Coronavirus: Services must be increased says Robin Swann

The health minister has said services must be increased as soon as possible, as he published the next stage of health trust rebuilding plans.

Robin Swann said at the same time the trusts must prepare for any potential future surges of the coronavirus.

He said services would need to be prioritised, "given the significant constraints" health and social care continues to face.

The plans cover the period from July to September.

Mr Swann said increasing activity and capacity within the health service would require flexibility and adaptability.

He thanked the public for their support for the service and appealed for continuing patience during the rebuilding phase.

The Department of Health has also published a "data annex", which sets out anticipated activity by each trust across a range of services.

These projections are based on there being no resurgence of the virus before September.

Robin Swann says services must be increased across the health trusts

The management board will monitor progress against these projections.

The following are the three-month plans for each trust:

Belfast Trust

• Planned cancer surgery and increased treatment capacity will continue eg. radiotherapy for prostate patients

• Oncology ambulatory assessment and chemotherapy treatments to return to NI Cancer Centre from Ulster Independent Clinic.

South Eastern Trust

• Explore the feasibility of reopening the Downe Hospital Emergency Department - the first phase being the provision of a Minor Injuries Service.

• Continue to provide cancer diagnostics, surgery, oncology and haematology systemic anti-cancer treatments (including chemotherapy) as per national and Northern Ireland Cancer Network regional guidance; as well as restart deferred treatments.

• In parallel with other Regional Addiction Treatment Units, plan to reopen services in late July/August using phone and video call with some face to face for prioritised cases

• Derriaghy Centre - develop plans for reopening to a limited number of service users, in phase 3, based on a risk assessment.

Northern Trust

• Create access to urgent care: provide a process for general practice to refer suitable patients to urgent care services. Redirect patients from ED to urgent care streams. Enable ring before you attend: promote an urgent care telephone number to contact us before you travel.

• ICU will be re-housed temporarily in C7 and will have side rooms to accommodate up to a maximum of four Covid-19 patients and up to a maximum of six non-COVID patients within two separate areas.

• The Antrim Area Hospital unit will be staffed for a maximum of six Level 3 ICU patients and the CH unit will be staffed for four beds. Beds will open and close within the Covid and non-Covid areas, routine paediatric imaging commencing

• Outpatient services - A phased step-up plan has been agreed for July to September. Face-to-face activity will be re-established as well as the continued development of virtual activity. The ratio of face to face appointments v virtual appointments will be approximately 1: 3.-

• Mental health inpatient facilities - The inpatient addiction ward at Holywell Hospital will be re-opened by mid-July 2020. The ward will operate at the reduced capacity of five beds (out of full complement of 10). All five beds will be occupied, with an average length of stay of approximately three weeks.

• Surgery for adults and paediatrics - Inpatient emergency paediatric services as for Phase 1 - Antrim Area Hospital A2 and Causeway children's ward activity resumes. From 15 June both Causeway I/P and Antrim Area Hospital ambulatory services returned to normal activity.

Altnagelvin Hospital in Londonderry falls under the Western Trust

Western Trust

• Inpatient elective/emergency and day case surgery for adults and paediatrics - During Covid-19 we continued to provide 10 inpatient theatre sessions per week at Altnagelvin for red flag and time critical procedures. We will increase capacity to 35% from July to provide 25 inpatient and day case sessions per week increasing to 5.

• Cancer Services - We will start to recommence infusion treatments and reinstatement of nonmedical prescribing will continue.

• The venesection service will be recommenced (40-45 patients per week).

• Children's disability community teams and community nursing learning disability - Phased reopening of Rosebud Cottage (2-4 children per week)

• Children and corporate parenting - early years - increase by 50% as providers begin to reopen following lockdown and the restrictions imposed by Covid-19

Southern Health Trust

• Urgent and emergency care - Paediatric triage returned to the main emergency department at Craigavon Area Hospital

• The older persons assessment unit at Daisy Hill Hospital will recommence services two days per week

• Breast screening to recommence in July focused on addressing the significant backlog

• Cancer services - It is anticipated during the next three-month phase that SACT treatments will gradually return to normal levels.

• The gynaecology ward in Craigavon Area Hospital will reopen initially with nine beds for gynae emergency admissions and also for additional capacity for general surgical female admissions.

• Day care - Recommence monitoring visits in residential/nursing homes.