Trust And Council Say Downe A&E Is Open All Hours

Trust wish to work closely with the Council in the interests of the new Downe Hospital and other health services in the area. He said, “Some services need to be delivered in the community and we therefore need councillors to help deliver this in the community’s interest.” He further discussed the need to build confidence in the new Downe hospital, and added that one regional newspaper had caused quite a negative response by a cartoon which led people to believe that the Downe A&E was closed after 10pm, when in fact it is open. [caption id="attachment_11653" align="alignleft" width="200" caption="Hugh McCaughey, South Eastern HSC Trust Chief Executive led a team to the Down District Council chamber to present on the current state of affairs on health services at the Downe Hospital and across the area. "][/caption] He added, “However, it is a real difficulty for us that we cannot find sufficient medical staff. At the Lagan Valley A&E  they are now closed at 8pm. Unlike the Downe A&E, they have no front door.  At the Downe patients are continually being seen after 10pm. I think the regional picture has changed but I think we are in a good position at the Downe. The Downe is working well. And the Out Of Hours system at the A&E has taken us out of the debate about A&E’s across Northern Ireland. This is a sustainable model, one we are confident we can staff.” Michael Johnston, working in the Downedoc EGPOOH as a GP and member of the Trust team, said, “We need to make this quite clear, the A&E is not closed at night. People will be seen if they turn up to the hospital. We are capable of dealing with most cases that are presented at the A&E on a daily basis. But in the past major trauma and surgical problems have been transferred to other specialist hospitals. Patients are getting better service in the OOH A&E and receive plenty of attention from nurses. We are very keen to make this work. And we must accept that some things cannot be treated there. This is a novel service and we are all working together as a team on it.” Mr McCaughey also explained that the Trust is currently working up information on the admissions to the Downe Hospital and is waiting on detailed findings. He added, “We are expecting 500 more day cases to be treated in the general hospital in 2011-12. We are committed to building sustainably for the future. However, admissions to the Downe are down and we need to understand why this is. “Partnership between  the Trust and the Council, community, and the media is what we have continued to move forward with and adapt.” But other services are important too indicated McCaughey and in the midwife-led unit, the target of 50 births in one year was met and the second year target of 122 is now being addressed with already 32 births at the Downe this year. Mothers can now be locally assessed and do not have to make the trip to Belfast for this ante-natal care. “It is about the range of services provided,” said Mr McCaughey, “Confidence is growing and more people are using it.” It was also announced that work on the new section at the Downe Hospital to take up the services provided by the Pound Lane Clinic which was damaged by a malicious fire a couple of years ago is about to start. With the police service recently getting the go ahead to also build on the Downshire Estate site and the Bridge Street secure unit for the elderly to be completed by April next year.  Downpatrick is seeing a significant change in its infrastructure with these developments. Sean McGovern, Associate Clinical Director of Emergency medicine, speaking on the issue of the supply of junior and middle grade doctors which led to the change in the service method of operation at the Downe A&E, said, “It is now apparent to everyone that the supply of middle grade doctors is going to get worse. Therefore, we have to use our local resources in a better way. “Patient safety is a main driver for change and the principle of ‘operative stabilisation‘ kicks in. That means that the patient has to go to where the surgeons are.” Charlie Martyn, Medical Director, also addressed the issue of the supply of junior and middle grade doctors. He explained that it takes up to six years to train a doctor and numbers are up at the medical training school at Queen’s University, Belfast. However, there is an increase of female doctors (70% of total trainees) on this course, and they tend to get involved in specialisms. Also, he explained that it was more difficult to get doctors from the Indian sub-continent due to visa issues, and that doctors generally were subject to the new Working Time Directive from the EU. He said, “I can remember when I started in medicine. I used to work 80-100 hours a week. They cannot do that now. And there is the high cost of training too which is an important factor,” he added. [caption id="attachment_25675" align="alignright" width="300" caption="The Downe A&E is open 24/7... it is NOT closed at night."][/caption] The Trust team discussed the many challenges facing the district in years to come and the sharp increase in the incidence of dementia was very significant. One health official said that it was tripling. Also touched on were the many other services and community development programmes now running in the community such as Safe and Well and Roots of Empathy. The Mental Health Strategy was also discussed. Towards the end of the presentation, Cllr Curran said, “There is a lot of information that needs to get out into the community about the health services. I am quite surprised by all this. We will be working with you for the benefit of the people of this district.” Also discussed at the meeting was the new corporate plan for the South Eastern Health and Social Care Trust due to be launched at the end of September. Councillor Comments Cllr Colin McGrath.”There has been a perception that the Downe A&E was closed now at 10pm. We need a communications strategy delivered now. People need to know they will be seen when presenting to the A&E.” Also, he said, “The Trust needs to get behind Home Start who may lose their satellite operations shortly through lack of funding. It will cost the community more to meet the same needs if they are not supported. Maybe this Health Committee can do something to help them.” Cllr Patsy Toman. “I would like people to us the Downe as much as possible. When patients have to go to Belfast they are often faced with expensive taxi fares home… up to £40.” Cllr Willie Clarke: “This has been a positive meeting… I think it would be very useful to have a separate presentation on mental health services.” Cllr Stephen Byrne: “I welcome the figures provided which is good news, and it is assuring that the Downe Hospital is becoming a stable model… I think we can build on the existing communications for the benefit for the whole community.” Cllr Liam Johnston: “This novel model looks safe and sustainable and we will bring the community with us in the future on this.” Cllr Terry Andrews: “On waiting lists, I know someone recently who has had to wait 15 weeks for  dental treatment. This is unacceptable.” The discussion in the Council chamber was thorough and far reaching and a new accord between the South Eastern Health and Social Care Trust has been struck. For this relationship to grow there will have to be openness, transparency, accountability honesty, and respect on both sides. With an election now four years away, and party politics less likely to intervene, perhaps there is a sea change taking place in the delivery of our local health services. The Trust have a need to stabilise a confused public perception about the services they deliver, and the Council have a responsibility to ensure that the health needs of the local population are being met. Working together in a partnership approach may be a new road for both, and it may well just herald a new dawn in the local health scene around Down. But as a  caviat, health campaigners may well take the view that the 24-hour, consultant-led, A&E should still be the main aim of the Trust. This idea they maintain was written onto the original aims and design of the Downe Hospital.]]>