Draft letters + Contact List to seek support for Daisy Hill ED in Newry June 2020

People power through Consultations -Based on demographics Daisy Hill Acute Hospital, Newry should be confirmed as a location for a Hyperacute and Acute Stroke Unit

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:

Version1-Email-re-Daisy-Hill-acute-Hospital  or    Version2-Email-re-Daisy-hill-acute-Hospital           

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)

More information on why these Plans are concerning for those who use Daisy Hill Acute Hospital is available here  from the Daisy Hill for life post:  Southern Trust Plan to Keep Daisy Hill ED closed and Retain 3EDs for Craigavon

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:

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

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.

Please use your phone to speak up for Daisy Hill Acute Hospital

 

MORE CONTACT INFO & LINKS

Contact List for MLAs & MPs for Constituencies of Newry & Armagh/ South Down (14.06.2020)

Contact List to Download:  Contact List MLAs, MPs for Newry+Armagh_ South Down 16.06.2020

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

  1. Cathal Boylan (Sinn Féin)
  2. William Irwin (DUP)
  3. Liz Kimmins (Sinn Féin)
  4. Justin McNulty (SDLP)
  5. 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

(No Email listed on AIMS portal)

Parliamentary Address: Room 260, Parliament Buildings, Ballymiscaw, Stormont, Belfast, BT4 3XX

Constituency address details unknown; Phone: 028 3026 1693

Justin McNulty MLA (SDLP)

 Email: justin.mcnulty@mla.niassembly.gov.uk

Constituency Address: Trevor Hill, Newry, BT34 1DN Phone: 02830267933 or 028 37526800

Conor Murphy  MLA (Sinn Féin)

Email: conor.murphy@mla.niassembly.gov.uk

Constituency Address: Newry Street, Crossmaglen, BT35 9JH; Phone: 02830861948

MP for Newry & Armagh : Mickey Brady (Sinn Féin) Kilmorey Terrace, Patrick Street, Ballinlare, Newry, BT35 8DW; Phone: 02830 261693; Email: mickey.brady28@gmail.com

SOUTH DOWN MLAs

  1. Sinéad Bradley (SDLP)
  2. Sinéad Ennis (Sinn Féin)
  3. Colin McGrath (SDLP)
  4. Emma Rogan (Sinn Féin)
  5. Jim Wells (DUP)
  • Sinéad Bradley (SDLP)

Email: sinead.bradley@mla.niassembly.gov.uk

Constituency Address:  11-14 NEWRY STREET, RINGMACKILROY, WARRENPOINT, BT34 3JZ; Phone: 028 41754000

  • Sinéad Ennis (Sinn Féin)

Email: Sinead.Ennis@mla.niassembly.gov.uk

Constituency Address: SRÁID NA BANRIONA, WARRENPOINT, BT34 3HZ ; Phone 02841754448

  • Colin McGrath (SDLP)

Email: colin.mcgrath@mla.niassembly.gov.uk

Constituency Address : MAIN STREET, NEWCASTLE, BT330AE; Phone 02843798350

  • Emma Rogan (Sinn Féin)

Try Email: sinnfeindownpatrick@yahoo.ie  (No Email listed on AIMS portal)

Constituency Address : 64 St Patrick’s Avenue, Downpatrick, BT30 6ND; Phone: 028 44614405

  • Jim Wells (DUP)

Email: jim.wells@mla.niassembly.gov.uk

Constituency Address : Bridge Street, Kilkeel, BT344AD,

Phone: 02841769900

MP for South Down:

Christopher Hazzard (Sinn Féin)

Constituency Address 64 St Patrick’s Avenue, Downpatrick, BT30 6ND; Phone: 028 44614405;

Email: chrishazzardsf@gmail.com

Newry Mourne and Down Council Contacts

https://www.newrymournedown.org/your-councillors

LINKS AND FURTHER INFO

Government Official Links

Northern Ireland Assembly: AIMs Portal: http://aims.niassembly.gov.uk/mlas/search.aspx

UK Parliament Website: https://members.parliament.uk/

Other Useful Links

WriteToThem.com

Newry& Armagh search on WriteToThem: https://www.writetothem.com/who?pc=BT342PF&fyr_extref=https%3A%2F%2Fdemocracy.warwickshire.gov.uk%2FmgFindMember.aspx

South Down Search search on WriteToThem:  https://www.writetothem.com/who?pc=BT358QS&fyr_extref=https%3A%2F%2Ft.co%2Fe3BAO1Sagu%3Famp%3D1

https://members.parliament.uk/

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

Updates available on : https://www.facebook.com/daisyhillforlife/ Please like or follow the page to support. Thank you

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2021.

Clinical evidence proves the importance of ‘Golden Hour’ in Emergency Stroke care

The effectiveness of stroke treament within the ‘Golden Hour’ is well  documented in clinical research and in the stroke treatment community.   (Hussain, M.S.(2018); Fassbender, K.et al (2013); Saver, J.(2006,2010)

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 Golden Hour in stroke is well supported by Clinical Evidence

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).

The Golden Hour in stroke is well supported by Clinical Evidence

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 from the combined Specialist Acute Stroke/Rehab Unit, which has existed since pre-2003 in Daisy Hill Acute Hospital, Newry, must be challenged!

You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2021. 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!

Largest rural population in NI: Newry, Mourne and Down Local Gov. District must have immediate access to life saving 999 Emergency Stroke Care

Withdrawal of immediate access to life saving 999 Emergency Stroke Care, including direct admission into the existing specialist Acute Stroke Unit from Newry, Mourne & Down Locality is not fair and equitable treatment. 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.

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.

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

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

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), at Daisy Hill Hospital, Newry and Craigavon Hospital. This would ensure that everyone in the Southern Trust has immediate access to CT scanning and life saving thrombolysis, followed by direct access into a stroke unit.

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.

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

“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

Urgent Message to HSCNI: Retain Emergency Stroke Services in Newry Now

Urgent Message to the HSCNI: Retain Emergency Stroke Services in Newry Now (Re: NI stroke Consultation 2019) As Trusted Clinicians confirmed scanning and thrombolysis would remain in Daisy Hill Hospital, Newry city.

There is plenty of Clinical evidence in support of the combined Acute Stroke/Rehabilitation Unit at Daisy Hill Acute Hospital, Newry. Multiple official quotes show that Clinicians, Directors, Chief Executive and the Health Minister in 2014, spoke in favour of keeping all emergency Stroke Services, especially scanning and Thrombolysis (Alteplase – clot busting drugs treatment) in Daisy Hill Hospital.

This evidence from the Southern Trust Stroke Consultation in 2014 is relevant today as Stroke Services in the Southern Trust was used as a local case study in the Bengoa Expert Panel report (2016, p72). This Bengoa Report continues to inform Health Policy in 2019.

The 2014 Consultation questionnaire itself and clinician’s statements made it very clear that emergency services for stroke – Scanning and Thrombolysis would always be in Daisy Hill Hospital. This was reiterated by more official statements in press, minutes and meetings in 2014/15.

Now fast forward to 2019, the people of Newry & Mourne discover that in the latest NI wide Stroke Consultation, the Emergency services for stroke (Scanning and Thrombolysis), that Trusted clinicians had assured them would remain, are proposed for removal from Newry too.
Secondly Daisy Hill Hospital, Newry is completely excluded from the Stroke consultation Options and Questionnaire.

We will not accept this – and we ask the Permanent Secretary to deliver on his promised statement:

“to do better, for the public we serve”

(Source: Department of Health Blog 05.04.2019)

>This urgent message to the HSC Northern Ireland, is to ask them to publicly explain their actions for the proposed Change or Withdrawal of Services from Daisy Hill, Newry – one of the designated acute hospitals in Northern Ireland with 24/7 emergency services.

We urgently request the Health Social Care Northern Ireland (HSCNI) to take action to Retain Emergency Stroke Services in Newry Now.

We need to appeal for Emergency Care for the dying and vulnerable in our society.

Act FAST Stroke - HyperAcute Stroke Unit for Newry 2019

CLINICAL EVIDENCE QUOTE EXAMPLES – supporting Emergency Stroke Care at Daisy Hill Hospital, Newry

Example 1:

“The Southern Local Commissioning Group supported the proposal to retain thrombolysis on both Craigavon and Daisy Hill Hospital sites, given the need to ensure that for those patients who are suitable for this procedure, they receive it within the optimum time.”

(Source: Appendix 1, Southern Local Commissioning Group, March 2015)

Example 2:

“We are proposing that patients who have had a stroke will continue to go to their nearest Emergency department, at Daisy Hill or Craigavon, where they will receive the appropriate specialist assessment. Stroke Thrombolysis, the clot busting drug, can be provided at both sites to the patients who are suitable. This is the same immediate and urgent access to emergency care that patients experience at present.”

(Source: Southern Trust Chief Executive, M. McAlinden, at a meeting with the Newry & Mourne Council representatives, in the presence of senior medical staff and Directors, ‘Chief Executive meets with Newry and Mourne Council Representatives’ Southern Trust Website 21/10/2014)

BACKGROUND
The 2014 decision by the Southern Trust to create a single specialist stroke inpatient unit in Craigavon was widely contested by the people and the Council of the largest locality in the southern Trust – Newry & Mourne. The high performing stroke unit, on Level 6, Daisy Hill Hospital, Newry was the only existing Specialist Acute Stroke Rehabilitation Unit in the Southern Trust.

Newry and Mourne population Rally for enhanced Stroke services at Daisy Hill Acute Hospital in 2015
2015 Rally to Save Stroke Services at Daisy Hill Hospital, Newry was attended by over 10,000.

This appeal for Emergency Care for the dying and vulnerable in our society continues in 2020, so we urgently request the HSCNI to take action to Retain Emergency Stroke Services in Newry Now.

Please share widely if you agree. You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2021.

NI Stroke Consultation 2019: ‘TIME IS BRAIN’ – URBAN and RURAL

Time is Brain - Urban and Rural -None of the Options in the NI Stroke Consultattion are best for all of NI. Every minute matters during a stroke says London Stroke Strategy.

Stroke is a crucially time dependant 999 Emergency Service for ALL the POPULATION of Northern Ireland – no matter where they live – URBAN or RURAL. The location of stroke units is vitally important so that immediate access is available for ALL.

HSCNI Reshaping Stroke Care proposals 2019 do not reflect the URGENCY of the complete stroke pathway – especially from ONSET OF STROKE TO ARRIVAL IN HOSPITAL for ALL the population of Northern Ireland.

> Every delay in time in treating stroke patients will cost lives – not save lives.

The Royal College of Physicians states the best outcome for patients is achieved when the time from onset of Stroke to treatment is as SHORT as possible:

“So the more we can do both to reduce the time taken from the start of symptoms to arrival in hospital, and from arrival in hospital to treatment, the less disability people will suffer.”

[Royal College of Physicians SSNAP Report 2016.]

Newry Mourne and Down (which includes South Armagh) is the 3rd highest population in Northern Ireland with a population of 179,000 (105,000 living in a rural area).

Why does this local government district and other rural areas in Northern Ireland have to COMPROMISE YET AGAIN for life saving 999 EMERGENCY services, while all 6 proposed options in the Consultation include: Belfast, Derry and Craigavon.

Belfast, Derry and Craigavon areas do not even need to answer the consultation document, because in this Department of Health Stroke Consultation, Reshaping Stroke Care 2019’, they are guaranteed a Hyperacute Stroke Unit co located with Acute Stroke Unit on their doorstep.

CONCLUSION
Nothing justifies the removal of Stroke services from the long established combined specialist Acute Stroke/ Rehabilitation Unit in Daisy Hill Hospital, Newry City (the only one of its kind in the Southern Trust).

OPTIONS
Daisy Hill Hospital’s Specialist Stroke Unit in Newry must feature in the proposed 2019 NI Stroke Consultation Options.

It must be retained and enhanced to a Hyperacute Stroke Unit co-located with an Acute Stroke Unit as part of the LONG TERM future plan for Stroke Services in NI- so the dedicated staff can continue to save lives and reduce disability if the DoH NI wants to save lives with better outcomes.

For more info on this topic – see https://savedaisyhillhospital.com/2019/05/05/ni-stroke-consultation-2019-overview/ and
https://savedaisyhillhospital.com/2019/05/05/ni-consultation-document-does-not-fully-follow-the-research-evidence-referred-to/

You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

Why did the NI Stroke consultation doc leave out vital facts about local stroke units in London?

Why did the NI stroke consultation doc leave out vital facts about the remaining 22 local stroke units in London? Is Northern Ireland getting the full picture? 22 local stroke units remain in London as well as 8 Hyperacute units

IS N.IRELAND GETTING THE FULL PICTURE?

Like the Bengoa Report in 2016, ‘Reshaping Stroke Care’ 2019 uses the London Stroke Model as good practice to follow here, but by mentioning only the 8 Hyper Acute Stroke Units and ignoring the rest of the local stroke services network in London –are they giving the people of N. Ireland the full picture about the Complete Stroke Pathway?

Dying Stroke patients in Northern Ireland are entitled to better.

The NI Consultation document, like the Bengoa Expert Panel Report before it, imply that all the 30 Stroke Units in London were centralised to only 8 hyper acute stroke units. The facts are, as the info-graphic shows-:

AFTER reconfiguration of stroke services: A network of 30 STROKE UNITS REMAIN In London: 8 HYPERACUTE STROKE UNITS + 22 STROKE UNITS which provide both specialist treatment and acute rehabilitation.

None of the 30 mentioned SUs in London were closed.

It was never intended that ‘Hyper Acute’ Stroke Units in London should work in isolation from the other 22 existing local stroke units included in the Sentinel Audit.

According to the London Stroke Model HYPER ACUTE STROKE UNITS (HASUs) are only for the FIRST 72 HOURS of STROKE CARE – that is why a network of dedicated Local Stroke Units as well as the 8 Hyper Acute stroke units were needed in London.

Act FAST Stroke - HyperAcute Stroke Unit for Newry 2019
Image by VSRao from Pixabay

LONDON DEALT WITH THE COMPLETE STROKE PATHWAY

The 2010 London Stroke Model dealt with the complete stroke pathway including from 999 call to Hyperacute (HASU) and Stroke Unit (SU) care – where patients receive most of their care.

The London Consultation confirms the IMPORTANCE of the REMAINING 22 STROKE UNITS in London. (Known as non-routinely admitting Stroke Units in the Royal College of Physicians Sentinel SSNAP AUDIT.)

> Final Summary


Like London, the people of Northern Ireland and their dying stroke patients need this Consultation to consider the best care for all stages of the Complete Stroke Pathway. As the people of London were told:

“You will stay in the hyper-acute stroke unit for the first 72 hours, or until you are stable.
You will then be transferred to a dedicated local stroke unit in the same hospital or closer to your home where you will receive continued specialist treatment and intensive rehabilitation. CARE IN A LOCAL STROKE UNIT WILL SIGNIFICANTLY IMPROVE YOUR CHANCES OF RECOVERING FROM A STROKE.”

London Stroke Consultation

The people of all parts of Northern Ireland are entitled to the same care.

> This NI Stroke Consultation needs to be CHALLENGED to ensure that all local Stroke Units in all areas of Northern Ireland are included.

HyperAcute Stroke Unit for Daisy Hill -Newry and Mourne/South Armagh Area Hospital Reshaping Stroke Care Consultation 2019
Image by cor gaasbeek from Pixabay

BACKGROUND INFO:

LIST OF EXISTING STROKE UNITS IN LONDON
(Source: Royal College of Physicians Sentinel SSNAP AUDIT).

There are still 30 STROKE UNITS IN LONDON: 8 of these are called Hyperacute Stroke Units There are also 22 stroke units. (8 HASUs and 22 SUs).

8 HASUs in London :

Queens Hospital Romford HASU / Royal London Hospital HASU / Charing Cross Hospital HASU / Kings College Hospital HASU / Princess Royal University Hospital HASU / Northwick Park Hospital HASU / St George’s Hospital HASU / University College Hospital HASU /

22 Stroke Units in London: 8 of these are attached to Hyperacute Stroke Units.

[Queens Hospital Romford SU] / Newham General Hospital /Whipps Cross University Hospital / [Royal London Hospital SU] /Chelsea & Westminster Hospital /West Middlesex University Hospital /Croydon University Hospital / St. Helier Hospital / St Thomas Hospital / Hillingdon Hospital / Homerton University Hospital / [Charing Cross Hospital SU], Nine South Ward /[Princess Royal University Hospital SU] / [Kings College Hospital SU]/Kingston Hospital /University Hospital Lewisham /[Northwick Park Hospital SU] /North Middlesex University Hospital SU / Barnett General Hospital /Royal Free Hospital / [St George’s Hospital SU] / [University College Hospital SU] /

For more info on this topic – see https://savedaisyhillhospital.com/2019/05/05/ni-stroke-consultation-2019-overview/ and
https://savedaisyhillhospital.com/2019/05/05/ni-consultation-document-does-not-fully-follow-the-research-evidence-referred-to/

You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2021. 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!

NI STROKE CONSULTATION DOESN’T FULLY FOLLOW THE RESEARCH IT REFERS TO

The NI Stroke Consultation 2019* has stated various research to justify the choices that have been made, determining which hospitals will keep or lose their acute stroke units in Northern Ireland – but the very supporting research referred to, does not fully back up these configurations. Two Topic examples are given below.

books-408220_1920Image by Jens P. Raak PIXABAY

[TOPIC 1]:

RECONFIGURATION OF STROKE SERVICES IN LONDON

Bengoa and the NI Department of Health Reshaping Stroke Services 2019 have referred to the London Stroke (Model) as a good example to follow in Northern Ireland.

The main NI Stroke Consultation Document (like the Bengoa Report 2016**), implies that in London after Reconfiguration, the number of stroke units were REDUCED from 30 acute stroke units to 8 Hyperacute stroke units (HASUs) (see pg p25)

THIS IS NOT WHAT HAPPENED.

FACT: FOLLOWING RECONFIGURATION IN LONDON, 30 STROKE UNITS REMAINED and 8 OF THESE ARE HYPERACUTE STROKE UNITS (HASUs).

The fact is – that AS WELL as these 8 HASUs (Hyperacute SUs) – 22 stroke units ALSO remained and to this day provide continued specialist treatment and intensive rehabilitation. (8 of these are attached to these HASUs) Confirmation of this can be seen in the latest Royal College of Physicians Sentinel Audit. (see Background Information Source 3*** ).

LOCAL STROKE UNITS  ARE CRUCIAL IN THE STROKE PATHWAY

HyperAcute Stroke Unit for Daisy Hill -Newry and Mourne/South Armagh Area Hospital Reshaping Stroke Care Consultation 2019

The 2010 London Stroke Model dealt with the complete stroke pathway including from 999 call to Hyperacute (HASU) and Stroke Unit (SU) care – where patients receive most of their care.

The London Stroke Consultation document advised the public:

“You will stay in the hyper-acute stroke unit for the first 72 hours, or until you are stable. You will then be transferred to a dedicated local stroke unit in the same hospital or closer to your home where you will receive continued specialist treatment and intensive rehabilitation. CARE IN A LOCAL STROKE UNIT WILL SIGNIFICANTLY IMPROVE YOUR CHANCES OF RECOVERING FROM A STROKE.”

This quote above from the London Consultation confirms the IMPORTANCE OF THE REMAINING 22 STROKE UNITS in London which provide both specialist treatment (some including thrombolysis) and intensive rehabilitation. They are known as non-routinely admitting stroke units in the Royal College of Physicians Sentinel SSNAP AUDIT.

     

 

 

[TOPIC 2]

UNIVERSITY OF EXETER

UNIVERSITY OF EXETER ADVISES THAT EFFICIENT TRANSFERS TO LOCAL STROKE UNITS WILL BE NEEDED.

As stated in the Research documents which were commissioned for the NI Stroke Consultation 2019, the research concentrated only on proposed Hyperacute stroke units and the Thrombectomy Unit in the Royal Victoria, Belfast with the understanding that EXISTING ACUTE STROKE UNITS WOULD CONTINUE TO EXIST.

The University of Exeter Research**** (p31) states:

“We assume that patients are taken to their closest stroke unit first”.

>This information is vitally important as statements in the research do not support the closing of existing Stroke units in Daisy Hill in Newry or Causeway in Coleraine.

In fact the research actually supports the important role of transfers to local stroke units. The research paper (University of Exeter p38)states:

 “NI only focuses on the Hyper Acute Stroke Unit phase of stroke care and does not extend to organisation of ongoing step-down care in local stroke units, or after discharge home. We have also not modelled bed use in a reconfigured system; though IT IS LIKELY THAT EFFICIENT TRANSFERS BACK TO LOCAL STROKE UNITS WILL BE REQUIRED to prevent overload in the thrombectomy centre (and possibly the other local HASUs).

Consultant Doctor examining notes

IN CONCLUSION

The NI Reshaping Stroke Care consultation document does not fully follow the research evidence referred to and the Questionnaire provided has biased Options which completely excludes existing Acute stroke units in Daisy Hill Hospital, Newry City and Causeway Hospital, Coleraine.

If this goes ahead unchallenged – Newry Mourne and Down Council – the 3rd highest Local Government District in NI with a population of 179,000 people (with 105,300 residents in rural areas) will be left with no immediate access to a designated specialist stroke unit (either Hyperacute or Acute Stroke Unit) vital for saving lives.

Stroke patients will be denied immediate access to this 999 crucially time dependant Emergency stroke service including timely access to the existing Daisy Hill, Newry City, specialist Acute Stroke /Rehabilitation Unit as a ward of first admission – a key recommendation of the Royal College of Physicians.

Daisy Hill Acute Hospital specialist stroke unit has been in existence since pre 2002 and already has saved thousands of lives, thanks to its entire specialist frontline staff.

It is up to us and our representatives to keep it there.

We have a right to continue to challenge, at every opportunity, these vital healthcare decisions.

Support Daisy Hill Acute Hospital in the Reshaping stroke services Department of Health NI 2017 consultation. stroke services. Newry and Mourne is the right place for a hyperacute stroke unit.

ACTION NEEDED

Both of these issues must be rectified with immediate effect.

Please write to all your representatives, and to the Department of Health to sort this out before an unjust decision on the entire future of stroke units is made in Northern Ireland.



Background Information Sources

  • *Department of Health NI (2019) Reshaping Stroke Care – Saving Lives, Reducing Disability. Consultation 2019 – see p25 for partial London Centralisation quote.
  • **Department of Health NI (2016) Systems, Not Structures – Changing Health and Social Care – Expert Panel Report (Bengoa Report) Page 72 for partial London Centralisation quote.
  • ***Royal College of Physicians Sentinel Audit RCP SSNAP Audit 2018 – List of Hyper-acute Stroke Units and Stroke units in London

There are still 30 STROKE UNITS IN LONDON: 8 of these are called Hyperacute Stroke Units (HASUs and SUs).

8 HASUs in London :

Queens Hospital Romford HASU / Royal London Hospital HASU / Charing Cross Hospital HASU / Kings College Hospital HASU / Princess Royal University Hospital HASU / Northwick Park Hospital HASU / St George’s Hospital HASU  / University College Hospital HASU /

22 Stroke Units in London: 8 of these are attached to Hyperacute Stroke Units.

[Queens Hospital Romford SU]  / Newham General Hospital  /Whipps Cross University Hospital  /
[Royal London Hospital SU]  /Chelsea & Westminster Hospital  /West Middlesex University Hospital  /
Croydon University Hospital  / St. Helier Hospital  / St Thomas Hospital  / Hillingdon Hospital  /
Homerton University Hospital  / [Charing Cross Hospital SU], Nine South Ward  /[Princess Royal University Hospital SU] / [Kings College Hospital SU]/Kingston Hospital  /University Hospital Lewisham  /[Northwick Park Hospital SU]  /North Middlesex University Hospital SU / Barnett General Hospital  /
Royal Free Hospital  / [St George’s Hospital SU]  / [University College Hospital SU] /



You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2021. We welcome sharing of excerpts & 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!

NI Stroke Consultation 2019 – Overview

The NI Stroke Services Consultation, Reshaping Stroke Care 2019 aims to create Hyperacute stroke units attached to acute stroke units, while cutting existing stroke units “to as few as sites as possible” to consolidate staff.

This is a consultation like no other, where the Department of Health is inviting people all over Northern Ireland to decide which stroke units will be kept or closed.

If all acute stroke units in Northern Ireland had an equal chance – this would be fair consultation – but they do not.

Some entire Councils have been omitted completely. (E.g. Newry, Mourne & Down locality, and its population of 179,000 people).

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

SIX OPTIONS WHICH EXCLUDE ENTIRE POPULATIONS

There are Six Options in the Questionnaire of preferred hospital sites to choose for Hyperacute/Acute Stroke Units in Northern Ireland.

In this NI Stroke Consultation the existing acute stroke units in Daisy Hill, Newry and Causeway in Coleraine are excluded and do not even get a chance to be selected, because they do not appear anywhere in the Six Options.

These excluded populations are not even given the Option to voice their discontent with being left outas the Options Question does not have a neutral or ‘Disagree’ or ‘None of the above’ Option.

At the other end of the spectrum, appearing six times, in each available Option are the stroke units in Altnagelvin, Craigavon and Royal Victoria Hospitals. Their continuation has been pre-determined and recruitment for their foretold Hyperacute stroke Units may have already started.

Redress the unbalanced NI Stroke Consultation 2019 - additional Options needed to include the Excluded populations.

WE PRE PAY FOR EMERGENCY SERVICES INCLUDING STROKE & HEART

Hospital services are paid for with public money –general taxation, national insurance contributions and rates (including business rates).

All adults in Northern Ireland prepay for their life saving emergency care and hospitals, but this consultation downgrades Stroke from a time dependant Emergency service (which includes immediate vital CT scanning to confirm if patients are eligible for Thrombectomy and for Thrombolysis.

The NI Stroke Consultation 2019 has stated various research to justify the choices that have been made, determining which hospitals will keep or lose their acute stroke units in Northern Ireland – but the very supporting research referred to, does not fully back up these configurations.

These research Topics are looked at in more detail in the next article: https://savedaisyhillhospital.com/2019/05/05/ni-consultation-document-does-not-fully-follow-the-research-evidence-referred-to/


We have a right to continue to challenge, at every opportunity, these vital healthcare decisions

You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2023. We welcome sharing of excerpts & 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!

STROKE CONSULTATION (NI) 2019: Questionnaire Bias and Stroke Options that don’t fully reflect Research given

Intro and Recap

The NI Stroke Services Consultation 2019 aims to create Hyperacute stroke units attached to acute stroke units, while cutting existing stroke units “to as few as sites as possible” to consolidate staff.

This is a consultation like no other, where the Department of Health is inviting people all over Northern Ireland to decide which stroke units will be kept or closed. If all acute stroke units in Northern Ireland had an equal chance – this would be fair consultation – but they do not.

Some entire Councils have been omitted completely. (E.g. Newry, Mourne & Down locality, and its population of 179,000 people).

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

There are Six Options in the Questionnaire of preferred hospital sites to choose for Hyperacute/Acute Stroke Units in Northern Ireland.

In this NI Stroke Consultation the existing acute stroke units in Daisy Hill, Newry and Causeway in Coleraine are excluded and do not even get a chance to be selected, because they do not appear anywhere in the Six Options.

These excluded populations are not even given the Option to voice their discontent with being left outas the Options Question does not have a neutral or ‘Disagree’ or ‘None of the above’ Option.

At the other end of the spectrum, appearing six times, in each available Option are the stroke units in Altnagelvin, Craigavon and Royal Victoria Hospitals. Their continuation has been pre-determined and recruitment for their foretold Hyperacute stroke Units may have already started.

Redress the unbalanced NI Stroke Consultation 2019 - additional Options needed to include the Excluded populations.

WE PRE PAY FOR EMERGENCY SERVICES INCLUDING STROKE & HEART

Hospital services are paid for with public money –general taxation, national insurance contributions and rates (including business rates).

All adults in Northern Ireland prepay for their life saving emergency care and hospitals, but this consultation downgrades Stroke from a time dependant Emergency service (which includes immediate vital CT scanning to confirm if patients are eligible for Thrombectomy and for Thrombolysis.

It divides our society into the have (emergency stroke care) or have not.

NI CONSULTATION DOCUMENT DOES NOT FULLY FOLLOW THE RESEARCH EVIDENCE REFERRED TO

The NI Stroke Consultation 2019* has stated various research to justify the choices that have been made, determining which hospitals will keep or lose their acute stroke units in Northern Ireland – but the very supporting research referred to, does not fully back up these configurations. Two Topic examples are given below.

books-408220_1920Image by Jens P. Raak PIXABAY

[TOPIC 1]:

RECONFIGURATION OF STROKE SERVICES IN LONDON

Bengoa and the NI Department of Health Reshaping Stroke Services 2019 have referred to the London Stroke (Model) as a good example to follow in Northern Ireland.

The main NI Stroke Consultation Document (like the Bengoa Report 2016**), implies that in London after Reconfiguration, the number of stroke units were REDUCED from 30 acute stroke units to 8 Hyperacute stroke units (HASUs) (see pg p25)

THIS IS NOT WHAT HAPPENED.

FACT: FOLLOWING RECONFIGURATION IN LONDON, 30 STROKE UNITS REMAINED and 8 OF THESE ARE HYPERACUTE STROKE UNITS (HASUs).

The fact is – that AS WELL as these 8 HASUs (Hyperacute SUs)- 22 stroke units ALSO remained and to this day provide continued specialist treatment and intensive rehabilitation. (8 of these are attached to the HASUs) Confirmation of this can be seen in the latest Royal College of Physicians Sentinel Audit. (see Background Information Source 3*** ).

LOCAL STROKE UNITS  ARE CRUCIAL IN THE STROKE PATHWAY

HyperAcute Stroke Unit for Daisy Hill -Newry and Mourne/South Armagh Area Hospital Reshaping Stroke Care Consultation 2019

The 2010 London Stroke Model dealt with the complete stroke pathway including from 999 call to Hyperacute (HASU) and Stroke Unit (SU) care – where patients receive most of their care.

The London Stroke Consultation document advised the public:

“You will stay in the hyper-acute stroke unit for the first 72 hours, or until you are stable. You will then be transferred to a dedicated local stroke unit in the same hospital or closer to your home where you will receive continued specialist treatment and intensive rehabilitation. CARE IN A LOCAL STROKE UNIT WILL SIGNIFICANTLY IMPROVE YOUR CHANCES OF RECOVERING FROM A STROKE.”

This quote above from the London Consultation confirms the IMPORTANCE OF THE REMAINING 22 STROKE UNITS in London which provide both specialist treatment (some including thrombolysis) and intensive rehabilitation. They are known as non-routinely admitting stroke units in the Royal College of Physicians Sentinel SSNAP AUDIT.

     

 

[TOPIC 2]

UNIVERSITY OF EXETER

UNIVERSITY OF EXETER ADVISES THAT EFFICIENT TRANSFERS TO LOCAL STROKE UNITS WILL BE NEEDED.

As stated in the Research documents which were commissioned for the NI Stroke Consultation 2019, the research concentrated only on proposed Hyperacute stroke units and the Thrombectomy Unit in the Royal Victoria, Belfast with the understanding that EXISTING ACUTE STROKE UNITS WOULD CONTINUE TO EXIST.

The University of Exeter Research**** (p31) states:

“We assume that patients are taken to their closest stroke unit first”.

>This information is vitally important as statements in the research do not support the closing of existing Stroke units in Daisy Hill in Newry or Causeway in Coleraine.

In fact the research actually supports the important role of transfers to local stroke units. The research paper (University of Exeter p38)states:

 “NI only focuses on the Hyper Acute Stroke Unit phase of stroke care and does not extend to organisation of ongoing step-down care in local stroke units, or after discharge home. We have also not modelled bed use in a reconfigured system; though IT IS LIKELY THAT EFFICIENT TRANSFERS BACK TO LOCAL STROKE UNITS WILL BE REQUIRED to prevent overload in the thrombectomy centre (and possibly the other local HASUs).

Consultant Doctor examining notes

IN CONCLUSION

The NI Reshaping Stroke Care consultation document does not fully follow the research evidence referred to and the Questionnaire provided has biased Options which completely excludes existing Acute stroke units in Daisy Hill Hospital, Newry City and Causeway Hospital, Coleraine.

If this goes ahead unchallenged – Newry Mourne and Down Council – the 3rd highest Local Government District in NI with a population of 179,000 people (with 105,300 residents in rural areas) will be left with no immediate access to a designated specialist stroke unit (either Hyperacute or Acute Stroke Unit) vital for saving lives.

Stroke patients will be denied immediate access to this 999 crucially time dependant Emergency stroke service including timely access to the existing Daisy Hill, Newry City, specialist Acute Stroke /Rehabilitation Unit as a ward of first admission – a key recommendation of the Royal College of Physicians.

Daisy Hill Acute Hospital specialist stroke unit has been in existence since pre 2002 and already has saved thousands of lives, thanks to its entire specialist frontline staff.

It is up to us and our representatives to keep it there.

We have a right to continue to challenge, at every opportunity, these vital healthcare decisions.

Support Daisy Hill Acute Hospital in the Reshaping stroke services Department of Health NI 2017 consultation. stroke services. Newry and Mourne is the right place for a hyperacute stroke unit.

ACTION NEEDED

Both of these issues must be rectified with immediate effect.

Please write to all your representatives, and to the Department of Health to sort this out before an unjust decision on the entire future of stroke units is made in Northern Ireland.



Background Information Sources

  • *Department of Health NI (2019) Reshaping Stroke Care – Saving Lives, Reducing Disability. Consultation 2019 – see p25 for partial London Centralisation quote.
  • **Department of Health NI (2016) Systems, Not Structures – Changing Health and Social Care – Expert Panel Report (Bengoa Report) Page 72 for partial London Centralisation quote.
  • ***Royal College of Physicians Sentinel Audit RCP SSNAP Audit 2018 – List of Hyper-acute Stroke Units and Stroke units in London

There are still 30 STROKE UNITS IN LONDON: 8 of these are called Hyperacute Stroke Units (HASUs and SUs).

8 HASUs in London :

Queens Hospital Romford HASU / Royal London Hospital HASU / Charing Cross Hospital HASU / Kings College Hospital HASU / Princess Royal University Hospital HASU / Northwick Park Hospital HASU / St George’s Hospital HASU  / University College Hospital HASU /

22 Stroke Units in London: 8 of these are attached to Hyperacute Stroke Units.

[Queens Hospital Romford SU]  / Newham General Hospital  /Whipps Cross University Hospital  /
[Royal London Hospital SU]  /Chelsea & Westminster Hospital  /West Middlesex University Hospital  /
Croydon University Hospital  / St. Helier Hospital  / St Thomas Hospital  / Hillingdon Hospital  /
Homerton University Hospital  / [Charing Cross Hospital SU], Nine South Ward  /[Princess Royal University Hospital SU] / [Kings College Hospital SU]/Kingston Hospital  /University Hospital Lewisham  /[Northwick Park Hospital SU]  /North Middlesex University Hospital SU / Barnett General Hospital  /
Royal Free Hospital  / [St George’s Hospital SU]  / [University College Hospital SU] /



You can follow the Daisy Hill Acute Hospital campaign also by visiting and liking our Facebook page at https://www.facebook.com/daisyhillforlife/ – Thank you.

© Daisy Hill for Life on Facebook and http://www.savedaisyhillhospital.com, 2015 – 2019. We welcome sharing of excerpts & 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!

QUESTION OF TRUST – comparing Southern and Western Trust’s Stroke Proposals for NI

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), at Daisy Hill Hospital, Newry and Craigavon Hospital. This would ensure that everyone in the Southern Trust has immediate access to CT scanning and life saving thrombolysis, followed by direct access into a stroke unit.

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

Sources: http://www.westerntrust.hscni.net/about/3857.htm