A PUBLIC consultation that is set to define the future status of Downe and Daisy Hill Hospitals within a reconfigured hospital network goes live today (Wednesday).
The basis of this 16-week process is ‘Hospitals: Creating a Network for Better Outcomes’, a reconfiguration framework consultation document – launched by Health Minister Mike Nesbitt yesterday – that sets out ‘the key principles to underpin service reorganisation’ across Northern Ireland.
Having reviewed all existing hospital infrastructure, the Department of Health document has identified four new categories, and these include – in order of breadth of services – local hospitals, general hospitals, area hospitals and regional centres.
Under this categorisation, Downpatrick’s Downe Hospital is defined therein as a local hospital, and Newry’s Daisy Hill Hospital is a general hospital.
The document states that the use of categories will ‘form the basis of a potentially sustainable network of facilities that will deliver unscheduled, elective and local hospital services, and make best use of the existing physical estate’.
It notes that local hospitals will deliver ‘primary, secondary and community services in support of the area and general hospitals’.
General hospitals will deliver ‘defined secondary care services, including unscheduled care, geared to a specific, more isolated geographical location’, and will ‘also play an important part in the delivery of elective care to the region’.
Area hospitals – such as the those in Dundonald and Craigavon – will deliver ‘a full range of secondary care services, both unscheduled and elective, to the communities within a geographical area’.
Regional centres – such as Royal Victoria and Musgrave Park Hospitals – will deliver ‘specialist regional inpatient services for the whole population of Northern Ireland’.
The consultation document says that local hospitals are not ‘easy to define’, as they ‘have already evolved in different ways in response to local need and geographic imperatives’.
It cites Downe Hospital maintaining ‘inpatient acute medical consultant services, accommodating a service for all patients presenting at the site’, as an example.
The document adds that it is important that local hospitals continued to evolve to ‘best meet current and future local population health needs’.
‘Local hospitals can develop roles that are cost-effective and of high quality; however, it is important to avoid unnecessary replication or competition for resources,’ it reads.
‘The future of each local hospital must be considered in this context.’
It is highlighted that general hospitals – like Daisy Hill – ‘share many of the challenges of the area hospitals and, in reality, are competing with them for resources’.
‘The issues associated with the reconfiguration of these hospitals are historically the most disputed by local communities,’ the document states.
‘For many reasons, these hospitals are the ones that are most vulnerable to unplanned change in service.
‘Their geographical locations and the challenge of maintaining safety-critical medical rotas and wider clinical teams are the biggest issues.
‘They cannot just be small area hospitals; the resources do not exist to perpetuate this.
‘It is clear, however, that an achievable and sustainable solution that ensures the future of these hospitals is critical to developing a successful hospital network.
‘These hospitals have a key role in ensuring our system can respond to the challenges of an aging population, delivering a range of acute and rehabilitation services, with the advantage that they are closer to an otherwise more isolated community.’
In the consultation document’s ministerial foreword, Mr Nesbitt states that there are “many causes underlying the need for reform”, and that “we must accept that change is necessary”.
He adds that the consultation document “aims to describe our hospitals as a network, where all parts work together to deliver services across Northern Ireland, to ensure sustainability and provide clarity of who does what, which will help better achieve those better outcomes”.
“While not every hospital will deliver every service, leading to an element of reconfiguration, it is important to stress no acute hospital will close,” the minister concludes.
