DAISY HILL ACUTE HOSPITAL, NEWRY CITY IS ENTITLED TO ITS RIGHTFUL PLACE IN THE DESIGNATED NI NETWORK OF ACUTE HOSPITALS WITH 24/7 EMERGENCY SURGICAL AND MEDICAL CARE.
The Southern Trust are proposing yet again to withdraw Emergency Surgery Services from Daisy Hill Acute Hospital, Newry City, without adhering to any procedures that every other Health Trust has to follow, such as public consultation, Department of Health “Change or Withdrawal of Services.” Guidelines, Equality Impact Assessment, Rural Needs Act, Fair Treatment and Employment Legislation or NICE Clinical recommendations.
The Southern Trust needs to recognise that Daisy Hill Acute Hospital is not a support hospital for Craigavon. Daisy Hill Acute Hospital, Newry City has been given the right to be a fully functioning Acute Hospital, with 24/7 Emergency Surgical and Medical Care Services. It has a right to its place in the Regional Network of Emergency Care provision across NI since 2003.
It was a Department of Health decision to include Daisy Hill as a vital part of the Regional Network of Acute Hospitals with 24/7 A & E Services. In 2003 the Health Minister made an announcement that following Consultation, 8,000 reports, letters, postcards and e-mails as well as petitions bearing some 40,000 signatures that a Network of ten Acute Hospitals with 24/7 Emergency Departments with Accommodation, Emergency Surgery and Emergency Medical Care was the only way to ensure timely access to Acute Hospital Services and 24/7 Care for the entire population, no matter where they lived in NI.
The accompanying map shows Daisy Hill’s Geographic location in the designated DoH’s Network of Acute Hospitals. The ten Acute Hospitals of equal importance, each of which has a Type 1 Emergency Department covering both Urban and Rural geographic areas across NI are : Daisy Hill, Royal Victoria; Royal Belfast Children’s; Mater; Antrim; Ulster, Causeway; Craigavon; Altnagelvin and South West.
Under Human Rights Act and “Right to Life” No Health Trust or Department has the right to withdraw immediate LIFE SAVING SERVICES from one geographical area of Northern Ireland , especially since the Department of Health had decided already that it is essential to provide Emergency services in Daisy Hill, Newry location to SAVE lives.
Equality Laws and the Rural Needs Act are among the Statutory Rules put in place by the Government Departments responsible to protect the public, so that decisions made on public Health service provision are fair and equitable to all.
Action needs to be taken now by the Department of Health to protect the Services in the Regional Network of Acute Hospitals and all their Type 1 Emergency Departments across NI, before it’s too late.
Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ – Thank you. Please Follow or Like the Page to receive updates.
WHAT CAN WE DO ABOUT REMOVAL OF ACUTE SERVICES FROM DAISY HILL ACUTE HOSPITAL, NEWRY?
Whether it’s the Type 1 ED, Specialist Stroke Unit and even vital CT scanners – it’s a Tug of War with the Southern Trust. FINALLY NOW – here’s something we can do. We have an address and an opportunity to air our views as part of a Department of Health Framework Consultation. So we MUST USE THIS OPPORTUNITY –as Daisy Hill needs us!
During the Covid pandemic, at a days notice, (without providing a nearby alternative) the Southern Trust removed Daisy Hill Acute Hospital’s 24/7 Type 1 ED services and staff to provide 3 EDs in Craigavon Hospital – one Covid 19, one non Covid 19 and a new Children’s ED.
YOU CAN HELP shape the future, and ensure Daisy Hill isn’t missing from the Regional network as Northern Ireland Rebuilds during and after covid-19 by replying to the ‘Temporary Amendments to the HSC Framework Document’ Consultation, by this Friday 4th December 2020, 5pm.
The Consultation Documents along with info on how to respond can be read in full at: www.health-ni.gov.uk/consultations/HSCframework (Additionally Consultation Links are available at the end of this article.)
IMPORTANT ASPECTS DIGESTED
The Department of Health (NI) has made temporary changes to the 2011 Health and Social Care (HSC) Framework Document where it describes the Role and Responsibilities of HSC bodies .So, the Consultation asks :
If we agree with ‘temporary’amendments needed to change these roles and responsibilities. Although they frame it as an “administrative” change it will mean HSC Trusts will have MORE POWER than before.
2. If we agree with their decision to establish a ‘new’ Management Board for Rebuilding HSC Services in NI (which has been in operation since June 2020 without consultation, until now).
TRUSTS HAVE BEEN GIVEN THE GO AHEAD TO REBUILD AND EXPAND SERVICES WHERE THEY WANT.
The only function of Trusts before was as a ‘provider’ of hospital and community services. But as part of these amendments to the 2011 Framework Document in this Consultation – the role of Trusts is now elevated. Trusts are now responsible for assessing their population needs, planning to meet those needs and delivering ‘appropriate’ services in whatever location or hospital they deem appropriate.
If these changes to the 2011 HSC Framework Document go through according to this current Consultation, the Southern Trust will have the loudest voice influencing the future of Daisy Hill.
This will have a huge impact on all ED and specialist inpatient acute hospital services (including children’s services) in Daisy Hill Hospital, Newry as well as Capital investment shaping the future of Daisy Hill acute Hospital for good. Can you help?
PLEASE ENSURE DAISY HILL PART OF NI REBUILDING PLANS NOW – REPLY TO THE CONSULTATION
Nearly £7 billion has been allocated to the Department of Health and the Southern Trust handle over £800 million – we are entitled to our share of this. If we lose services in these Rebuilding Plans for two years to May 2022 we will not get them back. You can Reply to the Consultation to give your views and ensure Daisy Hill, Newry is part of the NI Health and Social Care Rebuilding Plans at both a Regional and local level.
As Health Minister Robin Swann MLA rightly stated at the 10th Annual Nicon Conference 2020
“Whilst we must face the challenges that lie ahead, we must also continue to rebuild; to transform our services in a way that ensures they are here for those who need them today, tomorrow, and for generations to come.”
Robin Swann MLA (10th Annual Nicon Conference 2020)
Newry & Mourne is projected to be the 3rd highest population in NI by 2025 and presently has the 3rd highest population of children in the whole of NI after only Belfast and greater Belfast.
We are entitled to the same investment as Altnagelvin. We must speak up for ourselves as we have seen that the Southern Trust priorities are not with Daisy Hill
We have to respond to this Consultation and speak up for ourselves, our children and their children to ensure retention and expansion of acute specialist acute services (including children’s services) in Daisy Hill acute Hospital in NI HSC Rebuilding plans NOW.
Ways to Respond
Dont forget the deadline is this Friday 4th December 2020, 5pm.
Which ever you prefer. But please do take part – do it for your family, the future of Daisy Hill, for those who cant take part themselves and for generations to come. Full instructions for responding to this Consultation are available on the Department of Health’s website at: www.health-ni.gov.uk/consultations/HSCframework
Nearly £7 billion has been allocated to the Department of Health and the Southern Trust handle over £800 million – we are entitled to our share of this. If we lose services in these Rebuilding Plans for two years to May 2022 we will not get them back. There has been a hospital in Newry for 175 years – NO ONE IS ENTITLED TO TAKE IT AWAY.
EXTERNAL LINKS TO CONSULTATION
Consultation on Temporary Amendments to the Health and Social Care Framework Document for the period June 2020 to May 2022
Rebuilding HSC Services Programme Coordination Office, Department of Health, Annexe 3, Castle Buildings, Stormont Estate, Belfast, BT4 3SQ
Email: RebuildingHSC.Services@health-ni.gov.uk
Telephone: 028 9052 3231
The Department of Health is inviting us all to tell them what we think about the new Amendments. If we DON’T respond we are letting the DoH and Southern Trust Rebuild (or not) for us and future generations – without us.
Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ – Thank you. Please Follow or Like the Page to receive updates.
MAKE SURE DAISY HILL ISN’T MISSING FROM THE NI REGIONAL NETWORK AS NORTHERN IRELAND REBUILDS DURING/ AFTER COVID-19– AND HELP SHAPE THE FUTURE, by replying to the ‘Temporary Amendments to the HSC Framework Document’ Consultation, by this Friday 4th December 2020, 5pm. The Consultation Documents and info on how to reply can be read in full at: www.health-ni.gov.uk/consultations/HSCframework
You can tell the Department of Health how you feel. It’s your Health service.
You can also use the Online Consultation form. Which ever you prefer. By the deadline of this Friday 4th December 2020, 5pm. But please do take part – do it for your family, the future of Daisy Hill, for those who cant take part themselves and for generations to come. There has been a hospital in Newry for 175 years – NO ONE IS ENTITLED TO TAKE IT AWAY.
EXTERNAL LINKS TO CONSULTATION
Consultation on Temporary Amendments to the Health and Social Care Framework Document for the period June 2020 to May 2022
Rebuilding HSC Services Programme Coordination Office, Department of Health, Annexe 3, Castle Buildings, Stormont Estate, Belfast, BT4 3SQ
Email: RebuildingHSC.Services@health-ni.gov.uk
Telephone: 028 9052 3231
The Department of Health is inviting us all to tell them what we think about the new Amendments. If we DON’T respond we are letting the DoH and Southern Trust Rebuild (or not) for us and future generations – without us.
Nearly £7 billion has been allocated to the Department of Health and the Southern Trust handle over £800 million – we are entitled to our share of this. If we lose services in these Rebuilding Plans for two years to May 2022 we will not get them back. DAISY HILL NEEDS YOU!
Information on this and other similar topics is also available at the companion Facebook page https://www.facebook.com/daisyhillforlife/ – Thank you. Please Follow or Like the Page to receive updates.
The Southern Trust must fast track their plans to open Daisy Hill Hospital ED at once, now that Craigavon Hospital has unfortunately fallen victim to COVID-19 clusters, which were reported on BBC NI News 01.09.2020.
Time is now opportune for the Southern Trust and Southern Local Commissioning Group to prove the truth of the rhetoric to the Southern Trust population how much an essential part of the hospital network, Daisy Hill in Newry is, by reopening the Emergency Department (ED) at once.
“Daisy Hill Hospital is based in the city of Newry and is an essential part of the hospital network provided by the Southern Trust and has been ranked as a CHKS Top 40 Hospital.” (Southern Trust 2017).
Daisy Hill Acute Hospital, Newry City
END OF SEPTEMBER NOT SOON ENOUGH TO OPEN ED
The Southern Trust stated on 24.08.2020 that work is progressing to reopen Daisy Hill ED on a 24/7 basis by the end of September. The Southern Trust Chief Executive has been asked repeatedly to open the ED and the end of September is not soon enough. It is vital to save lives that this date is brought forward to show how effectively they can manage their hospital network.
Daisy Hill 24/7 Type 1 ED was closed on 28th March 2020 – with little warning – so after 6 months to prepare – it is well past time it is reopened, especially given the current circumstance of several covid-19 clusters in Craigavon Hospital.
Mr Shane Devlin praised “The dedication and flexibility of staff during this time has been remarkable” (Southern Trust statement 24.08.2020). This is true of all Southern Trust staff, and especially of Daisy Hill staff who showed immense flexibility by also changing their workplace to Craigavon – but now given the changing circumstances and given the sheer population of Newry & Mourne and beyond – it makes sense that the Southern Trust uses the resources, facilities and staff available in the most sensible way now.
The Diagram and map shows the size of the Southern Trust and the 2 acute hospitals which operate in this Network. It should be noted that Daisy Hill Hospital, Newry is in Newry & Mourne with the largest population (106,499) and largest land mass (898.3 square Km) of all the 5 localities in the Southern Trust area.
Craigavon covers only 281.5 sq Km with less of a population of (102,566) in 2019. (All stats from NISRA) .The map shows the 5 localities / (former) local government districts/LGDs that still remain in the operational area of the Southern Trust, according to its founding legislation.
ED IS A REGIONAL SERVICE
The 106,499 population of Newry & Mourne are being denied time critical access to a Type 1 Emergency Department in a functioning acute hospital, since 28th March 2020 in Newry City.
As they have paid for Regional and Local Urgent and Emergency and acute services through their Regional Rates and Taxes, the population of Newry & Mourne (as well as all of the rest of the population across NI) are entitled to avail of the 24/7 Regional ED Services being provided by the Royal Group of Hospitals including the Royal Belfast Hospital for Sick Children, who have shorter waiting times.
The Southern Trust have a duty of care (under their founding legislation) to provide hospital services in Daisy Hill, Newry – not repeatedly take them away to Craigavon.
Daisy Hill’s Emergency Department has been a vital part of the Northern Ireland Network of Type 1 Emergency Departments for the past 17 years.
The Southern Trust have to end the uncertainty and anxiety caused to the population of Newry & Mourne by the removal of vital ED Services and return Daisy Hills ED and Specialist Staff back to Newry as a matter of urgency.
Sources: Population Stats NISRA 2019 Land Mass Figures – NISRA Southern Trust Statement 24th August 2020 Craigavon Area Hospital: Third Covid-19 outbreak confirmed, Louise Cullen BBC News NI, 01.09.2020 https://www.bbc.co.uk/news/uk-northern-ireland-53989892
PATIENTS ON DOCTORS REGISTERS (NISRA 2018) Derry: 122,280 under 5’s: 8,943 Newry & Mourne: 116,378: under 5’s: 9,481 Craigavon: 105,295 under 5’s: 8,504 Dungannon: 66,848 under 5’s: 5,746 Armagh: 67,930 under 5’s: 5,487 Banbridge: 51,494 under 5’s: 3,927
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Newry, the main Gateway City to NI now, and after we leave the EU, is being denied its rightful place in the Rebuilding of Health and Social Care Services, by the people who are paid to include them.
The graphics which follow show THERE IS NO OTHER Type 1 ED Department in NI that can be accessed within one hour by a third of the population of Newry & Mourne/South Armagh – 38,000 people.
That is why Newry City’s Acute Hospital, Daisy Hill’s ED department was designated in 2003 with 8 other EDs across NI to form a Regional network of 9 Type1 EDs , vital to ensure equality of access within one hour 24/7 to Consultant-led urgent and emergency Care to everyone in NI , no matter where they live – urban and rural.
The Southern Trust needs to take its responsibilities to the Newry & Mourne/South Armagh population seriously and be accountable for their actions. The function of the Southern Trust is to provide hospital accommodation and services in Newry City in Newry & Mourne – the largest administrative area in the Southern Trust.
Their function DOES NOT include the removal of Daisy Hill’s Emergency Department (ED) from the long established Designated Regional network of the nine 24/7 Type 1 ED Departments of Daisy Hill, Royal Group , Antrim, Ulster, Causeway, Mater, Altnagelvin, Craigavon, and S.W. Acute Hospitals, which provided a seamless web of ED care to all of the people of NI over the past 17 years.
The Southern Trust shut down Daisy Hill’s Type 1 ED, at a days notice, without consultation, or any adherence to Equality, Rural Needs, Human Rights, Disability legislation. This Type 1 ED in Daisy Hill Hospital is the only one serving the population of the Southern part of NI one hour drive-time ED Network.
GRAPHICS/MAPS
The accompanying Graphics ‘Drive Times to Nearest Type 1 ED’ show the effect the removal of Daisy Hill ED from the existing network of Nine Type1 EDs across NI has on the Population of Newry & Mourne.
The Department of Health/Public Health Agency and Southern Trust are aware of the importance of this Drive Time information as it was previously analysed and published in the Department’s Pathfinder Project Report and Appendices in 2017. The map in the graphic is a scaled drawn reproduction of the report’s map*(See end for source).
GRAPHIC 1: Drive Time shows approx Drive time to a Type 1 ED across the Southern Trust and wider area when Daisy Hill ED is excluded. It shows that people living in Armagh, Craigavon, Lisburn, and all across the greater Belfast Area are all within a 30 minute car drive time of a Type1 ED. This is as well as being only 30 min Drive time to all other Type 1 EDs in acute hospitals in Belfast). It also shows that Newry & Mourne is most badly affected by removal of Daisy Type 1 Hill ED.
GRAPHIC 2: Focus on Newry & Mourne – Drive Time – focuses in detail at the map showing the area of Newry and Mourne. The Rural areas of the Mournes and South Armagh are most affected without Daisy Hill ED.
Nearly 38,000 people in Newry & Mourne denied right to access a Type 1 ED within 1 hour
Nearly 38,000 people in Newry & Mourne denied right to access a Type 1 ED within 1 hour
Graphic 2 shows the area of Newry & Mourne affected with added reference to Electoral Ward populations. Without DHH ED the population of the following electoral wards have to travel 75 to 90 minutes+ to get to a 24/7 TYPE 1 ED in an emergency situation.
OVER 75 MINUTES DRIVETIME TO GET TO A 24/7 TYPE 1 ED (coloured dark orange on maps): see key
1 : Annalong: 2. Binnion 3 : Kilkeel Central 4 : Kilkeel South 5 : Lisnacree 6 : Rostrevor
60 TO 75 MINUTES+ DRIVE TIME TO GET TO A 24/7 TYPE 1 ED. (coloured dark yellow on maps): see key:
These times are only estimates. Only those of us who have had to make the journey to the nearest ED know exactly how long the journey takes.
The Southern Trust’s has a centralisation policy of provision of all medical and surgical Urgent and Emergency Services. Because of this Southern Trust policy – approximately 38,000 people in Newry & Mourne (including South Armagh) since 28th March 2020, have been potentially denied their right to access immediate life saving care in a Type 1 ED within one hour Drive time from their homes. This includes 8,403 children and 5,914 aged 65+. (Population data from latest NISRA estimated 2019 stats).
REBUILDING PLANS:
Southern Trust made an agreement with other Health Trusts and the Department of Health NI that they will:
(1) Ensure Equity of Access for the treatment of patients across Northern Ireland (2) Minimise transmission of Covid-19; and (3) Protect access to the most urgent services for our population.
By shutting down and refusing to reopen Newry City’s Type 1 ED department the Southern Trust have not ensured “Equity of Access” for the treatment of patients across NI and have denied approx 38,000 men, women and children in Newry and Mourne access to time critical immediate Urgent and Emergency Car within an hour.
They have also destroyed the existing 17 years Regional network of 9 Type1 EDs being provided by all the other Trusts.
JUST LIKE NEWRY AND DAISY HILL WAS LEFT OUT OF THE STROKE CONSULTATION OPTIONS
Like with the Stroke consultation (where all Stroke care was centralised to Craigavon from Newry), the Southern Trust has again wrongly left Daisy Hill out – this time out of the Regional Plans for Urgent and Emergency and other services in their Rebuilding Health and Social Care services plans.
STAND YOUR GROUND
It is on record that there has been a hospital in Newry caring for anyone in need of immediate life saving services for the past 175 years, through famine, wars and the Cholera epidemic.
It took the Southern Trust, to remove its caring specialist staff at a days notice, from Newry to Craigavon, when they were needed most in Newry, during the Covid 19 pandemic, leaving the entire population of Newry & Mourne without a lifeline in Newry city to time critical Urgent and Emergency Care.
All Politicians, Unions, community representatives and individuals. Please stand your ground to get what is rightfully ours because we have paid for it.
The Department of Health get £5 billion to improve the health and social Care of all of the people of NI who need healthcare no matter where they live. Together we will stand our ground to get Newry, the Gateway City to NI and Newry & Mourne/South Armagh firmly back on the map.
Background:
*Map – (Source: Appendices – Daisy Hill Hospital Pathfinder Project – Development of an Unscheduled Care Model through a Co-Production Approach, 20th December 2017. Appendix 2 – Population Needs Assessment – Report of the Needs Assessment Figure 6-2: Drivetime Analysis for NI – DHH ED excluded. Pg 87/88.)
TYPE 1 Emergency Departments are defined as those with a consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services on a round the clock basis.
Daisy Hill Acute Hospital with 24/7 Type 1 ED in Newry is in the Southern Health and Social Care Trust area.
RELEVANT RESEARCH
Extensive research by ‘Developing Better Services’ Report 2003 found that only a total of 9 EDs would ensure the entire population of NI had access WITHIN ONE HOUR to immediate urgent and emergency care no matter where they lived in both urban or rural areas.
Newry & Mourne is the largest locality of the 5 localities in the operational area of the Southern Trust. The five localities in consistent order of population size since the establishment of the Southern Trust in 2007 are: (1) Newry & Mourne (2) Craigavon (3) Armagh (4) Dungannon and (5) Banbridge.
GOVERNMENT CONSTITUENCY INFO
Newry & Mourne Locality is in Two Westminster and NI Assembly constituencies: Newry Armagh and South Down. 17 Wards are in the Newry Armagh Constituency and 13 Wards from Newry & Mourne are in South Down Constituency.
NEWRY & ARMAGH CONSTITUENCY: Daisy Hill, Drumalane, St Marys, St Patrick’s, Windsor Hill, Drumgullion, Ballybot, Newtownhamilton, Camlough, Derrymore, Bessbrook, Tullyhappy, Crossmaglen, Creggan, Silverbridge, Forkhill, Fathom.
SOUTH DOWN CONSTITUENCY: 13 electoral wards of Newry & Mourne are in South Down Constituency.
Spelga, Rostrevor, Sea View, Clonallan, Burren & Kilbroney, Mayobridge, Derryleckagh, Annalong, Binnion, Kilkeel Central, Kilkeel South, Lisnacree, and Donaghmore: 49,000 of the Newry & Mourne population are in the South Down Constituency.
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Southern Trust Rebuild Plans Phase 2 (July to 30 Sept 2020) now published show the Southern Trust have not committed to the permanent re-opening of Children’s and Adults ED Department in Daisy Hill Acute Hospital. Newry. (See Plan page 6, link at end)
Six months with no emergency department through the dark days of the continuing covid-19 pandemic and no commitment to reopen the Consultant Led-24/7 ED – is a public health failure.
The Southern Trust will go down in history as the Health Trust who denied access to Daisy Hill hospital for immediate life saving care to the men, women and children of the largest locality in their care- Newry & Mourne. (106,500 population: NISRA)
Both Phase 2 and Phase 1 Rebuild Plans by Southern Trust show they have not responded to calls by elected representatives and individuals who have campaigned for the return of the Type 1 24/7 ED in Daisy Hill, Newry.
LAW AND STANDARDS THE SOUTHERN TRUST MUST ADHERE TO
1. Establishment Order
The Southern Trust function under their founding legislation is to PROVIDE hospital accommodation and services, not to TAKE AWAY accommodation and Services in Daisy Hill acute hospital, Newry. Their function is not to centralise all services including immediate life saving services like ED from Newry to Craigavon. They have a duty to keep the doors of Daisy Hill acute hospital open to anyone in need of immediate life saving care.
The Southern Trust’s function is to provide health and social care services paid for with public money from Regional Rates and Taxes. They have almost 1,600 admin staff and were given nearly £700 million in 2019/20 from the HSCB for provision of services across ALL of the Southern Trust, not just in some of the 5 geographical areas under their care.
2. Rural Needs Act 2016
Trusts also have obligations under the Rural Needs Act. Every other health trust in NI continued to provide Covid and Non Covid Care in their Rural and Urban Acute Hospitals, except the Southern Trust. The Southern Trust decided to deny access to Daisy Hill Acute Hospital which provided life saving Urgent and Emergency services for children and adults to the largest Rural catchment population in their care. Daisy Hill had ED attendances of 58,277 people in 2018/19.
3. Quality Standards for Health and Social care
Quality Standards for Health and Social care take into account Equality and Human Rights legislation where everyone has to be treated equally and humanely.
To refuse access to immediate life saving care to children and adults alike in Daisy Hill hospital by closing the only Accident and Emergency Department they have access to for immediate life saving services is inhumane treatment and should not be condoned.
The Centralisation of Acute Hospital Services to Craigavon Agenda of the Southern Trust evident in their planning policies is unfair and inhumane – and does not take into account the legislation.
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These letters ask for the Return and Enhancement of all Acute and Emergency services and valuable staff transferred to Craigavon Hospital to be restored to Newry IMMEDIATELY, without delay. If you agree, please contact your local representatives, including Councillors, MLA’s and MP’s, Contact Details Follow Below
After downloading (Just Click on the Blue Links, Select Save and then OK to save to your own device.) The contents of these draft Letters can be used as they are or as a guide to copy and paste from to write your own message/letter to send to MPs, MLAs, Councillors and/other organisations like Health Authorities (e.g. Department of Health) and other Stakeholders regarding the Southern Trust – June 2020 Rebuild Plan.
Please add your name and address to the letter if you are attaching it to an Email so the recipient knows it is genuine and also remember to ‘Save As’ with a New Filename or your choice e.g. Daisy Hill Hospital-2020 or whatever you like maybe using your initials to make it unique.
Tips on attaching the Email-Letter Doc to an Email are at the end of this piece, should you need them.
Dept. of Health ‘Rebuilding Health and Social Care’ Framework docs show services provided during COVID by each of the 5 Health Trusts, and more importantly Plans on how the Health Trusts propose to both Restore and scale back services following the easing of COVID 19.
The Plans each Trust have for Rebuilding HSC Services can be found at:
This letter is to support the view that all Acute and Emergency services and valuable staff transferred to Craigavon Hospital should be restored to Newry IMMEDIATELY, without delay.
If you agree please contact all your local representatives, Councillors, MLA’s and MP’s. They are all in a position as stakeholders to represent our views in relation to the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
MORE CONTACT INFO & LINKS
Contact List for MLAs & MPs for Constituencies of Newry & Armagh/ South Down (14.06.2020)
They are all in a position as stakeholders to represent our views regarding the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
This contact list is based on information as listed on the NI Assembly Portal page and other sources such as MLA’s Facebook pages or political party websites. Despite attempts to be as accurate as possible, if there is any information which is not up-to-date – apologies. (MLAs are listed in alphabetical order.)
Contact List already downloaded from data.gov.uk also directly available here: nmddc-councillors-12nov19
Step by Step Instructions how to Use the Draft Email Letter
Download the Document to your device and ‘Save As’ to give the File a new name of your choice .
Edit the document as you please, either delete or add your own info.
Add your NAME and ADDRESS at the end (or Email Address) so the recipient knows it is a genuine letter.
Click ‘Save’ to Save your new Changes
Compose New Message and Select the Paperclip Icon and select your File to Attach it to your Email message. (You will see the Filename attached to your Email when it has uploaded)
Type the email address of the person you want to send an email to in the To Field.
DAISY HILL HOSPITAL, NEWRY NEEDS YOUR SUPPORT LIKE NEVER BEFORE
3 Reasons why it is so important to Email your Representatives.
>REASON 1: THESE HSC REBUILD PLANS WILL DICTATE WHAT ACUTE SPECIALIST SERVICES WILL BE CENTRALISED TO CRAIGAVON FOR NOW AND THE FUTURE.
The Southern Trust Plan for June to September shows that although they promised to return the urgent and Emergency Care Services and staff to Daisy Hill as soon as the immediate threat of Covid- 19 was over – they have refused to do so. The Southern Trusts function, under the 2006 Establishment Order, is to provide hospital services, in Daisy Hill, Newry for the consistently largest population of the five localities in the admin area of the Southern Trust in Newry & Mourne – (their function is NOT to move them to Craigavon).
These Rebuilding Plans are LONG TERM future plans to decide location of all urgent and emergency care services, diagnostics, cancer, stroke, heart, and will decide which hospitals will shut in the future. This will dramatically affect provision of ED and inpatient hospital services in Newry & Mourne and NI FOR THE FUTURE.
>REASON 2: NEWRY & MOURNE HAS NO OTHER NEARBY ALTERNATIVE FOR URGENT AND EMERGENCY CARE AND INPATIENT CARE SERVICES:
In 2019 THERE WERE 60,000 ATTENDANCES TO DHH ED. When all ED services and ED staff were suddenly stripped from Daisy Hill Hospital and centralised to Craigavon Hospital at the height of the Covid Pandemic, the people of Newry & Mourne and surrounding areas unacceptably had no nearby alternative ED to go to for either Covid or non-Covid Emergencies. Adults and children alike, requiring any emergency care which needs immediate attention are now having their LIVES PUT IN DANGER because the Southern Trust are refusing to provide treatment in Daisy Hill ED now or in the future.
TAKE YOUR PICK
In direct comparison, Craigavon population has many alternative EDs to go WITHIN HALF HOURS MOTORWAY JOURNEY AWAY .They are as follows: The Royal (NI Regional Hospital), Royal Hospital for Sick Children, The Mater (NI Covid Centre), the Ulster, the City (formerly Covid Nightingale Hospital), Antrim Hospital, and Lisburn Hospital.
>REASON 3: POPULATION STATS: Newry & Mourne has been 4th highest locality population in NI since pre 1972 and is projected to be 3rd highest population in NI by 2023. Since the Southern Trust was established in 2007 Newry & Mourne has always been the largest of the 5 localities in the Southern Trust – with greatest need and THIS CAN BE IGNORED NO LONGER. In 2019 Newry & Mourne has the 3rd highest number of births in NI. This all can be confirmed by official NISRA stats.
>WHO CAN I EMAIL?
1. Representatives (Councillors, MLA’s and MPs).
2. Public Authorities (Public servants – Dept of Health, Health Trusts)
3. Others in your area who you may think of yourself e.g. Charities, community groups, business leaders etc
Two Draft Letter/Emails re Restoration of Daisy Hill ED June 2020 for those who wish to write to their MP, MLAs or Councillor or other Stakeholders regarding the Southern Trust – June 2020 Rebuild Plan is available by clicking on the blue links below:
for you to download and type on (or print off if you want to post it). After downloading save the File with a new name if you intend to attach it to an Email. Edit as you please and remember to add your NAME and ADDRESS (or Email Address) so they know it is a genuine letter.
Links to Contact Lists:
What is the Southern Trust Rebuild Plan? (June 2020)
Dept. of Health ‘Rebuilding Health and Social Care’ Framework docs show services provided during COVID by each of the 5 Health Trusts, and more importantly Plans on how the Health Trusts propose to both Restore and scale back services following the easing of COVID 19.
The Plans each Trust have for Rebuilding HSC Services can be found at:
This letter is to support the view that all Acute and Emergency services and valuable staff transferred to Craigavon Hospital should be restored to Newry IMMEDIATELY, without delay.
If you agree please contact all your local representatives, Councillors, MLA’s and MP’s. They are all in a position as stakeholders to represent our views in relation to the future Rebuilding of Health and Social Care services at a NI and local level and putting forward the case for restoration, and expansion of ED, inpatient bed capacity and Acute and unscheduled health care services in Daisy Hill acute Hospital, Newry.
MORE CONTACT INFO & LINKS
Contact List for MLAs & MPs for Constituencies of Newry & Armagh/ South Down (14.06.2020)
This contact list is based on information as listed on the NI Assembly Portal page and other sources such as MLA’s Facebook pages or political party websites. Despite attempts to be as accurate as possible, if there is any information which is not up-to-date – apologies. (MLAs are listed in alphabetical order.)
Newry & Armagh MLAs
Cathal Boylan (Sinn Féin)
William Irwin (DUP)
Liz Kimmins (Sinn Féin)
Justin McNulty (SDLP)
Conor Murphy (Sinn Féin)
Cathal Boylan MLA(Sinn Féin);
Email: cathal.boylan@mla.niassembly.gov.uk
Constituency Address: Thomas Street, Armagh, BT61 7QB;
Phone: 02837511797
William Irwin MLA (DUP)
Email: william.irwin@mla.niassembly.gov.uk
Constituency Address: 18 Main Street, Rich Hill, BT61 9PW; Phone: 028 38870500;
Liz Kimmins MLA (Sinn Féin)
Try Email as listed on MLA’s facebook profile, Email: lizkimminssf@gmail.com or Newry & Armagh Sinn Fein Email address: sfcrossmaglen@gmail.com
Clinical evidence proves the importance of the ‘GOLDEN HOUR’ in Emergency Stroke care, but ‘Golden Hour’ is not recognised by Department of Health (DoH).
It is well known that STROKE is a 999 EMERGENCY where every second counts for the patient receiving acute stroke care and the critically time dependant clot-busting drug Alteplase used in Thrombolysis.
The options given in the 2019 Stroke consultation show clearly that the Department of Health NI are IGNORING the fact that every stroke patient, no matter where they live, needs to be seen and treated as an Acute Stroke Care 999 Emergency ideally within the ‘Golden Hour’. This means making pre hospital travel times as SHORT AS POSSIBLE, so that the patient can ideally be treated within the ‘Golden Hour ‘from onset of stroke to needle time. Rather than make pre-hospital travel times SHORTER, the DoH are proposing to make pre hospital travel times LONGER for patients living in Newry Mourne & Down and other areas in NI.
Stroke patients who presently are scanned in Daisy Hill (and if eligible) given Thrombolysis are already immediately transferred to the Royal for Thrombectomy if suitable.
If 2019 Reshaping Stroke Care proposals go ahead, dying stroke patients
WILL BE DENIED IMMEDIATE TREATMENT and have to be transferred to
Craigavon, 45 minutes away (to see if they are even suitable for
Thrombolysis, never mind Thrombectomy) and will have much worse outcomes
due to the delay in transfer and will be denied the best chance for
survival.
TIME DELAY IN GETTING 999 EMERGENCY CARE IS NOT ACCEPTABLE
It is not acceptable that people from the Rural Areas of NI who will already have travelled long distances to access existing specialist Stroke Units, (using up precious minutes of the ‘Golden Hour’ already) will have to travel even FURTHER, losing vital brain cells and causing untold brain damage on the journey. It also means that patients who suffer a stroke when in hospital or ED will be denied access to the existing specialist Acute Stroke/Rehab Unit in Newry and denied immediate treatment.
WHY IS THE FIRST HOUR TERMED ‘GOLDEN’?
The effectiveness of treatment in the GOLDEN HOUR is well documented in
the emergency medicine and stroke treatment community, even if our DoH
refuse to recognise the term ‘Golden Hour’ in the recent FAQ/ Frequently
asked Questions supplement to the consultation document (see FAQ5).
It is well known that patients receiving treatment within the first 60
minutes of symptom onset, (termed the Golden Hour,) have the greatest
opportunity to benefit from restoration of blood flow therapy with
respect to disability and living independently. This time-frame is when
the volume of salvageable brain and the patient’s capacity to benefit
from clot-busting therapy are greatest.
The reason the first hour of stroke is called ‘golden’ is because
stroke patients have a much greater chance of SURVIVING and avoiding
long-term brain damage if they arrive at the hospital and receive
treatment with a clot-busting drug called TPA (Altepalse) within that
first hour from onset of stroke:
“Therapeutic benefit is maximal in the first minutes after symptom onset and declines rapidly during the next 4.5 hours.” (Saver MD)
DoH DO NOT RECOGNISE THE TERM ‘GOLDEN HOUR.’
The DoH try to justify selectively making Stroke patients travel further for immediate Emergency Stroke Care during the ‘Golden Hour’ from onset of stroke in Newry Mourne & Down by stating that: “the Golden Hour is not a recognised term in Stroke Care. In our healthcare system we work to the National Clinical Guidelines for stroke, which is the definitive source of how stroke care should be delivered in the UK.”
It is the DoH’s opinion that: “The most important factor in stroke care is not the time to hospital. It is the time to expert assessment, brain scanning and treatment that is critical.” (See FAQ 5:Taken from Questions and Answers Supplement to 2019 Stroke Consultation).
CLINICAL EVIDENCE SUPPORTING IMPORTANCE OF ‘GOLDEN HOUR’
At the International Stroke Conference 2018 in Los Angeles M. Shazam Hussain, MD, Director of Cleveland Clinic Cerebrovascular Center presented significant findings that the “golden hour” is proving to live up to its name, even for patients with one of the most serious forms of ischemic stroke.
According to this study, 52 percent of individuals suffering an ischemic stroke had better long-term outcomes if they received Thrombolysis medication (Alteplase) within 60 minutes of symptom onset. This compares to only 27 percent of patients showing good long-term outcomes – with respect to disability and living independently — if administered Alteplase beyond the golden hour.
A summary of The Lancet article (2013): ‘Streamlining of pre-hospital stroke management: the golden hour’ reinforces the importance of the narrow time-frame or ‘Golden Hour’:
“Thrombolysis with Alteplase administered within a narrow therapeutic window provides an effective therapy for acute ischaemic stroke. However, mainly because of prehospital delay, patients often arrive too late for treatment, and no more than 1–8% of patients with stroke obtain this treatment.
We recommend that ALL LINKS in the PREHOSPITAL STROKE RESCUE CHAIN must be optimised so that in the future more than a small minority of patients can profit from time-sensitive acute stroke therapy.”
The Lancet article (2013)
Therefore pre-hospital travel time for the Newry Mourne and Down population should also be shortened, not lengthened, in receiving 999 Emergency Stroke Care to save lives with better outcomes.
DAISY HILL, NEWRY IS THE RIGHT PLACE FOR A HYPERACUTE STROKE UNIT – A VITAL OMISSION FROM THE 6 PROPOSED 2019 STROKE CONSULTATION OPTIONS
Newry Mourne and Down – with a population of 180,000 is the third largest Local Government District population in NI. Daisy Hill Acute Hospital, Newry City with its STRATEGIC LOCATION – is the right place, entitled to have a hyperacute stroke unit co-located with an acute stroke unit.
This option will give a fair and equitable chance of survival with better outcomes for dying stroke patients in this LGD, like the population attending the Royal, Altnagelvin and Craigavon.
‘TIME LOST IS BRAIN LOST.’
The Emergency Stroke Care “Golden Hour” is already a very narrow time-frame. Additional delay in pre-hospital travel times which the DoH are selectively imposing on the Rural Catchment population of Newry Mourne and Down will cost lives, not save saves and cannot be condoned.
The population is entitled to fair and equitable treatment, so this proposal to withdraw emergency and specialist acute stroke care fromthe combined Specialist Acute Stroke/Rehab Unit, which has existed since pre-2003in Daisy Hill Acute Hospital, Newry, must be challenged!
Under the Rural Needs Act (NI) 2016 due regard must be given by Public Authorities to the needs of rural populations to fairly access key public services. This includes immediate, not delayed access to hospital stroke care.
The largest
rural population is in Northern Ireland is in Newry, Mourne & Down Local
Government District which includes South Armagh.
Since 2018, the Rural Needs Act 2016 (NI), which aims to deliver fairer and more equitable treatment in Rural areas, must be adhered to by all Public bodies in NI. Because of this, the Dept. of Health filled in a Rural Needs Assessment Form to accompany the 2019 NI Stroke Consultation.
Definition of Rural in Rural Needs Assessment Form
On this form, the definition of “Rural” which according to the DOH “is better able to distinguish between those who will be MOST IMPACTED by additional travel times caused by proposed changes to services is: “Populations outside of a 30 minute drive time of Derry/Londonderry or Belfast”
Using the above definition confirms that the 5 Urban hospitals in the Stroke Consultation 2019 are: Altnagelvin, Royal Victoria, Craigavon, Antrim and Ulster hospitals, while there are only three Rural Acute hospitals:– Daisy Hill, Newry, Causeway Hospital, Coleraine and South West Hospital, Enniskillen.
The DoH’s reply to Question 2B in the Rural Needs Assessment states:
“The key impact that differently affects rural dwellers is likely to relate to travel times to hospital etc.” They continue: “ALL OF THE OPTIONS outlined in the consultation document INCLUDE the provision of hospital care” at “Altnagelvin, Craigavon and Royal Victoria Hospital” (all URBAN Sites.) “Therefore people living in the catchment areas for these three sites WILL NOT experience any increase in respect of travel times. Under the potential options, people living in the catchment areas for Causeway Hospital and Daisy Hill Hospital, WOULD experience an INCREASE in journey times if taken to hospital after a suspected stroke.”
INCREASE IN JOURNEY TIMES AFTER A SUSPECTED STROKE FOR RURAL CATCHMENT AREAS
From research by Werner Hacke, MD It is known that the drug “Alteplase” used in Thrombolysis, is nearly twice as effective when administered WITHIN the first 1.5 hours after stroke as it is when administered 1.5 to 3 hours after stroke.
Yet, The DoH have admitted, above, that there WILL BE AN INCREASE IN JOURNEY TIMES for people living in the Rural Catchment areas of Causeway and Daisy Hill hospitals, and that people living in the Urban catchment areas of Altnagelvin, Craigavon, and Royal Victoria hospitals WILL NOT experience any increase in respect of travel times.
They have decided also to WITHDRAW COMPLETELY the existing stroke units in the Rural Locations of Daisy Hill Acute Hospital, Newry and Causeway Hospital, Coleraine. This proposal means dying stroke patients from these Rural localities will have to TRAVEL FURTHER for the CRITICALLY TIME DEPENDENT, LIFE-SAVING drug Alteplase used in Thrombolysis, and direct access from ED into the existing combined Specialist Acute/Rehabilitation Stroke Units in Daisy Hill, Newry, and Causeway Hospital, Coleraine, essential to save lives.
The 3
Urban Hospitals Altnagelvin, Craigavon, and Royal Victoria will never
experience an increase in travel times because they feature in all 6
Options in the 2019 Stroke Questionnaire to be upgraded to Hyperacute
stroke units with co-located Acute Stroke Units.
RURAL HOSPITALS OF DAISY HILL AND CAUSEWAY OMITTED FROM ALL SIX OPTIONS
However the two Rural hospitals of Daisy Hill and Causeway have been omitted altogether from all six options, confirming they will be shut down as if they never existed as part of the network providing 999 Emergency Stroke care to the population of NI.
THERE ARE NO RURAL HOSPITALS INCLUDED IN ALL 6 OPTIONS FOR HYPERACUTE AND ACUTE STROKE UNITS.
The DOH forget that Rurality is a factor in allocating Health and
Social Care Funding which means that there is extra money to provide
services in Rural areas which should be taken into account in deciding
where stroke Units will be provided.
*********RURAL NEEDS ACT (2016)*************
To have Three Hyperacute stroke units for Urban Areas of NI in all 6 Options and NO Option for a Hyperacute Stroke Unit for the Catchment population for the LARGEST RURAL POPULATION in NI namely Newry, Mourne & Down (which includes S.Armagh) Local Government District is NOT FAIR AND EQUITABLE TREATMENT in revising policies, strategies and plans, and designing and delivering public services such as Acute Stroke Care under the 2016 Rural Needs Act.
The Rural Needs Act NI 2016, (which is not a devolved matter) is there to PROTECT the Rural Population from this unfair treatment and “can relate to the ability to access key public services such as health, the ability to access suitable employment opportunities, and the ability to enjoy a healthy lifestyle”.
NEWRY MOURNE & DOWN LOCALITY SHOULD ALREADY HAVE A MAJOR ACUTE HOSPITAL
There is no doubt that Newry Mourne and Down LGD with the largest Rural
population in NI with 179,000 people, SHOULD ALREADY have a major acute
hospital, in Newry as proposed by Secretary of State Peter Hain in
2005.
This Stroke consultation shows that the Department of
Health are not even prepared to give dying stroke patients from the
largest rural Population in NI, the basic essential need of immediate
access to Emergency Stroke Care.
The Rural catchment population for Daisy Hill Acute Hospital, Newry, is not being treated fairly and equitability in the same way as the catchment population of the Urban Stroke Units in Altnagelvin, Craigavon and Royal Victoria Hospitals who will have immediate access, as they should, to life saving stroke care, in Hyperacute and Acute Stroke Units without having to travel further than at present.
This deliberate plan to exclude the Rural populations need for IMMEDIATE, not delayed, access to life saving Emergency Stroke Care, including CT scanning and Thrombolysis, followed by direct access into a specialist Hyperacute Stroke Unit /Acute Stroke Unit will COST LIVES, not save lives of Stroke patients and should not be condoned.
“RURAL NEEDS ACT (NORTHERN IRELAND) 2016 Duty of public authorities to have due regard to rural needs
1.(1) A public authority must have due regard to rural needs when— (a)
developing, adopting, implementing or revising policies, strategies and
plans, and (b) designing and delivering public services. 6. In this
Act— “the Department” means the Department of Agriculture and Rural
Development; “rural needs” means the social and economic needs of
persons in rural areas.” ‘PUBLIC AUTHORITIES’ include: A Northern Ireland department A district council A Health and Social Care Trust Invest Northern Ireland The Regional Agency for Public Health and Social Well-Being The Regional Health and Social Care Board
Daisy Hill Hospital for Life 