#SaveTheDal – Letter to the Minister

9 11 2014

dalriada[1] 

Copy of letter from local GPs to Health Minister:Mr Jim Wells 
The Minister
Department of Health, Social Services and Public Safety
Information Office
C5.20 Castle Buildings
Stormont Buildings
Belfast
BT4 3SQDear Mr Wells,

As you are aware Dr Tony Stevens, Chief Executive of NHSCT announced on Thursday 30th November 2014, the “temporary” closure of Dalriada Hospital in Ballycastle in its entirety at the end of November 2014.

Dalriada Hospital has provided outstanding medical care to the people of Ballycastle and the surrounding areas for decades.

This decision to close Dalriada hospital betrays the substance of Transforming Your Care which promotes intermediate care, with medical care being provided to patients either in their own homes or in intermediate care units as close as possible to their homes.

As GPs who work in Dalriada Hospital we wish to voice our grave concerns about the proposed closure of Dalriada Hospital. Although described as a “temporary” closure, Dr Tony Stevens CEO was unable to give any assurance that this would be the case, merely advising that there would be consultation about the provision of intermediate care throughout the Northern Trust area after the end of this financial year. He also stated that as this was “temporary” he was under no obligation to carry out any consultation.

The hospital encompasses 20 intermediate care beds and 12 regional Multiple sclerosis respite beds. Not only do we the GPs accept patients on a step-down basis from the acute hospital setting (e.g. for rehabilitation following orthopaedic surgery for fractured hips) we also provide a step-up service.

The step-up service allows us to directly admit a patient from home, including Rathlin islanders to Dalriada Hospital who would otherwise require attendance at A+E and admission into an acute hospital bed. As you are aware the cost of a bed day in Dalriada Hospital is a fraction of the cost of a bed day in the acute hospital setting such as Causeway or Antrim Area Hospital.

The doctors also accept and provide medical cover for patients who have been assessed in A+E or admitted to the medical assessment unit and require further short-term clinical care and rehabilitation with the assistance of the multidisciplinary team.

Unfortunately the number of patients requiring complex palliative care treatment has escalated in the past years and Dalriada hospital has highly skilled clinical staff members who are fully dedicated and competent to provide this essential service to patients who otherwise their care could only be provided in the acute hospital setting.

Dalriada hospital also provides a regional respite service for patients with Multiple Sclerosis who have complex medical and nursing needs. During their respite stay the service users avail.

The many services on site including dentistry, podiatry, physiotherapy and occupational therapy. This prevents fragmented care at home. Sadly many of these patients are young. A nursing home environment would be totally unsuitable to their needs. This has been continually voiced by the Multiple Sclerosis Society.
The clinical care provided by the specialist nurses in Dalriada Hospital provides not only for the physical complexities, but also the psychological and social needs of the sufferers of Multiple Sclerosis and their families. This is unique and has been emphasised by the service users and reiterated in the media.

The disbandment of the hospital and these specialist skilled staff will have enormous clinical impact on the provision of acute hospital care and would appear to make no economic sense.

As GPs we are fearful of the impact this proposed major cutback in local healthcare provision will have on the patients in our practices populations. North Antrim and Rathlin Island have become popular retirement areas and hence we have a large proportion of frail elderly patients. In the winter months particularly, many of these patients unfortunately succumb to respiratory infections and fractures due to falls. The only option for these patients will be to attend A+E with long trolley waits and prolonged stay in acute hospital beds. These patients have been treated and have had rehabilitation (including after orthopaedic surgery) up to the present time in Dalriada hospital.

The Northern Trust representatives have argued that they have too many intermediate care beds. Unfortunately they have been disingenuous in their description of intermediate care beds. At present the only intermediate care facilities in the NHSCT area which are staffed by trained nurses are:
• Dalriada Hospital with 20 intermediate care beds. 
• Robinson Hospital in Ballymoney with 21 intermediate care beds 
• Inver in Larne with 16 intermediate care beds 
• Mid Ulster hospital in Magherafelt which has 3 assessment beds.

All the other units which the trust has called intermediate care beds are staffed by care assistants with no trained nurses. Patients can only be admitted to these care assistant staffed units if;
• they can be cared for with the assistance of one person, 
• if they do not have dementia and 
• If they do not have medical complications requiring skilled nursing care.

These care assistant staffed units are in Ballymoney, Ballymena, Antrim, Larne, Whiteabbey and Cookstown. None of these are within easy access of Ballycastle and the Glens.

1. If this proposed closure is enforced what is going to happen to the patients in this area of North Antrim and Rathlin Island?
2. Where are our patients with complex palliative care needs going to be admitted?
3. Can you give assurances that our frail elderly patients will not spend prolonged undignified days on A+E trolleys?
4. Where will the clients with Multiple Sclerosis avail of respite care?

The haste with which this announcement was made has caused enormous anxiety to the people of Ballycastle, Rathlin Island and the Glens. Unfortunately without the answers to the questions we pose we have been unable to allay these fears and anxieties. We would invite you to reply urgently to our questions so that we can assure our patients of a safe and high standard of medical provision.

We would also invite you to come to Dalriada hospital to see for yourself the excellent facilities which it provides, a service which actually saves the Health service money. You will be assured of a very warm welcome.
Yours sincerely,
Dr Mary McLister
Dr Martin O’Kane
Dr Bernie Hegarty
Dr Fergal Hasson
Dr Farah Nawaz
Dr Adrian Sterne
Dr Ian Hadden
Dr Stephen McDonnell
In support of: Dr Dermot Grant, Dr John McSparran and Dr Gillian Elder, Glens of Antrim Medical Centre
CCs
Mr Tony Stevens Chief Executive
Cllr Donal Cunningham
Cllr Joan Baird
Cllr Cara McShane
Ian Paisley MP
Robin Swann MLA
Jim Allister MLA
Daithi McKay MLA
Mervyn Storey MLA
Northern Local Commissioning Group

Public meeting to support campaign to keep Dalriada Hospital open arranged for Tuesday 18 November at 7pm in Dunluce School, Bushmills.

Dalriada Hospital, Ballycastle, Cuts – Action and Reaction

Coleraine Times slideshow of Public Meeting [Photos by Kevin McAuley; Slideshow by Una Culkin]

UTV coverage of white-line protest

Ministerial office email address for submission of views: private.office@

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