population Plan was used for decision making in the Public Consultation on Transforming Your Care (TYC) Health Review.

EXPLAINING THIS POPULATION PLAN TABLE AND WHY IT IS SO IMPORTANT TODAY

The Table* shown from the 2013 Population Plan Report presents the Population sizes of all 5 local government districts in the Southern Trust in a very distorted way. There are FIVE Localities or local government district LGDs named in the Southern Trust area, they are:

(1) Newry & Mourne LGD, (2) Banbridge LGD; (3) Dungannon LGD; (4)Craigavon LGD and (5) Armagh LGD.

WHAT IS WRONG WITH THIS TABLE?

This population plan table (reproduced in the graphic) implies that Newry & Mourne local government district (LGD) has the SMALLEST locality population in the Southern Trust area.  But this is wrong because Newry & Mourne was NOT the smallest population – it was the LARGEST (99,900) in the table (and still is the largest today with a population of 106,813 people in 2020).

So whoever compiled this Southern Locality Population Plan Table incorrectly displayed the standardised NISRA population figures of the Southern Trust area and by doing this – masked the true population sizes.

MASKING OF TRUE POPULATION SIZES

To understand this distortion of locality/LGD  population size as displayed in the reproduced Table, please look at the BRIGHT BLUE ROW OF HEADINGS shown on the Graphic.

First start with the first column named:

YEAR– then > go along to the Next Column: ARMAGH/DUNGANNON >then next Column: CRAIGAVON/BANBRIDGE then > next column: NEWRY/MOURNE

These Headings are misleading as the places named are TWO local government districts grouped and added together in one column – that is until you get to the fourth column which instead displays only one local government District instead of two LGDs like the other columns before it.  

So the grouped double LGDs are compared against one single LGD. This single LGD is Newry & Mourne LGD which is being compared inaccurately and misrepresented so it appears as the smallest population.

IN DETAIL

The second column in the Table adds the population of the 2 local government districts of Armagh LGD and Dungannon LGD together in one column to form a higher combined population total (117,100) than the Newry & Mourne LGD population which appears as one LGD on its own in the third column. (99,900)

Armagh LGD + Dungannon LGD =117,100

Compared against

Newry & Mourne LGD = 99,900

The third column again adds TWO LGD populations together – it adds Craigavon LGD and Banbridge LGD together in one column to give a COMBINED population Total (141,600) and then this Total figure is then compared alongside the single local government district of Newry & Mourne population, (99,900) which appears again on its own as ONE LGD.

Craigavon LGD + Banbridge LGD =141,600

Compared against

Newry & Mourne LGD = 99,900

Of course 2 local government district populations added together are likely to be much higher than one single LGD even if the single LGD is the largest population, but this is not a fair use or acceptable standardised practice, and Newry & Mourne is losing out because of it.

The former 26 Councils or Local Government Districts (LGDS) or localities are still named in legislation and remain as the Operational area of NI Health Trusts (Establishment Order 2006) and Commissioning Groups. In the Southern Trust area. (See Background and References for more information)

The Graphic titled FACT below shows how the populations of the 5 LGDs in the Southern Trust should have been shown if represented fairly and accurately: it is obvious from this accurate representation using the official standardised NISRA statistics that Newry & Mourne LGD is the largest Locality population in the operational area of the Southern Health and Social Care Trust.

THERE ARE FIVE LOCALITIES OR LOCAL GOVERNMENT DISTRICT LGDS NAMED IN THE SOUTHERN TRUST AREA NOT THREE!

The original Population Plan Table* from the Southern Local Commissioning Group Locality -Population Plan Report also gave the impression that there are only THREE localities or local Government Districts in the Southern Trust/Commissioning area and wrongly implies Newry & Mourne Local Government District has the least need, instead of correctly stating that there are FIVE localities in the Southern Trust with Newry & Mourne being largest population with greatest need.

This misinformation about the size of the Newry & Mourne LGD and the other LGDs in the Southern Trust area was presented to the decision makers in charge of planning future hospital services in the Transforming Your Care Review.

This TYC Review made it clear that there should only be 5-7 Acute Hospital networks for the entire population of NI. This Review knew there would be a huge interest in Acute Hospital sites and their future role and outlined that the final functionality of each of the (hospital) facilities will be based on POPULATION NEED and the principles set out in the report. (p116 TYC).

The Transforming Your Care Health Review was a population based planning of Services which then formed the foundation for many future Health Reviews which followed including Delivering Together, Donaldson, and the Bengoa Report.

WHAT CAN BE DONE? – POPULATION NEEDS ASSESSMENTS AND HOSPITAL FUNDING

This misinformation as presented in the table* was used to plan the current Acute Hospital services in the Southern Trust area and the rest of NI and is still used today.

This error will have been a major reason why Newry & Mourne LGD and Daisy Hill Acute Hospital have been placed at the back of the queue for hospital buildings and specialist acute inpatient services for many years, despite Newry & Mourne LGD being the HIGHEST LGD population in the Southern Trust area since it was formed in 2007, and the fourth Highest Locality (LGD) population in all of NI since 1971 with Belfast, Lisburn (Greater Belfast) and Derry.

This injustice must be rectified now by the DOH as discussions take place about the future Hospitals services here.

Acute hospital-Emergency entrance

ACTION NEEDED TO REPAIR THE DAMAGE DONE BY POPULATION PLANNING MISINFORMATION 

Newry & Mourne Acute Area Hospital at Daisy Hill needs re-imbursement for the years of lost funding (when they were placed bottom of the Queue) and return of inpatient beds and specialist services, in a fully functioning Major Acute Specialist Hospital (as designated by Government in 2003 and again earmarked for a major new acute hospital in 2005) which has still not been delivered by the Southern Trust and Department of Health 18 years later.

The Population Plan Table* – which in effect was a population needs assessment reveals why Daisy Hill is being wrongly treated as a ‘small local’ hospital today.   

ACTIONS NEEDED

As verified by official NISRA statistics, for over 50 YEARS since 1971, Newry & Mourne LGD has ranked in the TOP 4 HIGHEST POPULATIONS in NI with Belfast, Lisburn (Greater Belfast) and Derry.  

The number of people living within a locality (LGD) is supposed to be the primary factor when commissioning health Services so the misrepresentation of population sizes which continues today in population planning in Southern Trust must be corrected urgently.  

So, in order to repair the damage done by this misinformation in 2013, which made Newry & Mourne LGD appear wrongly as the smallest LGD instead of the largest in the Southern Trust area there are two actions needed:

1. The Southern Trust and Southern Local Commissioning Group must stop putting forward the misleading idea that there are 3 localities in the Southern Trust when we know there are really 5 localities (LGDs). The population sizes of the Southern Trust area must be presented accurately acknowledging that Newry & Moure (single LGD) is the largest LGD/locality of the FIVE localities in the Southern Trust.

2. All Public Consultations (at both Regional and at Southern Trust level) must be based on accurate population size and accurately assessed population need. All Consultations (including the EQIA) must be population evidence based including for Emergency services (Emergency Surgery, Stroke, specialist acute services and reduction in status to a Regional elective Centre).

This should be organised by the Department of Health, The Strategic Planning and Performance Group, Public Health Agency and Southern Trust in the spending of scarce capital resources and decisions on spending on Hospitals (which have been paid for with public money). The public should have right to reply and challenge centralisation of services and when their hospital is used as a case study for closure.

Newry Mourne & Down Council, MPS, MLAs and the community all can be confident in the knowledge that Newry & Mourne LGD has been short changed and is long overdue the required investment in a major Specialist Acute Hospital in Newry City instead being bartered off with a Regional Elective centre or privatised Community Health Centre instead of a Major Specialist Acute hospital with a 24/7 Consultant- Led Type 1 Emergency Department & Consultant- Led Maternity.

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

BACKGROUND AND REFERENCES

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

Operational areas in Health trusts still remain under the 26 council model.

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

The Five LGDs in Southern Trust in consistent order of size since Establishment of the Southern Trust on 1st April 2007 according to NISRA are:

>1st Newry & Mourne;

>2nd Craigavon;

>3rd Armagh:

>4th Dungannon:

>5th Banbridge

SoS Daisy Hill Hospital Campaign Rally - another show of community strength in Newry city on 25.06.2023. Estimated 10,000 attended the Rally in Marcus Square, Newry and then walked up to Daisy Hill Acute Hospital.

NEWRY & MOURNE LGD POPULATION

As verified by official NISRA statistics, for over 50 YEARS since 1971, Newry & Mourne LGD has ranked in the TOP 4 HIGHEST POPULATIONS in NI with Belfast, Lisburn (Greater Belfast) and Derry.

Based on population size, Daisy Hill should have a major Hospital the same size as Altnagelvin as its population size is very similar, and based on both population size, number of patients on GP Registers (c161,000)  and on its location -Daisy Hill should have a larger Specialist Acute hospital than Antrim, Craigavon, or Ulster Hospitals. Why? Because Newry & Mourne LGD has a population bigger than Antrim LGD, Castlereagh LGD, and also Craigavon LGD, who all have major acute hospitals already.

The Newry & Mourne LGD and Daisy Hill acute Hospital cannot be ignored any longer as there are many factors which require proper hospital services funding and commissioning in this area (1) it has the large population, (2) the highest number of births, (3) the Location

REFERENCES

Other References

Transforming Your Care : https://www.health-ni.gov.uk/topics/health-policy/transforming-your-care#toc-0

Transforming Your Care (TYC):  Vision to Action. A Consultation Document 9th Oct 2012 to 15th Jan 2013.

Transforming Your Care (TYC) : Vision to Action – A post Consultation Report  March – 2013 

The TYC Consultation Document ‘ Vision to Action’ was “based on the draft Population Plans which have been developed by Local Commissioning Groups with input from HSC Trusts, to reflect local needs and a Draft Strategic Implementation Plan which gives a wider NI overview.” (p3 Vision to Action. A Consultation Document 9th Oct 2012 to 15th Jan 2013).

“Population planning and local commissioning to be the central approach for organising services and delivering change.” (p8 TYC)

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

You can also read, like and share this post on Facebook at : Playing with numbers, playing with people’s lives

You may also be interested in other posts on Daisy Hill Acute Hospital, Newry city, like: https://savedaisyhillhospital.com/2022/02/28/daisy-hill-hospital-newry-is-one-of-the-nine-major-acute-hospitals-in-the-regional-network-designated-in-2003-like-antrim-ulster-etc/

Daisy Hill Hospital for Life


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Newry & Mourne LGD population abandoned by the Health authorities paid to provide for them in Daisy Hill Hospital, Newry.

FACT: For over 50 YEARS since 1971, Newry & Mourne LGD has ranked in the TOP 4 HIGHEST POPULATIONS in NI with Belfast, Lisburn (Greater Belfast) and Derry. (As verified by NISRA Statistics).

The highest population in the Southern Trust - Newry & Mourne LGD has been abandoned by the Health authorities paid to provide acute services for them in Daisy Hill Hospital, Newry.

Based on the population size of Newry & Mourne LGD, (106,813 people in 2020 (NISRA) – Newry City should have a Major Specialist state of the art Acute hospital (as planned by Newry & Mourne Health & Social Services Trust) with the same specialist acute services, inpatient beds and diagnostics as Altnagelvin Hospital and Craigavon Hospital.

It should be noted that while Newry & Mourne Local Government District (LGD) has a similar population size to Derry LGD, Newry & Mourne LGD has ALWAYS had a Higher population size than Craigavon Local Government District.

DAISY HILL, NEWRY IS A GOVERNMENT DESIGNATED MAJOR ACUTE HOSPITAL

In 2003 it was finally acknowledged by the Department of Health, that with the 4th highest population in NI, Newry & Mourne was entitled to have a major functioning acute hospital based on assessed need.

Following Regional Consultation on the DoH’s Developing Better Services, Daisy Hill Acute Hospital Newry City was designated one of 9 Major Acute Hospitals which would form a network of Specialist Acute Hospitals across NI.

This ensured that no matter where anyone lived in NI every person would have equal access within one hour to 24/7 Consultant Led Accident and Emergency Services, and 24/7 Consultant Led Maternity Services in one of nine Acute Hospitals in a Regional “seamless web of care.”

The number of people living within a locality (LGD) is supposed to be the primary factor when commissioning health Services – so why has the highest population in the Southern Trust in Newry & Mourne LGD been abandoned by the Health Authorities who are paid to provide acute services in Daisy Hill Acute Hospital, Newry City?

The Southern Health and Social Care Trust (who replaced Newry & Mourne Health and Social Services Trust in 2007) never had any intention of re-developing Daisy Hill Hospital into the major acute hospital the population of Newry & Mourne were entitled to. They were only interested in redeveloping Craigavon hospital.

Consequently now in 2023 after repeated excuses and public statements the Southern Trust have managed to destroy the reputation of the brilliant hospital they inherited from N&MHSST. The Southern Trust’s centralisation agenda and the organisation’s own inability/or refusal to recruit and retain staff has taken its toll on staff in the hospital resulting in the major public health crisis the population of Newry & Mourne now finds itself in.

The men, women and children of the Newry & Mourne population should not have the fear and worry which comes from the consistent drastic reduction of specialist services and inpatient beds from the major specialist acute hospital Daisy Hill, Newry City.

The main graphic shows the Southern Trust area and its 2 Acute hospitals. Newry & Mourne has the largest land mass (898.3 square Km) of all the 5 localities in the Southern Trust area.

Since the Southern Trust took over admin of Daisy Hill Acute Hospital on 1st April 2007, Newry & Mourne has ALWAYS has the highest population, highest number of births and highest number of children u18 of all the 5 LGDs in the Southern Trust.

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

BACKGROUND – The organisation of Health Care in NI

The former 26 Councils or Local Government Districts (LGDS) or localities are still named in legislation and remain as the Operational area of NI Health Trusts (Establishment Order 2006) and Commissioning Groups. In the Southern Trust area, there are still FIVE LGDs named as shown below and in graphic.

The Five LGDs in Southern Trust in consistent order of size since Establishment of the Southern Trust on 1st April 2007 according to NISRA are:

>1st Newry & Mourne;

>2nd Craigavon;

>3rd Armagh:

>4th Dungannon:

>5th Banbridge

Total LGD population order of size: (NISRA 2020):

>1st Newry & Mourne: 106,813

>2nd Craigavon: 103,341

>3rd Armagh: 63,874

>4th Dungannon: 63,552

>5th Banbridge: 50,567

Total LGD population Under 18’s: in order of population size, (NISRA 2020):

>1st Newry & Mourne: 28,116

>2nd Craigavon: 25,804

>3rd Armagh: 16,334

>4th Dungannon: 16,938

>5th Banbridge: 12,274

Official Northern Ireland Statistics and Research Agency (NISRA) Statistics.

Newry & Mourne, South Armagh Acute Area Hospital at Daisy Hill, in Newry city

ACTION 1

For Related Information

For another article on populations, the hospitals of the region including Daisy Hill Hospital, Newry -see also : https://savedaisyhillhospital.com/2020/01/15/ni-health-crisis-cut-in-number-of-specialist-acute-hospitals-their-uneven-spread-since-1995-is-a-major-factor/

The concentrated support of Newry Mourne and Down Council, to call for action and proper treatment of Daisy Hill Acute Hospital, the Area Hospital for Newry & Mourne and South Armagh is needed -for more info: https://wordpress.com/post/savedaisyhillhospital.com/3146

The people of Newry & Mourne LGD and surrounding areas show their support at the Save our Emergency Surgery March to Daisy Hill Acute Hospital, Newry on April 2023

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

We welcome sharing of this info and the use of excerpts and links, please give full and clear credit to http://www.savedaisyhillhospital.com and Daisy Hill for Life with appropriate and specific direction to the original content. Thank-you.

Transformed before your very eyes – is the Plan for Daisy Hill Acute Hospital, Newry City to be replaced by a Regional Planned Surgery Centre?

It was confirmed by the Clinicians at the recent Emergency Surgery public meeting on the 22nd March 2023 in the Canal Court, Newry that the Southern Trust and Department of Health’s plan is to turn Daisy Hill Specialist Acute hospital into a Regional Elective (planned surgery) Centre. 

Daisy Hill Acute Hospital had been previously designated by Government to provide timely access to 24/7 Emergency Surgery and Emergency Medical Services and Consultant led Maternity Services but the Southern Trust’s Chief Executive confirmed that ‘plans to turn the hospital into an elective overnight stay centre were progressing’ at the Canal Court Hotel public meeting.

BUT WHAT DOES IT MEAN TO BECOME A REGIONAL ELECTIVE CARE CENTRE?

Department of Health (DoH) Reports are clear on how they intend to provide elective care (planned surgery rather than Emergency or unplanned treatment). Hospitals designated as Elective Care Centres will be used for outpatient assessments, diagnostics, day surgery or short stay inpatient surgery UNINTERRUPTED BY EMERGENCY ADMISSIONS.”

The Patient and Client Council have stated that Elective care centres are specialist STANDALONE units DEDICATED PURELY to the delivery of PLANNED assessment and treatment…In practice, this means providing more treatment on a smaller number of specially designed standalone sites by moving this activity away from the busiest hospital sites.”

If Elective care centres are DEDICATED PURELY to the delivery of PLANNED assessment and treatment (for Regional Consultants and their patients) – what other specialist acute inpatient care services will be provided in Daisy Hill, Newry City FOR THE LONG TERM FUTURE for the 159,599 adults and children on Newry and District GP Registers, should it become an elective care centre? These specialist acute services should include 24/7 Type 1 Emergency Surgery and Emergency Medicine, inpatient paediatric services, HDU, Diagnostics, Maternity etc and clinical staff and inpatient beds (other than for Elective care)

2 STEPS ON THE WAY TO BECOMING A REGIONAL ELECTIVE CENTRE:

STEP 1: REMOVE EMERGENCY SURGERY / STEP 2: REMOVE MORE ACUTE SERVICES 

 (1) The Trust controversially withdrew the life saving Emergency Surgery service from Daisy Hill in Newry city, in Feb 2022 requiring all Southern Trust patients to travel to Craigavon Hospital.  Having after being withdrawn temporarily, the Trust now proposes all life saving Emergency Surgery will be permanently withdrawn from Newry City and will be only provided only in future in Craigavon. This withdrawal of Emergency Surgery service will also assist in the plan to prepare to turn Daisy Hill Hospital into a Regional elective centre.

 (2) The Trust’s next plan is to REMOVE other acute services from Daisy Hill Acute Hospital and send these services to a Community Treatment Centre in Newry. This was announced by Future Group Chairman Dr Patterson at the Canal Court public meeting describing the arrangement with the phrase to “free up space.” (This community centre will be privately and not HSC owned).

>IS THE PLAN FOR DAISY HILL TO BECOME A REGIONAL ELECTIVE CARE CENTRE INSTEAD OF A SPECIALIST ACUTE HOSPITAL?

If so, this proposal is a HUGE change of purpose for Newry & District’s designated Acute Hospital, at Daisy Hill, Newry.  This means that any Regional Surgeon, (either NHS or from a Private hospital),  will come to Daisy Hill for planned (elective) operations on their own regional patients from anywhere in NI  using the existing  operating theatres, beds, staff, and equipment in Daisy Hill. 

Controversial changes such as the change in Status/purpose of ANY of the 9 designated NI Acute Hospitals in NI (including Daisy Hill) from a Specialist Acute Hospital to a Regional Elective Care Centre must go to DOH NI wide Regional public consultation before any such decisions are made.

POPULATION FACTS : THE NEWRY & MOURNE LOCALITY IS THE HIGHEST POPULATION IN THE SOUTHERN TRUST AREA

The former Newry & Mourne locality is one of 5 local government districts in the Southern Trust operational area. Newry & Mourne (which includes South Armagh) IS and ALWAYS HAS BEEN the highest population in the Southern Trust. This population (along with other neighbouring areas and visitors) is served by Daisy Hill Acute Hospital in Newry. 

The NI public pay for Health and Social Care services through Regional Rates bills, Taxes and National Insurance deductions from their wages. The public must be consulted and asked to agree /approve changes to services for which they are paying and have paid to maintain – especially Changes that involve Withdrawal of services from a designated NI Acute Hospital. 

CONCLUSION:


REGIONAL PUBLIC CONSULTATION IS REQUIRED BEFORE DAISY HILL ACUTE HOSPITAL  IS CHANGED TO A REGIONAL  ELECTIVE CARE CENTRE

This is potentially unacceptable further withdrawal of specialist acute hospital services from Daisy Hill Hospital on a massive scale without Consultation or any due regard to the NI Rural Needs Act 2016, Equality Legislation, Fair Treatment and Employment 1998 or Change or Withdrawal of Services and population needs assessment .

Any change in Status/purpose of Daisy Hill from Acute Hospital to Regional Elective Care Centre dressed up as ‘transformation’ or ‘reconfiguration’ must be challenged by the Public and all Elected Representatives who believe In Equality and Timely Access to Healthcare in Newry & Mourne- South Down and South Armagh. This cannot go ahead without NI wide Regional Consultation for scrutiny and evaluation by the NI Assembly and public alike under the 2009 Act before any such decisions are made.

To end the uncertainty surrounding Daisy Hill, and for more information on plans for Newry’s Daisy Hill Acute Hospital and elective care centres –you can ask the local representatives on the Southern Local Commissioning Group, the Southern Trust, DoH NI, and Patient Client Council.

These organisations should be able to clarify and explain in detail what future plans they have for Daisy Hill Hospital and whether the concerns written about here are valid.

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

References and Further Reading:

Patient Client Council, Elective Care in Northern Ireland, 10th July 2019.

 Main DoH NI Elective Care Framework links :   

   
https://www.health-ni.gov.uk/publications/elective-care-framework-restart-recovery-and-redesign 

https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-elective-care-framework-restart-recovery-redesign.pdf  (*pgs 24, 63, 74, 75)

Elective Care Framework Restart, Recovery and Redesign 2021

Elective Care, is care that is planned in advance as opposed to Emergency or unplanned treatment. (p24: *Elective Care Framework Restart, Recovery and Redesign 2021).


“This requires commitment from all Trusts that in sites identified as regional elective care centres, that BEDS AND STAFF must be RING FENCED for the delivery of regional elective care.” (p63 *Elective Care Framework Restart, Recovery and Redesign 2021)

“Partnerships and cross-sector collaboration are ESSENTIAL. New services or interventions created, or existing ones that are transformed, WILL NOT ALWAYS BE HSC OWNED.” (p74 *Elective Care Framework Restart, Recovery and Redesign )


“We need more sites providing dedicated elective services that are ENTIRELY SEPARATE from unscheduled care.” ( p75 *Elective Care Framework Restart, Recovery and Redesign )   

More References and further reading to follow soon

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Daisy Hill Acute Hospital for Life, Daisy Hill acute hospital, Newry city.

WAITING TIMES IN EDs ACROSS N.I. SHOW CENTRALISATION OF EMERGENCY SURGERY FROM DAISY HILL HOSPITAL, NEWRY CITY TO CRAIGAVON IS NOT A SAFE OR VIABLE OPTION

N. Ireland Acute Hospital Emergency Dept Waiting Times 2021


The Southern Trust’s proposal to centralise Emergency Surgery from Daisy Hill Hospital Type 1 Emergency Department, Newry City, expecting patients needing immediate life saving emergency surgery to go to Craigavon, is not a viable or safe alternative.

As the accompanying ED Attendances Waiting Times Table shows: in the year Jan 2021 to Dec 2021 Craigavon ED had 11,009 patients who had to wait over 12 hours to be seen, discharged or admitted to hospital.

Dr Paul Kerr, Vice President of the Royal College of Emergency Medicine Northern Ireland on a BBC programme on 12 Feb 2022 speaking about long delays and long waits in Emergency Departments in NI in December 2021 said:

“The situation in Emergency Departments in Northern Ireland is dire, the data show that it is very bad indeed. The reality is that patient care is now regularly being compromised, their safety is at risk.
“We know that delays and long-waits in Emergency Departments are closely associated with patient harm and poor outcomes. The Royal College’s report ‘Crowding and its Consequences’ found that one in 67 patients waiting for 12 hours or more are associated with avoidable harm or potential death within 30 days.”

It is because nobody knows who is going to need Emergency Surgery or Emergency Medical Care that the Regional Network of Type 1 EDs (in the accompanying Table) were designated IN ALL 10 Acute Hospitals in a FAIR GEOGRAPHICAL provision of Emergency Surgical and Emergency Care across NI.

Centralisation of Emergency surgery from Daisy Hill Acute Hospital, Newry City to Craigavon is not a safe or viable option.

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

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

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2023. We welcome sharing of this info and the use of excerpts and links, provided that full and clear credit is given to http://www.savedaisyhillhospital.com and Daisy Hill for Life with appropriate and specific direction to the original content. Thank-you.

TIME TO OPEN DAISY HILL HOSPITAL ED NOW!

The Southern Trust must fast track their plans to open Daisy Hill Hospital ED at once, now that Craigavon Hospital has unfortunately fallen victim to COVID-19 clusters, which were reported on BBC NI News 01.09.2020.

Time is now opportune for the Southern Trust and Southern Local Commissioning Group to prove the truth of the rhetoric to the Southern Trust population how much an essential part of the hospital network, Daisy Hill in Newry is, by reopening the Emergency Department (ED) at once.

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


“Daisy Hill Hospital is based in the city of Newry and is an essential part of the hospital network provided by the Southern Trust and has been ranked as a CHKS Top 40 Hospital.” (Southern Trust 2017).

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

END OF SEPTEMBER NOT SOON ENOUGH TO OPEN ED

The Southern Trust stated on 24.08.2020 that work is progressing to reopen Daisy Hill ED on a 24/7 basis by the end of September.
The Southern Trust Chief Executive has been asked repeatedly to open the ED and the end of September is not soon enough. It is vital to save lives that this date is brought forward to show how effectively they can manage their hospital network.

Daisy Hill 24/7 Type 1 ED was closed on 28th March 2020 – with little warning – so after 6 months to prepare – it is well past time it is reopened, especially given the current circumstance of several covid-19 clusters in Craigavon Hospital.

Mr Shane Devlin praised “The dedication and flexibility of staff during this time has been remarkable” (Southern Trust statement 24.08.2020). This is true of all Southern Trust staff, and especially of Daisy Hill staff who showed immense flexibility by also changing their workplace to Craigavon – but now given the changing circumstances and given the sheer population of Newry & Mourne and beyond – it makes sense that the Southern Trust uses the resources, facilities and staff available in the most sensible way now.

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

The Diagram and map shows the size of the Southern Trust and the 2 acute hospitals which operate in this Network. It should be noted that Daisy Hill Hospital, Newry is in Newry & Mourne with the largest population (106,499) and largest land mass (898.3 square Km) of all the 5 localities in the Southern Trust area.

Craigavon covers only 281.5 sq Km with less of a population of (102,566) in 2019. (All stats from NISRA) .The map shows the 5 localities / (former) local government districts/LGDs that still remain in the operational area of the Southern Trust, according to its founding legislation.

ED IS A REGIONAL SERVICE

The 106,499 population of Newry & Mourne are being denied time critical access to a Type 1 Emergency Department in a functioning acute hospital, since 28th March 2020 in Newry City.

As they have paid for Regional and Local Urgent and Emergency and acute services through their Regional Rates and Taxes, the population of Newry & Mourne (as well as all of the rest of the population across NI) are entitled to avail of the 24/7 Regional ED Services being provided by the Royal Group of Hospitals including the Royal Belfast Hospital for Sick Children, who have shorter waiting times.

The Southern Trust have a duty of care (under their founding legislation) to provide hospital services in Daisy Hill, Newry – not repeatedly take them away to Craigavon.

Daisy Hill’s Emergency Department has been a vital part of the Northern Ireland Network of Type 1 Emergency Departments for the past 17 years.

The Southern Trust have to end the uncertainty and anxiety caused to the population of Newry & Mourne by the removal of vital ED Services and return Daisy Hills ED and Specialist Staff back to Newry as a matter of urgency.

Sources:
Population Stats NISRA 2019
Land Mass Figures – NISRA
Southern Trust Statement 24th August 2020
Craigavon Area Hospital: Third Covid-19 outbreak confirmed, Louise Cullen BBC News NI, 01.09.2020
https://www.bbc.co.uk/news/uk-northern-ireland-53989892

PATIENTS ON DOCTORS REGISTERS (NISRA 2018)
Derry: 122,280 under 5’s: 8,943
Newry & Mourne: 116,378: under 5’s: 9,481
Craigavon: 105,295 under 5’s: 8,504
Dungannon: 66,848 under 5’s: 5,746
Armagh: 67,930 under 5’s: 5,487
Banbridge: 51,494 under 5’s: 3,927

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

Newry, the main Gateway City to NI now, and after we leave the EU, is being denied its rightful place in the Rebuilding of Health and Social Care Services, by the people who are paid to include them.

The graphics which follow show THERE IS NO OTHER Type 1 ED Department in NI that can be accessed within one hour by a third of the population of Newry & Mourne/South Armagh – 38,000 people. 

That is why Newry City’s Acute Hospital, Daisy Hill’s ED department was designated in 2003 with 8 other EDs across NI  to form a Regional network of  9 Type1 EDs , vital to ensure equality of access within one hour 24/7  to Consultant-led urgent and emergency Care to everyone in NI , no matter where they live – urban and rural.

The Southern Trust needs to take its responsibilities to the Newry & Mourne/South Armagh population seriously and be accountable for their actions.   The function of the Southern Trust is to provide hospital accommodation and services in Newry City in Newry & Mourne – the largest administrative area in the Southern Trust.

Their function DOES NOT include the removal of Daisy Hill’s Emergency Department (ED)  from  the long  established Designated Regional network of  the nine  24/7 Type 1 ED Departments of Daisy Hill, Royal Group , Antrim, Ulster, Causeway,  Mater, Altnagelvin, Craigavon,  and  S.W. Acute Hospitals,  which provided a seamless web of ED care to all of the people of NI over the past 17 years.

The Southern Trust shut down Daisy Hill’s Type 1 ED, at a days notice, without consultation, or any adherence to Equality, Rural Needs, Human Rights, Disability legislation. This Type 1 ED in Daisy Hill Hospital is the only one serving the population of the Southern part of NI one hour drive-time ED Network.

GRAPHICS/MAPS

The accompanying Graphics ‘Drive Times to Nearest Type 1 ED’ show the effect the removal of Daisy Hill ED from the existing network of Nine Type1 EDs across NI has on the Population of Newry & Mourne.

The Department of Health/Public Health Agency and Southern Trust are aware of the importance of this Drive Time information as it was previously analysed and published in the Department’s Pathfinder Project Report and Appendices in 2017. The map in the graphic is a scaled drawn reproduction of the report’s map*(See end for source).

Put Daisy Hill acute hospital Newry & its Type 1 ED for children and adults back on the map! Newry, the main Gateway City to NI now, and after we leave the EU, is being denied its rightful place in the Rebuilding of Health and Social Care Services, by the people who are paid to include them.

GRAPHIC 1: Drive Time shows approx Drive time to a Type 1 ED across the Southern Trust and wider area when Daisy Hill ED is excluded. It shows that people living in Armagh, Craigavon, Lisburn, and all across the greater Belfast Area are all within a 30 minute car drive time of a Type1 ED. This is as well as being only 30 min Drive time to all other Type 1 EDs in acute hospitals in Belfast). It also shows that Newry & Mourne is most badly affected by removal of Daisy Type 1 Hill ED.

GRAPHIC 2: Focus on Newry & Mourne – Drive Time  – focuses in detail at the map showing the area of Newry and Mourne. The Rural areas of the Mournes and South Armagh are most affected without Daisy Hill ED.

Nearly 38,000 people in Newry & Mourne denied right to access a Type 1 ED within 1 hour

Graphic 2 shows the area of Newry & Mourne affected with added reference to Electoral Ward populations. Without DHH ED the population of the following electoral wards have to travel 75 to 90 minutes+ to get to a 24/7 TYPE 1 ED in an emergency situation.

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

OVER 75 MINUTES DRIVETIME TO GET TO A 24/7 TYPE 1 ED (coloured dark orange on maps): see key

1 : Annalong: 2. Binnion  3 :  Kilkeel Central 4 :  Kilkeel South 5 : Lisnacree 6 : Rostrevor 

60 TO 75 MINUTES+   DRIVE TIME TO GET TO A 24/7 TYPE 1 ED.  (coloured dark yellow on maps): see key:

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

These times are only estimates. Only those of us who have had to make the journey to the nearest ED know exactly how long the journey takes.

The Southern Trust’s has a centralisation policy of provision of all medical and surgical Urgent and Emergency Services.  Because of this Southern Trust policy – approximately 38,000 people in Newry & Mourne (including South Armagh) since 28th March 2020, have been potentially denied their right to access immediate life saving care in a Type 1 ED within one hour Drive time from their homes. This includes 8,403 children and 5,914 aged 65+.  (Population data from latest NISRA estimated 2019 stats).

REBUILDING PLANS:

Southern Trust made an agreement with other Health Trusts and the Department of Health NI that they will:

(1) Ensure Equity of Access for the treatment of patients across Northern Ireland  (2) Minimise transmission of Covid-19; and (3) Protect access to the most urgent services for our population.

By shutting down and refusing to reopen Newry City’s Type 1 ED department the Southern Trust  have not ensured “Equity of Access” for the treatment of patients across NI and have denied approx 38,000 men, women and children in Newry and Mourne access to time critical  immediate Urgent and Emergency Car within an hour. 

They have also destroyed the existing 17 years Regional network of 9 Type1 EDs being provided by all the other Trusts.

JUST LIKE NEWRY AND DAISY HILL WAS LEFT OUT OF THE STROKE CONSULTATION OPTIONS

Like with the Stroke consultation (where all Stroke care  was centralised to Craigavon from Newry), the Southern Trust has again wrongly left Daisy Hill out –  this time out of the Regional Plans for Urgent and Emergency  and other services in their Rebuilding Health and Social Care services plans.

STAND YOUR GROUND

It is on record that there has been a hospital in Newry caring for anyone in need of immediate life saving services for the past 175 years, through famine, wars and the Cholera epidemic.

It took the Southern Trust, to remove its caring specialist staff at a days notice, from Newry to Craigavon, when they were needed most in Newry, during the Covid 19 pandemic, leaving the entire population of Newry & Mourne without a lifeline in Newry city to time critical Urgent and Emergency Care.                                          

All Politicians, Unions, community representatives and individuals.  Please stand your ground to get what is rightfully ours because we have paid for it.  

Time for Investment for Newry +Mourne LGD 2020

The Department of Health get £5 billion to improve the health and social Care of all of the people of NI who need healthcare no matter where they live. Together we will stand our ground to get Newry, the Gateway City to NI and Newry & Mourne/South Armagh firmly back on the map.

Background:

*Map –  (Source: Appendices – Daisy Hill Hospital Pathfinder Project – Development of an Unscheduled Care Model through a Co-Production Approach, 20th December 2017.  Appendix 2 – Population Needs Assessment – Report of the Needs Assessment Figure 6-2: Drivetime Analysis for NI – DHH ED excluded. Pg 87/88.)

TYPE 1 Emergency Departments are defined as those with a consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services on a round the clock basis.

Daisy Hill Acute Hospital with 24/7 Type 1 ED in Newry is in the Southern Health and Social Care Trust area.

The Golden Hour in stroke is well supported by Clinical Evidence

RELEVANT RESEARCH

Extensive research by ‘Developing Better Services’ Report 2003 found that only a total of 9 EDs would ensure the entire population of NI had access WITHIN ONE HOUR to immediate urgent and emergency care no matter where they lived in both urban or rural areas.

Newry & Mourne is the largest locality of the 5 localities in the operational area of the Southern Trust. The five localities in consistent order of population size since the establishment of the Southern Trust in 2007 are: (1) Newry & Mourne (2) Craigavon (3) Armagh (4) Dungannon and (5) Banbridge.

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

GOVERNMENT CONSTITUENCY INFO

Newry & Mourne Locality is in Two Westminster and NI Assembly constituencies: Newry Armagh and South Down.  17 Wards are in the Newry Armagh Constituency and 13 Wards from Newry & Mourne are in South Down Constituency.

NEWRY & ARMAGH CONSTITUENCY: Daisy Hill, Drumalane, St Marys, St Patrick’s, Windsor Hill, Drumgullion, Ballybot, Newtownhamilton, Camlough, Derrymore, Bessbrook, Tullyhappy, Crossmaglen, Creggan, Silverbridge, Forkhill, Fathom.

SOUTH DOWN CONSTITUENCY:  13 electoral wards of Newry & Mourne are in South Down Constituency.

Spelga, Rostrevor, Sea View, Clonallan, Burren & Kilbroney, Mayobridge, Derryleckagh, Annalong, Binnion, Kilkeel Central, Kilkeel South,  Lisnacree,  and Donaghmore:
49,000 of the Newry & Mourne population are in the South Down Constituency.

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

Links to all Trust Rebuild Plans 2020 here:

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

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

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

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

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