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The Southern Trust have confirmed that Emergency Surgery at Daisy Hill Hospital will be moved to Craigavon from 28 February although this won't affect the Emergency Department. Patients who attend Daisy Hill Emergency Department who require admission for emergency surgical treatment will be transferred to Craigavon for ongoing care.
From that date all emergency surgical patients requiring inpatient assessment in the Southern Trust will be admitted to Craigavon Area Hospital until a full consultation on a sustainable future service model has been completed with outcomes agreed.
There will be no change to the Emergency Department at Daisy Hill which will continue to operate as usual on a 24/7 basis.
A Trust spokesperson said "Despite repeated recruitment advertisements, from the end of February, Daisy Hill will have one permanent Consultant General Surgeon out of six funded posts and Craigavon will have eight out of nine.
"The consolidation of emergency surgery to one site will allow the team to maintain the safety of the service for all Southern Trust patients whilst a longer term best-practice model is developed to improve both emergency and elective general surgery."
The proposal was formally agreed at the January Trust Board today (27 January).
Outlining the plans to Trust Board members, Director of Acute Services, Melanie McClements said: “Recruitment of general surgical consultant posts has been an ongoing challenge across Northern Ireland and work has been progressing locally and regionally to develop more sustainable emergency and elective surgical services.
“However, recent changes to our workforce have presented a very immediate and major risk for the safety of our service in the Southern Trust. We cannot maintain a fully responsive emergency surgical service with one permanent surgeon at Daisy Hill. With staffing now so stretched across both sites, the safest way of achieving a more equitable service and the best possible outcome for patients is to have all emergency surgical patients admitted to Craigavon.”
Commenting on longer term plans, Melanie continued: “While work continues to develop and enhance our surgical model, we are clear on our immediate priorities for surgery across the Southern Trust.
“We want to create a secure service with rapid access to expert assessment and care, ensuring the best outcomes for all patients.
“We want to create a surgical service that is attractive to surgeons, giving them the opportunity to develop their specialist skills and experience through the right balance of elective and emergency work.
“And we need to fully utilise all of our theatre capacity across Daisy Hill, Craigavon and South Tyrone to undertake more elective procedures to benefit the growing numbers of patients on our waiting lists.
“I would like to pay tribute to our surgical team for their continued commitment despite these mounting pressures and thank staff at both Daisy Hill and Craigavon for their flexibility in supporting these temporary arrangements.”
She added: “I want to assure local people that Daisy Hill remains an essential part of the Southern Trust hospital network. It has a very busy Emergency Department and a wide range of very vibrant specialities. We aim to maintain the acute status of Daisy Hill through this process, whilst securing and enhancing its elective surgical capacity.
“We ask for public support and understanding as we continue to work through the challenges to develop a solution that meets the future needs of our population.”
A formal project structure is now being established to develop longer term proposals for public consultation on elective and general surgery across the Southern Trust.
First Class Hospital
Newry and Armagh MLA, Liz Kimmins has urged for a rapid return of emergency surgery to the hospital.
Kimmins believes that it is imperative that services are reinstated at Daisy Hill as soon as possible.
Kimmins said “I and my Sinn Féin colleagues have met with the Trust Chief Executive and his Senior Management team on a number of occasions where they have outlined the issues they are having with staffing levels, and particularly with the recruitment of surgical staff.
“This has consequently impacted on the ability to provide emergency surgery safely at Daisy Hill as they are currently operating with one consultant out of the required six. This is clearly untenable and we will continue to engage with the Trust and the Health Minister to ensure all possibilities are being explored so that this is a strictly temporary measure in the interests of the health and safety of all patients and staff.
“Daisy Hill is a first class hospital and Sinn Féin has fought hard over the years to retain its services for the community of Newry and South Armagh. It is currently the only hospital between Drogheda and Portadown, and therefore it is absolutely essential that it is in a position to serve this wide geographical area.
“Sinn Féin will continue to ensure there are no attempts to dilute services in Daisy Hill and have a key focus on its upgrade and expansion to fulfil its true potential in the time ahead.
“The pandemic has served to put further pressure on a health service that was already struggling after a decade of Tory Austerity cuts
“My colleague, Conor Murphy MLA, the Finance Minister has given significant funding to the Health service and has proposed significant funding for health as part of the proposed budget to try and mitigate against the damage caused by these cruel Tory cuts.
“It is crucial that these services are returned to Daisy Hill as soon as possible.”
Downgrade attempts are reckless
MLA Justin McNulty was highly critical of the Southern Trust earlier this week before todays decision was announced for what he described as a smokescreen double standards agenda on the future of Daisy Hill Hospital’s Emergency Department and he warned that the public was fed up with being taken as fools by the “constant ducking, diving, and doublespeak of the Trust in defence of the recklessly indefensible.”
Responding to calls by the Trust to ‘think radically’ about the future surgical model at Daisy Hill, the Newry and Armagh MLA said that “attempts to downgrade Daisy Hill’s Emergency Department are reckless, not radical.”
“I note that the Trust were tripping over themselves to deny that they hadn’t been totally up front, but they were deafeningly silent on the alarming reports of plans to downgrade our Emergency Department. When whistle-blowers come to me, not out of concern for their own jobs or positions, but out of fear for their patients and the communities they serve, then as a public representative, I have a responsibility to act. Equally, the Trust has a responsibility to lay all of the facts out and categorically state that emergency surgical services will be retained and expanded at Daisy Hill, and that our Emergency Department’s Type-1 status will be permanently safeguarded.
McNulty continued “It is clear to see that the Trust’s intention is to divert attention from the issue and deflect responsibility away from themselves by pointing to difficulties in recruiting surgical staff as the reason for the threat to Daisy Hill’s ED. People don’t want to hear excuses from those who are supposed to be leading us through a health crisis, they want action. If the Trust was serious about filling the surgical gap in Daisy Hill, they would be broadening their search for staff beyond our shores, attracting the talent needed by providing whatever incentives were necessary, and they’d be moving mountains to pull surgeons back into active duty to clear our waiting lists and boost our ED.
“Instead, the Trust is stressing the need to ‘think radically’ about future surgical models. If the Trust’s plans are allowed to go through, it will downgrade the status of Daisy Hill Hospital and dismantle an Emergency Department which serves the people of Newry, South Armagh, and South Down."
Questions and Answers
The Trust have published some general Questions and Answers regarding their decisions below
What will happen to patients who need emergency surgery?
Patients who attend Daisy Hill Emergency Department who require admission for emergency surgical treatment (approximately 5-6 per day) will be transferred to Craigavon for ongoing care during this time.
There will be 24/7 anaesthetic and surgical cover for both Daisy Hill and Craigavon.
Arrangements will be made on site for any patients in extreme circumstances who are considered unfit for transfer from Daisy Hill.
What will happen to surgical patients for example who have a road traffic accident or need an ambulance?
999 should be called in the usual way. The operator will assess the situation and dispatch an ambulance/air ambulance as usual and work through the Northern Ireland Trauma Network if appropriate to agree the most suitable hospital for example, Daisy Hill, Craigavon or the Royal Victoria Hospital.
What surgery will continue at Daisy Hill Hospital?
Elective (planned) surgery will continue from Daisy Hill, Craigavon Area and South Tyrone hospitals. It is hoped through our longer term plans that we will be able to enhance our surgical capacity across our sites to address the growing waiting times for many patients.
What will happen to the Daisy Hill surgical nursing workforce?
The Surgical Nursing workforce will have the option to remain in their designated wards at Daisy Hill to cover continued elective surgery and care of acute medical patients. New surgical models including assessment and ambulatory services will present further opportunities for surgical nurses across the Trust.
What does this mean for junior/trainee surgical doctors?
We will continue to support the same number of trainee surgical doctors who will rotate across Craigavon and Daisy Hill hospitals for a range of emergency, elective and outpatient experience.
What does this mean for Daisy Hill Hospital Emergency Department?
Daisy Hill Hospital’s ED team looks after well over 4000 patients every month with a wide range of conditions across a many specialties. The team will continue to assess surgical patients who they will refer for other appropriate treatment or transfer to Craigavon if required.
Daisy Hill ED remains absolutely essential in meeting the unscheduled care needs of our local population.
We remind anyone who needs to attend our EDs or Minor Injuries service with less urgent symptoms to continue to phone first Monday to Friday 9am to 9pm 0300 123 3111.
What does this mean for the rest of the hospital?
Daisy Hill is a very busy and essential part of the Southern Trust acute hospital network. Along with Craigavon, it has a very vibrant range of acute specialist services including general medicine, surgical, renal, paediatrics, obstetrics and gynaecology which are needed to serve our population of approximately 383, 541 people. We want to develop and enhance our Trust wide surgical service to offer the same safety, quality and care for all patients attending - Daisy Hill, Craigavon or South Tyrone hospitals.
