by Admin 4

NEW! Write for your Rights! Dept. of Health Equality & Disability Action Plans Consultation (24.06.2025)

The Department of Health has developed New Draft Equality and Draft Disability Action Plans for 2025 to 2030. They write: “This consultation gives you an opportunity to tell us what you think should be included in our Equality Action Plan and Disability Action Plans for the next 5 years.”This Regional Consultation is our chance to put in writing the need for Equality in Newry Mourne and Down. Give a voice to the vulnerable and ill. Please take part.

DOH Draft Equality & Disability Action Plans Consultation 2025 – 2030.

INEQUALITY – STILL HERE in JUNE 2025.

Write For Your Equality Rights (DoH Draft Equality/Disability Public Consultation 2025)

This time two years ago, on 25^th June 2023 people came out in their thousands to show their support for Daisy Hill Hospital at the SOS Daisy Hill Hospital Committee Public Rally in Newry. People here care and will show up for Daisy Hill, the designated Acute Hospital in Newry city.

Now its June 2025, so have there been announcements of more investment for specialist acute services for Daisy Hill Acute Hospital, for its large and growing population? After all, Official population figures right back to 1971 show that Newry & Mourne (former) local government district (LGD) has always ranked in the TOP 4 populations in NI.

No, instead of return of specialist services (like Emergency Surgery and acute stroke) and more capital investment for Daisy Hill Hospital, Newry, (Apart from proposing some essential Electrical Maintenance), the following is recorded in the DOH 2023-4 Annual Report :

‘Progress and key achievements in 2023/24: The initial phases of REMODELLING THE ACUTE MODEL at Daisy Hill Hospital by REDUCING BED CAPACITY and INCREASING COMMUNITY based medical management. Further development is ongoing in 2024-25 and it is expected that OTHER LOCAL HOSPITALS CAN LEARN from this model in the future.’ (Department of Health Annual Report 2023-4, Page 10)

COMPARING THE TWO SOUTHERN TRUST ACUTE HOSPITALS – DAISY HILL, NEWRY AND CRAIGAVON (From 2023- on)

While the longest established Hospital in the Southern Trust, Daisy Hill Acute Hospital, Newry gets ‘remodelled’ /’reconfigured’, ‘re-designated’ by re-moving /withdrawing and centralising its specialist services to Craigavon and vital equipment for the LONG TERM future is stalled again e.g. CT/ MRI Scanners. There is a different story in the other Acute Hospital in the Southern Trust, (newly built in 1971). Craigavon Hospital is treated much more favourably in the Department of Health Budget 2023-24 with the opposite proposal of EXTRA BEDS:

‘There are a number of critical capital schemes that the Department would like to commence in 2023/24 which include…THE PROVISION OF ADDITIONAL BED CAPACITY at CRAIGAVON Area Hospital’ (Department of Health Budget 2023-24 Equality Impact Assessment, page 10.)

CRAIGAVON CAPITAL PROPOSAL FOR £2.4 BILLION: REVENUE £38.5 MILLION. FUNDING STREAM IS NAMED AS DOH.

Craigavon Hospital continues to get major investment, beds, equipment and staff and still wants MORE

E.g. Southern Trust Board Report Jan 2025 lists the ‘new Capital Proposal for Craigavon Area Hospital Site Wide Redevelopment Programme with a Capital/Revenue Value £2.4 BILLION/ Revenue £38.5million.’ The Funding Stream is named as DOH. (Department of Health)

NEWRY & MOURNE HAS A HIGHER POPULATION THAN CRAIGAVON

Official population figures right back to 1971 show that Newry & Mourne local government district (LGD) has always ranked in the top 4 populations in NI and since 2007 has always had the HIGHEST population of the 5 LGD areas in the Southern Trust area. (See References for Figures)

So, given the consistently large recorded population size – where is the access to timely Regional Emergency Services and Specialist inpatient services at Daisy Hill Hospital in Newry, for the people of Newry, Mourne & Down?

Lack of inpatient hospital access (to the only hospital in this area – Daisy Hill) is a major health inequality affecting the adults and children who live in Newry & Mourne. And how can people bring this inequality to light in 2025?

The Department of Health has developed New Draft Equality and Draft Disability Action Plans for 2025 to 2030. They write: “This consultation gives you an opportunity to tell us what you think should be included in our Equality Action Plan and Disability Action Plans for the next 5 years.”This Regional Consultation is our chance to put in writing the need for Equality in Newry Mourne and Down.

Rally and another show of strength for Daisy Hill Acute Hospital, Newry city 25.06.2023

>WHY ANSWER THIS NEW CONSULTATION?

The DOH has given an opportunity to write to them directly about inequalities so this is a real chance to write about major health inequalities in the Southern Trust. This inequality affects all Section 75 groups in the population regarding lack of access to acute hospital inpatient treatment at Daisy Hill Acute Hospital in Newry, because vital TIMELY life saving Regional Accident and Emergency Medical inpatient services (like Stroke, timely Emergency Surgical inpatient Services, and vital timely Critical Care Services High Dependency beds) were withdrawn from Daisy Hill Hospital in Newry without the Department going to the necessary Public Regional Consultations.

Emergency Surgery was removed permanently in Jan 2024 when there was no NI Executive in place. It was also announced Daisy Hill Hospital change of use to a Regional Elective care centre, and removal of beds without Public Regional Consultation. These are huge inequalities as it was the only acute Hospital in NI treated this way and will have a negative effect on health outcomes of the very large numbers of children and adults living here.

Newry & Mourne is a major settlement, the 4^th highest population in NI and has always had the highest (former) local government district population in the Southern Trust operational area, but it is being wrongly categorised as an ‘isolated community’ in the DoH Hospital Network Consultation. Newry & Mourne is not an isolated community; the populations’ needs are not being assessed correctly.

To help people write in to the Department about inequality in this Public Consultation – Some suggested Answers will be available on this page.

Please Help and Please Share. Thank you.

REFERENCES AND LINKS

https://www.health-ni.gov.uk/consultations/consultation-draft-equality-action-plan-and-draft-disability-action-plan

The Southern Trust Operational Area is still the former five Local Government Districts of Newry & Mourne, Armagh, Craigavon, Dungannon and Banbridge. Projected population for 2026 in Southern Trust/ SLCG: Newry & Mourne (111,508); Craigavon (109,655); Armagh (66,848); Dungannon (67,870) and Banbridge (53,202) NISRA June 2025.

Department of Health Budget (DoH) 2023-24 Equality Impact Assessment, Page 10

Department of Health Annual Report 2023-4, Page 10)

*Definition –‘Centralise’ “concentrate under one control” (Collins English Dictionary)

Ways to respond are detailed below.

DEPARTMENT OF HEALTH CONSULTATION LINKS

https://www.health-ni.gov.uk/consultations/consultation-draft-equality-action-plan-and-draft-disability-action-plan

The link above is the main Consultation link from the Department of Health website . It gives all documents including main report, Rural Impact and Equality Impact Assessments, Consultation Questionnaire Word document all available to download and read.

Public Consultations should be freely accessible to all – if you are unable to save or open any of the Department of Health Consultation documents in the formats provided – please contact the Department of Health using the information provided below, to let them know and see if they can offer alternative formats.

WAYS TO RESPOND TO THE CONSULTATION

There are 3 WAYS TO RESPOND to Department of Health Draft Equality & Disability Action Plans Consultation 2025 – 2030

1>By Email > Send your completed Questionnaire by email to the Department by attaching the Consultation Questionnaire to the email address: equality&humanrights@health-ni.gov.uk

2>By Online Questionnaire

Click on the Online Questionnaire link below and scroll down to and click ‘have your say’

https://consultations2.nidirect.gov.uk/doh-1/draft-equality-action-plan-and-di/

3>By Post > A hard copy of your response Questionnaire can also be sent in Writing to:

Write to:
Equality and Human Rights Unit,
Castle Buildings,
Stormont,
Belfast,
Northern Ireland,
BT4 3SQ

By the Closing Date of Saturday 28th June 2025 by 5pm.

For Enquiries on the Department of Health Draft Equality & Disability Action Plans Consultation 2025 – 2030 the contact email is: equality&humanrights@health-ni.gov.uk

Department of Health General Telephone number is : Telephone: 028 9052 0500

Daisy Hill Acute Hospital, Newry City. — Daisy Hill Hospital, Newry City

BACKGROUND INFORMATION

WHY DAISY HILL HOSPITAL IN NEWRY IS ENTITLED TO BE AN AREA HOSPITAL:

>Reason 1 – Population fact 1: Out of 17 GP Federations in NI, Newry & District GP Federation has the 2nd highest number of patients (161,308) registered after only Derry GP Federation since 2017 (Source: DOH 2023/24).

Newry & District includes 36,018 children and young people aged U18, the 2^nd highest of the 17 GP Federations after only Derry (Source: DOH 2023/24).

Reason 2 – Population fact 2: Newry & Mourne Local Government District (One of 26 Former Councils) RANKED IN THE TOP FOUR HIGHEST POPULATION CENTRES In NI after only Belfast, Derry and Lisburn. (From 1971 to 2014)

Reason 3> Population fact 3: Newry & Mourne LGD has ALWAYS HAD THE HIGHEST POPULATION of the 5 LGDS in the operational area of Southern Trust. (Source NISRA). The 5 LGDS are Newry & Mourne, Craigavon, Armagh, Dungannon and Banbridge.

Reason 4 – Landmass fact : Newry & Mourne local government district area alone has the 3RD LARGEST LANDMASS in NI (898.3 Sq Km: Source NISRA).

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BACKGROUND

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

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

NEWRY

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

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

ENNISKILLEN

Western Trust Corporate Risk Update at 30 May 2024

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

Next Consultation:

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

Background ends

Please share if you can. Thank you.

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

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

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

02.23.25

by Admin 4

How to take part in the DOH Hospital Network Consultation with Suggested Responses (Updated! 23.02.2025)

DOH Hospital Network Consultation 2024-2025 – Some Suggested Responses

Daisy Hill Acute Hospital, Newry is entitled to be an Area Hospital due to the consistently high population size, need and land mass area in Newry & District. In the Department of Health’s new public Consultation ‘Hospitals – Creating a Network for better outcomes’, Daisy Hill Acute Hospital has been put into the wrong Hospital category of ‘General Hospital’.

Public help is needed to answer through the Questionnaire to put the case forward to the Department of Health through the Public consultation process for Daisy Hill to be made an Area Hospital, like the other Area Hospitals, as it is entitled to be.

You can help by responding to this Department of Health Consultation ‘Hospitals – Creating a Network for better outcomes.’ (October 2024) (More information on the topic is explored in ‘Why This Consultation Matters’ section below.

SUGGESTED ANSWERS HELP 1 AVAILABLE HERE

Word versions of the Questionnaire with some pre-filled selected options to read or use for your own answers, (now with extra info on the Rural Needs and Equality Questions) are available to download by clicking on the Download buttons below : (File name: V3 Extra info-Questionnaire-doh -hospitals) has detailed LONGER answers.

V3 Extra info-Questionnaire-doh-hospitals Download

A word version of the Questionnaire with SHORTER ANSWERS (File name ‘W shorter-questionnaire -doh-hospitals) with some pre-filled selected options to read or use for your own answers is available to download by clicking on the Download button below.

W shorter -questionnaire-doh-hospitals Download

Notes for the Prefilled Questionnaire

>If you use this pre-filled version you will first need to save the file to your phone/computer/device etc), Select the Save As Option, and select where you want to save it in Downloads/Documents etc.

>Then give it a new filename by adding your initials at the front/end or some other change to the standard name.

Example 1. New file name: AB questionnaire doh-hospitals-better-outcomes.

Example 2. New file name: questionnaire doh-hospitals-better-outcomesRR1

>Edit the new version by starting with Q1 to add your name and Q2 to add your Email address by typing into the Space in the Answer Boxes on the Questionnaire. This is really important so the department will count it as a real response coming from you. (There is space to add extra comments on some of the other answer boxes if you wish. )

>When you are finished Save your file again and then your version of the Questionnaire is ready. This new filename is the version you can send as an email attachment, (or for printing, if you want to post it.)

Ways to respond are detailed below.

Daisy Hill Hospital Newry is entitled to be an Area Hospital in the Department of Health Hospital Network Consultation 2024-2025.

DEPARTMENT OF HEALTH CONSULTATION LINKS

https://www.health-ni.gov.uk/consultations/hospitals-creating-network-better-outcomes-public-consultation

The link above is the main Consultation link from the Department of Health website for the ‘Creating a Network for better outcomes’ Consultation . It gives all documents including main report, Rural Impact and Equality Impact Assessments, Consultation Questionnaire Word document all available to download and read.

WAYS TO RESPOND TO THE CONSULTATION

There are 3 WAYS TO RESPOND to Department of Health Hospitals – Creating a Network for better outcomes Consultation proposals 2024-2025:

1>By Email > Send your completed Questionnaire by email to the Department by attaching the Consultation Questionnaire to the email address: rebuildinghsc.services@health-ni.gov.uk

2>By Online Questionnaire

Click on the Online Questionnaire link below and scroll down to and click ‘have your say’

https://consultations2.nidirect.gov.uk/doh-1/hospitals-creating-a-network-for-better-outcomes/

SUGGESTED ANSWERS HELP 2 (ONLINE QUESTIONNAIRE) AVAILABLE HERE

There are two versions of the Suggested Answers (ONLINE QUESTIONNAIRE ) AVAILABLE

V6 (With Longer Detailed Answers)

V8 (With Shorter Answers)

You can use these two Suggested Answer Sheets (Ready Reference) Answers BELOW to help you if you need some ideas while you are filling out this online questionnaire. If you agree with the typed answer suggestions you can even copy and paste the answers in part or full. (Just download it to your device and open the file for reference)

LONGER (MORE DETAILED) SUGGESTED ANSWER SHEET FOR ONLINE QUESTIONNAIRE AVAILABLE HERE:

V6 extra-ONLINE-Qs-suggested-answers Download

SHORTER SUGGESTED ANSWER SHEET FOR ONLINE QUESTIONNAIRE AVAILABLE TO DOWNLOAD HERE:

V8 Shorter Ready Ref Answers for Online Qs -DoH Download

3>By Post > A hard copy of your response Questionnaire can also be sent in Writing to:

Transformation Branch
Regional Health Services Transformation Directorate
Department of Health
Annex 3, Castle Buildings
Stormont Estate
Belfast
BT4 3SQ

By the Closing Date of 28th February 2025.

For Enquiries on the ‘Hospitals -Creating a Network for better outcomes’ consultation the Department of Health contact email is: rebuildinghsc.services@health-ni.gov.uk

Department of Health General Telephone number is : Telephone: 028 9052 0500

WHY THIS CONSULTATION MATTERS

In 2019, you did it – over 19, 500 people sent back consultation Reponses disagreeing with Dept of Health plans to cut the existing number of Stroke Units in NI and centralise stroke services to as few as sites as possible.

People power here worked after thousands filled in the Questionnaire with 95% rejecting the options, with concerns about longer travel times in an emergency. Following this consultation – the Health Minister Robin Swann MLA said stronger evidence was needed – so change can happen if we write in large numbers to these consultations.

In 2024/5 there is a new plan as the Department of Health now proposes to go way beyond centralising Stroke services and proposes changes to the whole Regional Hospital Network. This plan puts Hospitals in NI into four categories: Local, General, Area Hospitals and Specialist Regional Centres.

The majority of Specialist Inpatient Services for example Stroke, Emergency Surgery etc are proposed to be centralised to 5 newly chosen Area Hospitals (at Antrim, Altnagelvin, Craigavon, Ulster and Belfast Group Hospitals) and Specialist Regional Centres (at Altnagelvin, Ulster Hospital and Belfast Hospitals) (*Ref1)

In these proposals Daisy Hill Hospital (Newry); South West (Enniskillen) and Causeway (Coleraine) are to be known as ‘General Hospitals’. (Very different from the new proposed ‘Area Hospitals’)

The Government now wants to consult with you, the public who are paying for the service to see if they agree with these new proposals.

DAISY HILL HAS BEEN PUT IN THE WRONG CATEGORY OF ‘GENERAL’ HOSPITAL – BUT THIS CAN BE CHANGED IF ENOUGH PEOPLE DISAGEE WITH THE NEW PROPOSALS

As mentioned in previous posts, only 5 places have been selected to be upgraded to be higher level ‘Area Hospitals’ – they are: Craigavon, Antrim, Altnagelvin, Ulster and Belfast Group Hospitals. “These Area Hospitals will maintain a 24/7 emergency department, a 24/7 emergency surgery and anaesthetic rota and theatre, and be supported by a critical care unit.” (Consultation Doc p35/37pdf) Annex D also states Area Hospitals will be expected to have 31 specialty services with inpatient beds. (Page 106/8)

What about the General Hospitals?

Information on the limited services expected to be available from ‘General hospitals’ can be read in the Consultation document ‘Hospitals – Creating a Network for better outcomes’ from the Department of Health’s website. (See p23, 34-36, and 113)

In the document’s very important Actions page (p113, See Action 4) –it is rather concerning that the words ‘Short to Medium Term’*(Ref 2) are used when referring to maintaining core services in the ‘General Hospital’ category. And it is the Hospital Trusts who will be in charge of this.

Are core services not going to be maintained for the Long Term in the General Hospitals then? No other Hospital Category is dealt with in this way in the Actions Page.

Daisy Hill Acute Hospital, Newry has been incorrectly put in the ‘General Hospital’ category in this new report which also falsely describes the Newry area as a small ‘isolated’ geographical location and community (*(Ref 3) See pages 6,23, 34).

The Department of Health report fails to recognise the consistently large population size, recorded illness statistics needs and large land mass area in the Newry & District area.

Daisy Hill Hospital, Newry must be given the long overdue investment and specialist inpatient services it and the rate-paying and tax paying population here deserves.

We must challenge these unfair proposals. In Health and Wellbeing 2026 Delivering Together (p19) First Minister and former Health Minister Michelle O’Neill MLA stated “Our HSC system belongs to all of us and we all bring valuable insights in to how it can improve. We must work in partnership – patients, services users, families’ staff and politicians – in doing so we co-produce lasting change which benefits us all.” *(Ref 4)

DAISY HILL HOSPITAL IS ENTITLED TO BE AN AREA HOSPITAL & NEEDS YOUR HELP – PLEASE DISAGREE WITH THE PROPOSALS

Your help is needed to answer the Consultation through the Questionnaire and let the Dept of Health know that they have put Daisy Hill Acute Hospital, Newry into the wrong category –due to the population size, need and land mass here.

We have a right to continue to challenge, at every opportunity, these vital healthcare decisions. Pls take part in the Consultation and Strongly disagree with the proposals, stating in the Questionnaire that Daisy Hill Acute Hospital, Newry is entitled to be and should be categorised as an ‘Area Hospital’ along with the other Area Hospitals.

Please ask everyone in your house to take part take part in this public Consultation too and pls ask your friends, family and community and Elected Representatives to do the same.

BACKGROUND INFORMATION/ REFERENCES

REFERENCES

*Ref. 1. Hospitals – Creating a Network for better outcomes. Department of Health, (October 2024). Main Consultation document, Hospital Categories (Pages – pdf pg no. p23-25)

*Ref. 2. Action 4 states that “Consideration to be given to how in the short to medium term HSC Trusts can work in collaboration to maintain these core General Hospital services.” Creating a Network for better outcomes. Department of Health, October 2024. Main Consultation document, (pdf pg no p113)

*Ref. 3 Description of General Hospitals ,In ‘Creating a Network for better outcomes’. (Department of Health, October 2024,) the word ‘isolated’ is used 3 times describing the ‘location’ and ‘community’ of the 3 named proposed ‘General hospitals’: Causeway Hospital, Daisy Hill Hospital and South West Hospital(p6,p23, p34).

P6/23 : “General Hospitals, delivering defined secondary care services including unscheduled care, geared to a specific, more ISOLATED geographical location…”

P34/ “What and Where: General Hospitals” – …… These hospitals have a key role in ensuring our system can respond to the challenges of an aging population, delivering a range of acute and rehabilitation services, with the advantage that they are closer to an otherwise more ISOLATED community.”]

*Ref. 4. Health and Wellbeing 2026 – Delivering Together – Department of Health, (October 2016.) (p19)

*Definition –‘Centralise’ “concentrate under one control” (Collins English Dictionary)

BACKGROUND INFORMATION

WHY DAISY HILL HOSPITAL IN NEWRY IS ENTITLED TO BE AN AREA HOSPITAL:

Newry & District includes 36,018 children and young people aged U18, the 2^nd highest of the 17 GP Federations after only Derry (Source: DOH 2023/24).

Reason 4 – Landmass fact : Newry & Mourne local government district area alone has the 3RD LARGEST LANDMASS in NI (898.3 Sq Km: Source NISRA).

Further reading: https://savedaisyhillhospital.com/2025/01/28/gp-registers-show-vital-need-for-daisy-hill-newry-as-an-area-hospital-with-24-7-level-1-ed/

Further reading: https://savedaisyhillhospital.com/2025/02/23/new-updated-shorter-ready-reference-suggested-answers-online-consultation/

Further Reading: https://savedaisyhillhospital.com/2025/01/26/daisy-hill-newry-is-entitled-to-be-in-the-area-hospital-category-in-the-doh-hospital-network-public-consultation-2024-25/

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

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01.05.25

by Admin 4

DOH Hospital Network Consultation 2024-2025 – Suggested Response (Updated! )

Important: For detailed info on this topic and why it is important to take part- please read the full article.

QUICK LINKS – SHORT EXTRACT

*SUGGESTED ANSWERS HELP 1 – FULL QUESTIONNAIRE (Prefilled)

NEW SHORTER ANSWERS – PREFILLED QUESTIONNAIRE IN WORD IS AVAILABLE BELOW:

A NEW word version of the Questionnaire (W shorter -with Shorter Answers – with some pre-filled selected options to read or use for your own answers is available to download by clicking on the Download button below.

W shorter -questionnaire-doh-hospitals Download

LONGER ANSWERS PREFILLED QUESTIONNAIRE IN WORD IS AVAILABLE BELOW:

A word version of the Questionnaire (version V3-Longer Answers) with some pre-filled selected options to read or use for your own answers is available to download by clicking on the Download button below.

V3 Extra info-Questionnaire-doh-hospitals Download

*SUGGESTED ANSWERS HELP 2 (ONLINE QUESTIONNAIRE)

Shorter Answers V8

V8 Shorter Ready Ref Answers for Online Qs -DoH Download

You can use this V8 Shorter Suggested Answers – Ready Reference Sheet (word document) BELOW to help you if want to copy and paste onto or if you need some ideas while you are filling out the online questionnaire. (Link to the online Questionnaire in main article)

You can use this V6 Extra Online Qs Suggested Answers Sheet (word document) BELOW to help you if you need some ideas while you are filling out the online questionnaire. (Link to the online Questionnaire in main article)

If you agree with the typed answer suggestions you can even copy and paste the answers in part or full. (Just download it to your device and open the file for reference)

OR

You can use this V6 Extra Online Qs Suggested Answers Sheet (lONGER ANSWERS) (word document) BELOW to help you if you need some ideas while you are filling out the online questionnaire. (Link to the online Questionnaire in main article)

If you agree with the typed answer suggestions you can even copy and paste the answers in part or full. (Just download it to your device and open the file for reference)

V6 extra-ONLINE-Qs-suggested-answers Download

Please note these files are in Word document format, if you are unable to open these files on your mobile or laptop successfully, it may be because your device doesn’t have Word installed.

Updated Feb 2025

If you are unable to download the Word files and want to fill in the Online Questionnaire page- you can go to these pages below instead :

FOR NEW SHORTER ANSWERS – see this page:

https://savedaisyhillhospital.com/2025/02/23/new-updated-shorter-ready-reference-suggested-answers-online-consultation/

OR FOR MORE DETAILED LONGER ANSWERS – SEE THIS PAGE BELOW:

– https://savedaisyhillhospital.com/2025/02/19/ready-reference-suggested-answers-online-consultation/

Full original article – STARTS HERE.

DOH Hospital Network Consultation 2024-2025 – A Suggested Response

SUGGESTED ANSWERS HELP 1 AVAILABLE HERE

An updated word version of the Questionnaire with some pre-filled selected options to read or use for your own answers, (now with extra info on the Rural Needs and Equality Questions) is available to download by clicking on the Download button below :

V3 Extra info-Questionnaire-doh-hospitals Download

NEW SHORTER ANSWERS!!

OR A NEW word version of the Questionnaire (W shorter -with Shorter Answers – with some pre-filled selected options to read or use for your own answers is available to download by clicking on the Download button below.

W shorter -questionnaire-doh-hospitals Download

Notes for the Prefilled Questionnaire

>Then give it a new filename by adding your initials at the front/end or some other change to the standard name.

Example 1. New file name: AB questionnaire doh-hospitals-better-outcomes.

Example 2. New file name: questionnaire doh-hospitals-better-outcomesRR1

Ways to respond are detailed below.

DEPARTMENT OF HEALTH CONSULTATION LINKS

https://www.health-ni.gov.uk/consultations/hospitals-creating-network-better-outcomes-public-consultation

WAYS TO RESPOND TO THE CONSULTATION

There are 3 WAYS TO RESPOND to Department of Health Hospitals – Creating a Network for better outcomes Consultation proposals 2024-2025:

1>By Email > Send your completed Questionnaire by email to the Department by attaching the Consultation Questionnaire to the email address: rebuildinghsc.services@health-ni.gov.uk

2>By Online Questionnaire

Click on the Online Questionnaire link below and scroll down to and click ‘have your say’

https://consultations2.nidirect.gov.uk/doh-1/hospitals-creating-a-network-for-better-outcomes/

SUGGESTED ANSWERS HELP 2 (ONLINE QUESTIONNAIRE) AVAILABLE HERE

You can use this NEW V6 Extra Online Qs Suggested Answers Sheet or V8 Shorter ready Ref answers BELOW to help you if you need some ideas while you are filling out this online questionnaire. If you agree with the typed answer suggestions you can even copy and paste the answers in part or full. (Just download it to your device and open the file for reference)

V6 extra-ONLINE-Qs-suggested-answers Download

SHORTER ANSWERS FOR ONLINE QUESTIONNAIRE AVAILABLE HERE

V8 Shorter Ready Ref Answers for Online Qs -DoH Download

3>By Post > A hard copy of your response Questionnaire can also be sent in Writing to:

Transformation Branch
Regional Health Services Transformation Directorate
Department of Health
Annex 3, Castle Buildings
Stormont Estate
Belfast
BT4 3SQ

By the Closing Date of 28th February 2025.

For Enquiries on the ‘Hospitals -Creating a Network for better outcomes’ consultation the Department of Health contact email is: rebuildinghsc.services@health-ni.gov.uk

Department of Health General Telephone number is : Telephone: 028 9052 0500

WHY THIS CONSULTATION MATTERS

The Government now wants to consult with you, the public who are paying for the service to see if they agree with these new proposals.

DAISY HILL HAS BEEN PUT IN THE WRONG CATEGORY OF ‘GENERAL’ HOSPITAL – BUT THIS CAN BE CHANGED IF ENOUGH PEOPLE DISAGEE WITH THE NEW PROPOSALS

What about the General Hospitals?

Are core services not going to be maintained for the Long Term in the General Hospitals then? No other Hospital Category is dealt with in this way in the Actions Page.

The Department of Health report fails to recognise the consistently large population size, recorded illness statistics needs and large land mass area in the Newry & District area.

Daisy Hill Hospital, Newry must be given the long overdue investment and specialist inpatient services it and the rate-paying and tax paying population here deserves.

DAISY HILL HOSPITAL IS ENTITLED TO BE AN AREA HOSPITAL & NEEDS YOUR HELP – PLEASE DISAGREE WITH THE PROPOSALS

Please ask everyone in your house to take part take part in this public Consultation too and pls ask your friends, family and community and Elected Representatives to do the same.

BACKGROUND INFORMATION/ REFERENCES

REFERENCES

*Ref. 1. Hospitals – Creating a Network for better outcomes. Department of Health, (October 2024). Main Consultation document, Hospital Categories (Pages – pdf pg no. p23-25)

P6/23 : “General Hospitals, delivering defined secondary care services including unscheduled care, geared to a specific, more ISOLATED geographical location…”

*Ref. 4. Health and Wellbeing 2026 – Delivering Together – Department of Health, (October 2016.) (p19)

*Definition –‘Centralise’ “concentrate under one control” (Collins English Dictionary)

BACKGROUND INFORMATION

WHY DAISY HILL HOSPITAL IN NEWRY IS ENTITLED TO BE AN AREA HOSPITAL:

Newry & District includes 36,018 children and young people aged U18, the 2^nd highest of the 17 GP Federations after only Derry (Source: DOH 2023/24).

Reason 4 – Landmass fact : Newry & Mourne local government district area alone has the 3RD LARGEST LANDMASS in NI (898.3 Sq Km: Source NISRA).

Further reading: https://savedaisyhillhospital.com/2025/01/28/gp-registers-show-vital-need-for-daisy-hill-newry-as-an-area-hospital-with-24-7-level-1-ed/

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

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07.07.24

by Admin 2

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

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

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

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

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

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

CONCLUSION

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

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

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

ILLNESS PREVALANCE STATS SHOW THE NEED IN NEWRY & DISTRICT

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

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

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

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

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

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

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

REFERENCES AND LINKS

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

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

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

Who are the Nuffield Trust?

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

POPULATION INFORMATION

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

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

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

Excerpts and links may be used, provided that full and clear credit is given to http://www.savedaisyhillhospital.com (Daisy Hill Hospital for Life) and Daisy Hill for Life on Facebook with appropriate and specific direction to the original content. Thank-you. We welcome sharing.

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07.30.19

by Admin 4

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).

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.

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.

Act FAST Stroke - HyperAcute Stroke Unit for Newry 2019

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!

07.20.19

by Admin 4

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

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

06.11.19

by Admin 4

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.

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.

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05.29.19

by Admin 4

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.

05.28.19

by Admin 4

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.

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] /

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 Hospital for Life

Campaign to enhance Daisy Hill Acute Hospital, Newry for future generations

Tag Archives: stroke services

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

BACKGROUND

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

ILLNESS PREVALANCE STATS SHOW THE NEED IN NEWRY & DISTRICT

REFERENCES AND LINKS

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

WHY IS THE FIRST HOUR TERMED ‘GOLDEN’?

CLINICAL EVIDENCE SUPPORTING IMPORTANCE OF ‘GOLDEN HOUR’

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

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

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

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

LONDON DEALT WITH THE COMPLETE STROKE PATHWAY

INEQUALITY – STILL HERE in JUNE 2025.

REFERENCES AND LINKS

Ways to respond are detailed below.

DEPARTMENT OF HEALTH CONSULTATION LINKS

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BACKGROUND

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Ways to respond are detailed below.

DEPARTMENT OF HEALTH CONSULTATION LINKS

WHY THIS CONSULTATION MATTERS

DAISY HILL HAS BEEN PUT IN THE WRONG CATEGORY OF ‘GENERAL’ HOSPITAL – BUT THIS CAN BE CHANGED IF ENOUGH PEOPLE DISAGEE WITH THE NEW PROPOSALS

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Shorter Answers V8

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DOH Hospital Network Consultation 2024-2025 – A Suggested Response

WHY THIS CONSULTATION MATTERS

DAISY HILL HAS BEEN PUT IN THE WRONG CATEGORY OF ‘GENERAL’ HOSPITAL – BUT THIS CAN BE CHANGED IF ENOUGH PEOPLE DISAGEE WITH THE NEW PROPOSALS

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ILLNESS PREVALANCE STATS SHOW THE NEED IN NEWRY & DISTRICT

REFERENCES AND LINKS

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WHY IS THE FIRST HOUR TERMED ‘GOLDEN’?

CLINICAL EVIDENCE SUPPORTING IMPORTANCE OF ‘GOLDEN HOUR’

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LONDON DEALT WITH THE COMPLETE STROKE PATHWAY

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