AT a public meeting convened by the Down Community Health Committee (DCHC) held in Owenbeg Bowling Club last Thursday (13th October), South Eastern Health and Social Care Trust Chief Executive addressed the meeting accompanied with Seamus McGoran, Director of Hospital Services.
The meeting was called specifically to give the Trust the opportunity to explain what services were in the Downe Hospital and what is planned in the future.
DCHC Chairman Eamonn McGrady said, “Our organisation is completely behind the promotion of local services at the Downe Hospital for the people of Down and Mourne. We hope there will be more services there in the future. It has been delivered by the power of ordinary people who campaigned unrelentlessly. But we have fought to get this hospital moving forward and we may not always agree with the Trust or others but we will be aspiring to meet the best possible health aims. With that in mind, what services are available locally?
“We have a wonderful new comfortable hospital facility that everyone is delighted with. But what is in the hospital? The Trust is aware that there has been a hospital in this area fro around 150 years and we understand the argument to retain and enhance services.
“Our message from the Down Community Health Committee is simple: the Downe is open for business. It is an excellent facility and we need to have more confidence in it. The people are not sure exactly what is in the new hospital. Tonight is a great opportunity to clarify this.”
Hugh McCaughey responded to the comment ‘open for business’ and welcomed the opportunity to address the meeting. He explained that the A&E focus in the media had taken away much of attention to developments in other areas of the Downe Hospital. “We have not been getting the message across,” he said. “New services are now available and this is better than before. The Downe is a real success. It is an incredible building and we are absolutely committed to this hospital. We may at times differ in our views but change does have to happen. Health care is changing.”
Mr McCaughey explained the background to the recruitment issues in hospitals for doctors and middle grade doctors saying it was a UK-wide issue. ‘Our real concern was that this problem of recruitment could see A&E closing down. Having taken the measures we did the hospital now seems more settled down and secure. The review of A&E’s has seen the closure of these departments at Lagan Valley and the City Hospital… all because of problems trying to recruit junior doctors and delivering the service safely.
“The current Downe A&E model is now seen as successful and over the coming months we will see our changes have brought stability to this service while other hospitals are faced with difficulties.
Seamus McGoran, Director of Hospital Services also added, “We have every confidence in the Downe Hospital. From the ‘developing Better Services ‘ strategy in 2002, the Downe even then always seemed to be ahead and the decision was to move forward to being a big acute hospital or a local hospital. The case was argued for it to be an advanced local hospital.
“A number of significant factors have caused changes to how hospitals are run and resourced. Firstly, after the Developing Better Services policy, the European Working Time Directive came in limiting doctors hours to 48 per week. Then there was a growing shortage of middle grade doctors across the health service. There has also been a process of continual changes in standards, and recently we have seen the Review of Public Administration introducing cuts to the funding of the health service.
“In April 2007, the South Eastern HSC Trust was established. We were bowled over by the enthusiasm of the staff, but we saw some vulnerabilities particularly at the old Downe Hospital. The Downe has a team of specialist consultants who were literally ageing and could not be replaced.
“We thought it was important to retain acute medicine and stroke and coronary care services and to retain a 24-A&E service. We thought if patients by-passed the A&E it would undermine the viability of the medical dimension. And we thought that we should be delivering services locally where possible so that we can have more patients using the Downe Hospital. Since January 2008 the Trust has taken on 16 new posts to December 2010.
“We have many excellent specialist services in place at the Downe Hospital. Sexual Health services are now centralised there, and others such as colostomy screening which is also a Trust-wide service.
“Therefore the new model we have at the A&E was really to deal with our future concerns in assessing the delivery of services in this department. It was a bit scary to begin with but is working well now. We expect that 97% of the patients presenting themselves from 10pm-8am will be treated in the Downe, and around one per evening may be transferred or referred to other hospitals for treatment.
“The Trust is about growing services and activity in the hospital. We can now staff the current A&E model and there is stability in the hospital. Lagan Valley A&E is now only taking 80% of its A&E admissions, so it was essential to have that medical presence at the front door.”
Mr McCaughey appealed for different agencies to work together and in referring to the judicial review that is being taken against the Trust over the removal of consultant led care in the A&E, he said, “The legal challenge will run its course”, and added later that at the heart of the issue was the need to instil confidence in the whole system.
Speaking at the end of the meeting during theg debate, UUP MLA John McCallister said, “The new A&E model has taken the Downe off the radar and we are now looking at bigger hospitals coming under scrutiny. I understand that the Southern Health Area are now looking at this successful A&E model. I have not had one complaint in my constituency office about the new OOH system at the Downe Hospital. Minister Poots is currently reviewing maternity services and NI has teh highest rate of caesarian operations in the UK. We hope to have Health Minister Poots down to the Downe Hospital by the end of the year for a visit.”
Councillor Patrick Clarke said, “My concern over the hospital was a confidence issue. Was it safe? Will the A&E close? Now we need to sell the services at the Downe – this will instil confidence in the new hospital. I believe a lot of people still think that the A&E is closed at night when it isn’t. We need to address this big confidence issue.”
Councillor Cadogan Enright, said, “A lot of people are expressing concern about the protocols by the NI Ambulance Service of taking people past the hospital at night to other hospitals. And there is an issue with many people being treated in hospitals in Belfast only to be released at night to make their own way home facing a taxi bill of around £40.”
There was also a discussion about the addiction services in the Downe hospital and these services were viewed by everyone as excellent and were seen as a model that many other agencies look up at.
In a joint information leaflet, the Down Cmmunity Health Committee and the Ardglass and District Health Support Group released a list of all the services available at the new Downe Hospital.
The New Downe Hospital – ‘The People’s Hospital’.
Services available in the new hospital.
LOWER GROUND FLOOR.
* Dementia-assessment beds
* Acute Mental Hospital
* Out Patients Department
– routine medical and surgical clinics
– minor operations
– PUVA clinic (ultra violet light treatment for psoriasis)
– mental health (moved from Finnestson House to Downe)
– sexual health – Trust wide service.
* Rehabilitation Department
– Full rehabilitation suite which is one of the most modern in NOrthern Ireland, with trial stair lift. Facilities fro kitchen assessments for wheelchair and wheel chair ‘run to trial electric wheelchairs.
– physiotherapy and OT assessment and tratment rooms
– cardiac rehabilitation
– pulmonary rehabilitation
– outreach physio clinics
– women’s health physio
– Marie Curie day therapy service.
* Diagnostics / Imaging
– fully digital imaging department (filmless) providing a service for patients across the Trust area.
– CT scans (64 slice scanner).
– ultra sound scans
– fluroscopy tests
– dental imaging
– barium tests
– NIPAC’s – linked across the Trust
– cardiac CT service.
* Midwifery Led Maternity Unit
– 24/7 stand alone unit for low risk women who meet specified criteria
– provides anti and post natal care
– consultant clinic on a Tuesday pm fro high rish ladies.
– water births
* Education Centre
– Full state-of-the-art facilities with mannequins.
* Emergency Department
– Level 2 operating from 8am tp 10pm.
* Enhanced GP Out Of Hours
– GP out Of Hours servive from 10pm until 8am. The enhanced OOH service includes the support of experienced Emergency Department nurses, radiology support, advice from Emergency Department at the Ulster Hospital, and direct admission into medical wards within the Downe Hospital.
* Day Procedure Unit
– general surgery (hernia repair, minor ops, varicose veins, minor rectal).
– Critical Care Services
– Dental – special needs patients
– JAG bowel screening centre – Trust wide.
– Cataracts – 2 month ongoing up to 4 months.
– Orthopaedics – frees up theatre time at Ulster Hospital for more complex cases
– maxillo-facial surgery.
– Children’s Community Services
Including Speech and Language Therapy, Physiotherapy, Occupational Therapy, paediatrician and Children’s Nurses.
– cardiac ambulance
* General Wards
– general medical conditions
– stroke unit
– fracture rehabilitation.