Radical changes to local health services primarily accessed by the elderly could be introduced within the next number of years, Armagh I can reveal.
If rubber-stamped, acute stroke services would no longer be available at Daisy Hill Hospital, while dementia assessment inpatient care would cease in Armagh, with both being centralised in Craigavon.
In addition, in-patient non-acute hospital services for older people, which are currently available at five locations across the entire Southern Trust area, would be reduced to two – Daisy Hill and Craigavon.
All of the proposals, which are detailed below with the Trust’s thinking behind the plans, are now open to public consultation.
The Southern Trust has begun a four month consultation process on the relocation of the Gillis Unit in Armagh to a new fit for purpose unit on the Craigavon Area hospital site. The Gillis unit is the centre for Dementia Assessment Inpatient Care in the Southern area.
The consultation process, the Trust says, is to agree a clear vision for this important service, while recognising it will be two to three years before there will be any change in where the service is currently located.
Most people with dementia are looked after in the community, supported by families and carers and by a range of Trust services, including memory clinics, day care and community dementia teams. There is no-one in the Southern Trust with dementia who is currently living in long-term hospital care.
The Gillis Unit is the Trust centre for specialist dementia inpatient services.. Patients who are admitted to the unit will have a complex range of physical and mental health needs and can also need access to care in an acute hospital, which currently involves potentially distressing and unsettling transfers between hospitals.
Explaining the proposals, Trust Chief Executive Mairead McAlinden said: “Expert evidence recommends that inpatient care for dementia patients is best provided on an acute site to ensure access to the full range of diagnostic and treatment services.
“We are proposing to relocate this service to Craigavon, which will improve immediate access to acute care and psychiatric services and allow us to develop accommodation which is designed to meet the particular needs of patients with dementia.
“At the same time, we are enhancing our community dementia services to offer a range of support to patients with dementia including the development of long term placements in the community for patients with challenging behaviour.
“Our aim is that everyone has the right to equal care, and that when anyone needs health or social care they will be treated in the right place, by the most appropriate person and in a timely and compassionate way.”
The Trust has also launched a consultation on how stroke services should be reorganised to meet national standards of care.
The consultation, it says, is to agree a clear vision for this very important service, which will allow planning to begin for changes in the service over the next two to three years.
Mrs McAlinden explains: “People with symptoms of stroke are always taken first to the Emergency Department in either Daisy Hill Hospital or Craigavon Area Hospital for assessment and treatment and our proposals would not change this.
“This consultation looks at inpatient stroke care in the crucial first few weeks after a stroke.
“The Trust is proposing the development of a specialist acute stroke unit at Craigavon Area Hospital to provide enhanced, evidenced based standards of stroke care for the days immediately following a stroke. We are recommending Craigavon Hospital as the location of this new unit because it is the hospital used by the majority of the Trust population and Craigavon also has access to a full range of diagnostic services.
“The proposals are driven by evidence from the National Institute for Health and Care Excellence and the Royal College of Physicians which shows that delivering early treatment and rapid access to specialist stroke care with 7 day specialist input improves survival and recovery rates and that concentrating expertise in specialist centres with expert care teams leads to better patient outcomes.
“Inpatient stroke services in the Southern Trust are currently spread out over 4 hospital sites – Craigavon for acute care, Daisy Hill for acute and rehabilitation and Lurgan and South Tyrone for rehabilitation only – and they all provide very good care. However, these new guidelines raise the bar even higher in terms of what else can be done to give our stroke patients the best possible chance of recovery.
“The proposals mean we will be able to concrete the specialist skills of staff and ensure a 7 day dedicated team is available to give stroke patients the intensive support they need.
“Finally, I would encourage anybody with comments or concerns about the proposals to get involved in the process and send a response.”
NON-ACUTE HOSPITAL INPATIENT SERVICES FOR OLDER PEOPLE
A four month consultation process is also underway on where inpatient non-acute hospital services for older people should be provided in future.
The consultation process is to agree a clear plan for these key services, while recognising it will be two to three years before there will be any major changes in how the services are organised.
Inpatient non-acute hospital services are currently provided at Loane House, South Tyrone Hospital, Lurgan Hospital, Daisy Hill Hospital and Craigavon Area Hospital.
The Trust is proposing that all acute and non-acute hospital in-patient care should be provided at Daisy Hill and Craigavon Hospitals. Day assessment, rehabilitation and other outpatient services will continue to be provided at the day hospitals at South Tyrone and Lurgan Hospital.
Explaining the plans in this area, the Chief Executive said: “The principle behind our proposals is that, regardless of age, everyone has the same right to the expert health care they need. It is our plan that whenever anyone needs health or social care they will be treated in the right place, by the most appropriate person and in a timely and compassionate way.
“Through the development of community services, day hospitals and engagement with local communities many illnesses that were previously treated in hospital can now be managed in the community.
“Increasingly, hospital stays are for a short, acute illness or injury with ongoing specialist care provided outside hospital.
“But when older people do need to be in hospital, it should be provided in a high quality environment by an expert team of health professionals with access to all the necessary diagnostics, specialist knowledge and care.
“We are simply not able to provide the same immediate access to all of these services in Loane House and Lurgan Hospital and we need to ensure that the same quality of care is available to our older population as it is to the rest of the population who need acute hospital care.
“A wide range of important local services will remain on the Lurgan and South Tyrone Hospital sites. New services for older people have been developed on both sites, such as day assessment and rehabilitation. Older people will still be able to access the vast majority of their care from their local community.”
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