Coronavirus: Robin Swann reveals plan to rebuild hospital services

Lagan Valley Hospital in Lisburn is to become Northern Ireland's first day procedure centre.

It is part of the rebuilding of hospital services while dealing with the ongoing impact of Covid-19 on patients and staff.

The announcement was made by the Health Minister Robin Swann on Tuesday.

He also told the assembly that Musgrave Park Hospital and Altnagelvin Area Hospital will be designated as hubs for orthopaedic procedures.

The aim is to ensure services can be protected from Covid-19 and maintained in the event of an expected second wave.

This is designed as an interim step, ahead of longer-term redesign and reform, and the two hubs and day procedure centre are expected to be open in the autumn.

While there will be some public consultation, these changes will be introduced as short-term services, with the final configuration decided with input from the consultation.

The Department of Health said there is a clear public health imperative to implement changes quickly.

However the Royal College Nursing (RCN) said that the lack of engagement with staff about the plans was "very disappointing".

Nurses are unhappy about the lack of consultation over the plans says the RCN

Rita Devlin from the RCN told BBC Radio Ulster's Evening Extra that the union only found out an hour before the plans were announced.

She said: "It is very disappointing that yet again we find out at the last minute about things that will have a significant impact on our members and how they work.

"Changes are being made, yet the people who would be expected to work differently and make these things work are not involved in the decision making."

Ms Devlin said the RCN welcomed "anything that would have a positive impact on our totally unacceptable waiting lists".

But she added: "Decisions are not in consultation with the staff and the staff are feeling totally demoralised and undervalued that they are a commodity to be moved about and used whenever someone else sees fit.

"That lack of engagement is starting to have an impact on their feelings of frustration and fatigue."

Elective surgery was halted in Northern Ireland as the health service reconfigured to cope with the pandemic.

Robin Swann made the announcement in the Assembly on Tuesday

All elective cases will be now referred to Lagan Valley, with clinically acute patients who've been waiting being seen first.

The centre will deal with general surgery, ear/nose/throat, gynaecology, urology and some endoscopy day procedures.

It is estimated around 136,000 procedures will be transferred to the centre annually.

The emergency department will remain open at Lagan Valley, as it has a separate entrance and can be maintained separately from the new day procedure centre.

But there will be some "displacement" of services in the South Eastern Trust, which will require full public consultation.

Staff will also be consulted at a Trust level, around working patterns to support services.

Altnagelvin Hospital will become an orthopaedic hub

Orthopaedic patients will be seen at either Musgrave Park Hospital or Altnagelvin Area Hospital, creating two specialist hubs for the whole region.

At Musgrave Park Hospital, the Duke of Connaught building will be reopened to become the orthopaedic hub.

It too will have a separate entrance, facilitating infection control.

An assessment will be carried out for the orthopaedic unit at Altnagelvin, to ensure infection control there.

Backlog

The immediate priority is addressing the backlog.

Before the pandemic, Northern Ireland already had some of the worst waiting lists in the UK, with some patients waiting as long as five years for procedures such as hip replacements.

Waiting lists are kept on a Trust level. This move will create regional lists.

For the past year, prototype clinics have been running at five dedicated centres across Northern Ireland for cataract surgery and varicose vein treatment.

The department said these have shown increased productivity.

This is the first stage of the rebuilding of services.

Trusts have produced three month plans to September, with another plan to follow for the remainder of the year.

The Department of Health is preparing papers on rebuilding cancer services, and urgent and emergency care, as well as a surge plan for the second wave of the virus.

They are all expected to be announced next month.

There are plans to reopen the emergency department at Daisy Hill Hospital by the end of September

The proposals announced on Tuesday focussed on regionalising services.

In questions after the statement, the minister confirmed emergency services in the Downe Hospital in Downpatrick has a planned reopening date of 19 October.

The Southern Trust is also working towards reopening the emergency department at Daisy Hill Hospital in Newry at the end of September.

Emergency services in the Southern Trust were moved to Craigavon during the reconfiguration so as to concentrate A&E and respiratory specialisms on one site.

Meanwhile, the chair of the health committee, Sinn Féin's Colm Gildernew, expressed his concern that changes had been announced "with no engagement and co-production with service users and staff".

'Building blocks'

Mr Gildernew asked the health minister what level of engagement he felt it necessary to take.

Mr Swann referred to the "building blocks" of work by previous ministers and said the development of the hub-and-spoke model had been done in consultation with and led by clinicians.

He added that he had written to the unions this morning to advise them.

"There's serious engagement that we will now be having with our trade union colleagues, with the professions and with the stakeholders," he said.