Tag Archives: Western Trust

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BACKGROUND

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

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

NEWRY

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

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

ENNISKILLEN

Western Trust Corporate Risk Update at 30 May 2024

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

Next Consultation:

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

Background ends

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Emergency Surgery

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04.14.19
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QUESTION OF TRUST – comparing Southern and Western Trust’s Stroke Proposals for NI

Just as in the Western Trust (with a total population of 301,448*) there is need for TWO Specialist Acute Stroke Units - so too, the Southern Trust (with a larger population of 380,312*) is also entitled to TWO Specialist Stroke Units (HASUs and Acute Stroke Units), at Daisy Hill Hospital, Newry and Craigavon Hospital. This would ensure that everyone in the Southern Trust has immediate access to CT scanning and life saving thrombolysis, followed by direct access into a stroke unit.

One of the Functions of the Southern Health and Social Care Trust under the 2006 Establishment Order is to PROVIDE SERVICES – (not take away existing services) to the population of the five former Local Government Districts (LGD)s  or Localities of            (1) Newry & Mourne LGD  (105,161); (2)Craigavon LGD (100,310); (3)Armagh LGD (62,427); (4) Dungannon LGD (62,149) and (5) Banbridge LGD (50,265).

The Southern Trust have a duty of care to plan provision of services in equal measure to all 380,312* people under their care.

Proof that the future configuration of Hyperacute and Acute stroke Units in the Northern Ireland Stroke Consultation Document 2019 was decided not only by the Department of Health, but also by all of the Health Trusts in NI,  can be seen from the Western Trust website which states:-

‘Speaking ahead of the meeting of the Western Trust Board this week, Dr Anne Kilgallen, Western Trust Chief Executive said:

“The Department of Health is leading on the Stroke Consultation and all Health and  Social Care Trusts have been actively involved in the discussions in preparation. We in the Western Trust are very pleased that both the South West Acute and Altnagelvin Hospitals are part of the options being considered.”‘

If only it could be said that the Southern Trust were also actively involved in discussions and preparations to make sure that the existing Specialist combined Acute Stroke /Rehabilitation Unit in Daisy Hill, Newry City (in the largest locality in the Southern Trust) was being put forward as a vital Hyperacute Stroke Unit, co-located with an Acute Stroke in the future network of specialist Stroke Units in NI.

Compare how inclusively the Western Health and Social Care Trust have reassured their staff and population of 301,448*, that they are doing their best to retain and enhance their TWO ACUTE STROKE UNITS in Altnagelvin Hospital in Derry and the South West hospital in Enniskillen, with the Southern Trust’s approach.

The Southern Trust (SHSCT), has consistently pushed forward at every opportunity, removal of vital life saving stroke services from Daisy Hill, out of reach to Craigavon in their Centralisation Programme of all specialist services to Craigavon.   (Even the 2016 Bengoa Report’s only Local Case Study promoted SHSCTs proposal to centralise all Stroke services to Craigavon and remove them forever from Daisy Hill, Newry City).

Because of this, Daisy Hill Acute Hospital, Newry City specialist combined Acute/Rehabilitation Stroke Unit, (in the largest of the five Local Government Districts in the Southern Trust), does not even warrant a mention on the list of options given in the Northern Ireland Stroke Consultation 2019.

A HASU and ASU is proposed for Craigavon, not on one, but on ALL SIX OPTIONS. It is clear from this, that nobody seems to have spoken out for provision of Stroke services in NEWRY CITY.

It also shows that the SHSCT are proposing to continue with their plans to withdraw existing life saving specialist Acute Stroke and Stroke Rehabilitation Services from Daisy Hill Acute Hospital, without making any provision of a NEARBY alternative Specialist Stroke Unit. They are required to do this under equality of access to provide EMERGENCY timely life saving specialist services e.g. CT scanning, thrombolysis, etc and acute Stroke Rehabilitation.

CONCLUSION

Just as in the Western Trust (with a total population of 301,448*) there is need for TWO Specialist Acute Stroke Units – so too, the Southern Trust (with a LARGER population of 380,312*) is also entitled to TWO Specialist Stroke Units (HASUs and Acute Stroke Units).

This would ensure that everyone in the Southern Trust has, as they have at present, immediate access to CT scanning and life saving thrombolysis, followed by direct access into a stroke unit – the stroke pathway recommended by The Royal College of Physicians for better outcomes.

>The Southern Trust need at this stage to speak up for ALL the population they are duty bound to provide specialist stroke services for in the future stroke network in Northern Ireland, in the same inclusive manner as the Western Trust.

*NISRA 2017

Southern Trust population 380,312 : Western Trust population 301,448  : NISRA 2017

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