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.
Emergency general surgery had been split across Craigavon and Daisy Hill Hospital until a shortage of general surgery consultants led to the temporary suspension of provision at Daisy Hill.
Today’s (Monday) decision makes that temporary position permanent.
Related: Emergency surgery to be permanently removed from Daisy Hill, Trust confirms
The Department has concluded that the temporary arrangements demonstrated the merits of consolidation on a single site. It provided stability in clinical staffing, meaning safe services can be sustained in the longer term.
An average of three patients per day have been directed to Craigavon from Daisy Hill for emergency general surgery services. Assessment of these arrangements has found no indication of any patient coming to harm.
General Surgery specialises in abdominal organs such as stomach, gallbladder and bowel. Emergency general surgery is the overall term for unscheduled care in this field and can mean specialist advice, admission for tests and, for some patients, an operation.
DoH Permanent Secretary Peter May said: “The approval reflects the reality that all hospitals cannot provide all services. There has to be a level of consolidation and specialisation in light of advances in medicine.
“Daisy Hill Hospital will continue to provide a vital service to the local community, across a range of key specialities. The Department’s commitment to Daisy Hill is reflected in the decision to make it an Elective Overnight Stay Centre, caring for patients who may require an overnight stay in hospital after planned surgery.
“The Trust advises that since April 2023, over 6000 patients have been treated at Daisy Hill EOSC across a range of specialties including general surgery, gynaecology, ENT and endoscopy.
“The Department has also confirmed capital investment to upgrade the electrical infrastructure at Daisy Hill Hospital.”
Today’s approval on consolidating emergency general surgery at Craigavon Area Hospital aligns with the direction of travel set out in the Department of Health’s Review of General Surgery published in June 2022.
The Permanent Secretary continued: “The inability to recruit and retain consultant general surgeons to Daisy Hill was due to clinical factors, not any lack of effort. When hospitals have lower patient numbers, this can create significant issues for professionals working in key specialties. These include rota/on-call pressures inherent in smaller clinical teams, as well as insufficient case mix to support specialisation, training and skill development.
These issues inevitably have consequences for recruitment and retention.”
The Southern Trust decision followed a public consultation.
The Permanent Secretary also stated: “I am satisfied that my approval of the Trust’s decision is in accordance with Northern Ireland Executive Formation legislation and the associated Guidance published by the Secretary of State for Northern Ireland.
“It is also in step with the transformation agenda for health which emphasises that changes are required to maintain sustainable services.”
Reaction
Sinn Féin MLA Liz Kimmins described the decision as “extremely disappointing”.
She said the decision “will cause great concern across all communities served by the hospital”.
Adding: “The Southern Trust must be clear about what real steps they are taking to secure the safe delivery of services at Daisy Hill now and into the future.
“We will continue to work with other parties and experts through the Daisy Hill future group to protect Daisy Hill for all in our community.
“Our Health service is facing huge challenges due to a lack of resources and understaffing, this needs to be urgently addressed.
“We need the Executive restored now and all parties working together to invest in our health service to help it deal with the unprecedented challenges it is facing.”
The Southern Health and Social Care Trust has welcomed the Department of Health’s approval on its decision to deliver all emergency general surgery services for the area from the Craigavon Area Hospital site.
The Southern Trust’s Medical Director, Dr Stephen Austin, said: “Meeting the clinical standards to ensure the best outcomes for all patients living across the entire southern area, has been our absolute priority throughout this process.
“I commend our surgical team who are constantly working to improve their service and have developed this new model for emergency general surgery to give patients the safe, high quality and modern care that they deserve. Delivering emergency general surgery from one site helps us to meet the latest regional standards set out in the Review of General Surgery. It is also more sustainable and with successful recruitment of new surgical consultants in recent months, shows that it will be more attractive in recruiting and retaining staff.
“We acknowledge concerns raised, particularly from some living in the Newry, Mourne, South Down and South Armagh areas about access to the service and understand that people would value a service closer to home, but we must always prioritise quality of care and patient safety.”
Cathrine Reid, Director of Surgery and Clinical Services, continued: “Patients should continue to phone first or attend their nearest Emergency Department with any seriously urgent symptoms. Daisy Hill continues as a Type 1 consultant led ED, assessing all medical and surgical patients, 24/7.
“We have pathways for those who need transferred to Craigavon, to be directly admitted to the surgical ward, so it is important that Newry and Mourne patients always attend Daisy Hill first to benefit from this process. It is rare for someone to need very immediate surgery for a life-threatening condition, but we can assure local people that we have arrangements in place for the patient to be operated on at Daisy Hill should this happen.
“With emergency surgery concentrated at Craigavon, we now have additional theatre time at Daisy Hill to benefit more people waiting on planned procedures. We have excellent surgical facilities at Daisy Hill and our surgical team has been working hard to gradually increase theatre activity over recent months and develop our plans as a regional elective overnight stay centre.”
