Tag Archives: hyper-specialist services

05.24.25
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EMERGENCY SURGERY – THE HAVES AND THE HAVE NOTS (N.IRELAND)

Over c.453,455 people (nearly a quarter of the NI population) have been denied access to a Regional service at Daisy Hill Acute Hospital in Newry and at South West Acute Hospital in Enniskillen, because two Health Trusts decided to withdraw life-saving Emergency Surgery at these acute hospitals, even though the decisions to remove these Regional Emergency Services never went to REGIONAL Public Consultation.* (See Background)

The accompanying map graphic shows the stark reality of the areas and numbers affected. The grey coloured area on the map shows where the 453,455 (adults and children alike), have now been left without access to Emergency Surgery in these two designated acute hospitals Newry and Enniskillen. This number does not even include the thousands of tourists who visit this area.

The accompanying map graphic shows the stark reality of the areas and numbers affected. The grey coloured area on the map shows where the 453,455 (adults and children alike), have now been left without access to Emergency Surgery in these two designated acute hospitals Newry and Enniskillen. This number does not even include the thousands of tourists who visit this area.

The local populations objected to the removal of Emergency Surgery from the two Acute Hospitals since 2022 through the only mechanisms open to them through their local councils and by objecting in their thousands through the Trust ONLY LOCAL LEVEL consultations.

In Newry, the ‘Save Our Emergency Surgery Action Group’ organised a huge rally in opposition to centralisation of Emergency Surgery to Craigavon Hospital and collected and submitted 12,000 responses to the Southern Trust LOCAL Emergency Surgery Consultation. Mr Francis Gallagher the group’s Chair stated in a Newry Reporter article : “Tell the DOH and the trust that we demand equality and respect by having equal timely access to life-saving healthcare” (Newry Reporter April 2023).

Save our Acute Services who also co-ordinated a community campaign in Fermanagh area stated they secured over 30,286 individual responses to Western Trust consultation on ‘temporary’ removal of Emergency Surgery from the South West Acute Hospital in Enniskillen.

The Community campaigns also had strong local government support, with both Newry Mourne and Down Council and the Fermanagh and Omagh Councils strongly opposing the withdrawal of Emergency Surgery from their Acute Hospitals and communicating with the Department of Health on this issue. 

FOR BETTER OUTCOMES AND EQUALITY, ALL HEALTH TRUSTS MUST ADHERE TO THE RURAL NEEDS ACT AND RETURN EMERGENCY SURGERY TO THESE ACUTE HOSPITALS.  

Health Trusts should have remembered before they took it on themselves to withdraw life saving Regional services like Emergency Surgery  from the predominantly Rural  (NUTS Classification) ‘West and South of NI’, that they have a “duty of care” to continue to provide, not deprive this population of  life saving Emergency Surgery. 

The Southern and Western Health Trusts also have to adhere to the NI Rural Needs Act 2016 and consider the extent of harm their decision did to this predominantly Rural Population when they withdrew timely life saving Emergency Surgery.  Because of this they should reverse their decision and return Emergency Surgery without delay to achieve better outcomes for the Rural population under their care.  

The Rural population in NI are entitled to the same value for public money for Life-saving Emergency services as the urban population, as the quote from the Rural Needs Act below shows.

RURAL NEEDS ACT 2016:
“In seeking to identify Rural Needs public authorities should consider to what extent the policy, strategy, plan or public services will meet the social and economic needs of people in rural areas and whether the outcomes delivered for people in rural areas will be similar to the outcomes delivered for people in urban areas.”

It is a serious situation that over 453,455 people (nearly a quarter of the NI population) has been denied access to a Regional service at Daisy Hill Acute Hospital in Newry and at South West Acute Hospital in Enniskillen.

The removal of a life saving Regional Service like Emergency Surgery is one that can only be dealt with through a REGIONAL Public Consultation. The fact that Emergency Surgery was removed from two designated acute hospitals, without a REGIONAL Public Consultation or due process makes this a Rural Needs and an Equality issue. 

The best way to continue to bring this to the attention of the Dept of Health and Health Minister is though our politicians – MLAs, Councillors and MPs and directly through the next available Equality and Disability Public Consultation. 

The latest Consultation is open and is asking for public feedback, so this a good opportunity to keep up standing our ground for our acute Hospitals, designated by Government in  2003 and paid for with our public funds, taxes and national insurance contributions.

Details on the ‘Public Consultation on the Department of Health’s Draft Equality Action and Draft Disability Action Plan 2025-2030’ will follow shortly.

BACKGROUND

Graphic Source: Population projections for the 5 former NUTS UK Eurostat Administrative Areas (year 2025): Source NISRA. NUTS III Areas still relevant because these areas cover the 26 councils which still remain the operational areas of the 5 Health Trusts.

*Emergency Surgery Withdrawn from two Acute Hospitals in NI without regional consultation

NEWRY

*Emergency Surgery withdrawn from Daisy Hill acute Hospital in Newry – permanent service change (8 January 2024)

‘DoH approves permanent service change – The Department of Health has approved the Southern Health and Social Care Trust decision to permanently consolidate emergency general surgery services at Craigavon Area Hospital.’ Date published: 8 January 2024

ENNISKILLEN

Western Trust Corporate Risk Update at 30 May 2024

23/05/2024 ‘Temporary suspension (Emergency General Surgery) remains in place with Trust now in the preparatory stages to move to consultation on a permanent change delivery model.’

Next Consultation:

Public Consultation on the Department of Health’s Draft Equality Action and Draft Disability Action Plan 2025-2030

Background ends

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Emergency Surgery

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07.07.24
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Nuffield Trust Report recommended Daisy Hill Hospital, Newry should be bolstered with some Hyper-Specialist Services (e.g. Stroke)

Nuffield Trust Report 2023 Recommended Daisy Hill Hospital, Newry should be bolstered with some Hyper-Specialist Services (e.g. Stroke)

The independent think tank Nuffield Trust were commissioned by the Southern Health and Social Care Trust to report on ‘how care might be improved at the Daisy Hill (DH) site.’ and review services. This Nuffield Trust Report* dated 31 March 2023 sent to Dr Maria O’Kane, Chief Executive of the Southern Trust provides key findings and suggestions for building a sustainable model of care at Daisy Hill Hospital in Newry. One of the main recommendations in the Nuffield Trust Report was that there should be:

‘Bolstering of the DH site through provision of some hyper-specialist services (e.g., stroke), as well as regular outpatient clinics in each specialty on site.’ (Page 4)

As well as this recommendation emphasising the need for Specialist services like Hyper Acute Stroke in Daisy Hill Hospital, the Nuffield Trust Report emphasises the importance of Critical Care Services in Daisy Hill (e.g. the High Dependency Unit) and for Outpatient Clinics in each specialty on the DHH site. 

The Nuffield Trust also discusses staffing considerations across the Southern Trust’s TWO acute Hospitals, at Daisy Hill, Newry and at Craigavon. (*A link to the full report is available in References/Links below.)

CONCLUSION

BOLSTERING OF HYPER-SPECIALIST SERVICES IN DAISY HILL, NEWRY IS NEEDED TO SAVE LIVES

In their Report of March 2023 following their review, the Nuffield Trust came to the conclusion that there was need for more Hyperacute services in Daisy Hill Acute Hospital, Newry stating Daisy Hill Hospital should be bolstered with Hyper-Specialist services e.g. stroke. (See p4)

Looking at the illness prevalence on the list of patients in the 17 GP Federations across NI it can be seen why bolstering of Hyper-Specialist services in Daisy Hill Acute hospital, Newry is necessary to save lives. An official Needs assessment will also back this up, as Dept of Health illness stats by area detailed below show.

ILLNESS PREVALANCE STATS SHOW THE NEED IN NEWRY & DISTRICT

According to GP Registers in 2023 Newry & District GP Federation had the HIGHEST number in NI of patients on their register for Heart Failure (2,060 patients);also THIRD HIGHEST of the 17 GP Federation Registers for Hypertension (21,465 patients); Cancer (4,582 patients); Coronary Heart Disease (5,259 patients); Asthma (9,613 patients); Chronic Kidney disease (6,434 patients) and Atrial Fibrillation (3,258 patients).

Newry & District Federation also had fourth highest number of patients in NI with Stroke (2,680 patients) after GP Federations in Derry (3,991 patients) East Antrim (3,282), South West (2,749). (Source: DOH 2023)

THE NUFFIELD TRUST SAYS – URGENT NEED FOR SOUTHERN TRUST EXECUTIVE TEAM TO COMMIT TO THE DAISY HILL SITE

The Nuffield Trust Report also advised the Southern Trust that Public commitment to Daisy Hill Hospital from the Southern Trust Executive Team was urgently needed, writing: 

1.Public commitment to the DH Site – There is an urgent need for the Executive Team to commit to the DH site and to a long-term plan for the two sites to be developed.’
(Page 4)

As recommended by the impartial Nuffield Trust Report, the Southern Trust Executive Team needs to make a firm commitment to Daisy Hill Acute Hospital and develop a long term plan for its future development. 

Back in 2005 Labour Secretary of State to NI Peter Hain MP said that Daisy Hill Acute Hospital in Newry should have full investment and development, and as the people here will testify, it is long, long overdue.

REFERENCES AND LINKS

*The full Nuffield Trust Report 31st March 2023 can be read in the preview below or downloaded by clicking on the Download button underneath :

Nuffield-Trust-review-of-Northern-Ireland-provision-of-hospital-care (1) – CopyDownload

(This report is also available from the Southern Trust website.)

Who are the Nuffield Trust?

“The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.” https://www.nuffieldtrust.org.uk/about/what-we-do

POPULATION INFORMATION

Newry & District’s very large population size is proven by official data, as in 2023 Newry & District has the 2nd highest number of patients on GP registers in NI (with 160,615) after only Derry, including the 2nd highest number of children in NI under 18, with (36,228 ): (Source DOH 2023).

Newry Mourne and Down is the 3rd largest Council in NI with a population of 182,634.This includes 45,193 children under 18 and 31,473 over the age of 65 (NISRA 2022).

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

Text, graphics and logo ©Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com,
2015 – 2024.

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