Contact for MLAs, MPs, Councillors and Public Representatives:
Chris Curran
Public Affairs, Relations and Engagement Manager
Western Trust Single Point Of Contact for MLA, MP, Councils, Public Representatives
Communications & Digital Media Manager
- Email: chris.curran@westerntrust.hscni.net
- Mobile: 07825 378780
- Direct Line: 028 8283 5457
Or
Oliver Kelly, Head of Communications
Individual Constituent Enquiries by email only (Consent form must be provided)
- Individual Constituent Enquiries by email contact please use the following method of communication:
Email: Madonna McGinley, Chief Executives Office, at Madonna.mcginley@westerntrust.hscni.net
Out of Hours URGENT Contact only: outside of 9am-5pm, Monday to Friday
- Out of Hours URGENT CONTACT only: Please telephone the Out of Hours Number on 075 2589 7187. (Out of Hours: outside of 9am-5pm, Monday to Friday)
Briefing Sessions, Meetings and Engagement with MLA and MPs
Requests for MLA, MP or Public Representative meetings or engagements with the Western Trust Chief Executive or senior staff in the Western Trust must be requested via email to: chris.curran@westerntrust.hscni.net and madonna.mcginley@westerntrust.hscni.net.
Next MLA & MP Briefing Sessions as follows:
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- Friday 11 October 2024, 2.30pm-4.00pm (incl. All MLA/MPs)
- Western Trust Chief Executive and all Directors, covering all services, will be in attendance for these sessions. It is planned to host these Sessions as ‘In-person’ Briefings and we will have a venue meeting room available in MDEC, Omagh and SWAH for attendance. Virtual dial-in to the meetings will also still be available.
- Final Agenda, presentation and papers will be issued by email to MLA/MPs ahead of the meetings. If a MS Teams Link is required this will also be issued.
All-Party Group for South West Acute Hospital, Enniskillen
The above full MLA/MP Briefing Session dates are separate to the SWAH All Party Group Meetings which are scheduled as follows below.
These APG Meetings include the Trust team of Neil Guckian (Chief Executive), Dr Brendan Lavery (Medical Director), Mark Gillespie (Director of Planned Care), Prof Ronan O’Hare (Deputy Medical Director), Prof Monica Monaghan (Divisional Clinical Director, Associate Professor Royal College Surgeons Ireland), Chris Curran (Public Affairs, Relations and Engagement Manager) and Oliver Kelly (Head of Communications).
Next Meeting of the SWAH APG:
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- Friday 15 November 2024, 10.00am-11.30am, in SWAH Boardroom.
- This will include a MLA/MP Walk-around to some service areas and meeting staff ahead of the meeting – including the SWAH Stroke Services Unit. Details to be confirmed ahead of the meeting.
- Friday 15 November 2024, 10.00am-11.30am, in SWAH Boardroom.
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24/10/2024: Health Inequalities Project Locations Announced
DEPARTMENT OF HEALTH, 24 October 2024:
Health Minister Mike Nesbitt today announced the first locations for Live Better, a new initiative on addressing health inequalities.
The initial phase of the programme will involve neighbourhoods in Belfast and Derry/Londonderry, with the intention of expanding the approach, should it prove effective, across multiple urban and rural communities.
Describing this new approach, the Minister stated:
“I have been clear from the outset that I want to make a real and lasting difference to the health and wellbeing of the people of Northern Ireland, and in particular to reduce the unfair differences in health outcomes that are experienced by some of our most vulnerable individuals and communities.”
“If we consider two babies born today in the same hospital in Northern Ireland, how can it be fair that one can expect to live some 10 fewer years in good health, just because of the area in which they grow up? I think we can all agree this has to change.”
“That is why health inequalities are one of my key areas of focus and, to further deliver on this commitment, my Department and the Public Health Agency have been developing the Live Better approach. Following a process led by the Public Health Agency to identify the areas in which to initially evaluate this approach, I am pleased to announce that Live Better will be delivered in the Fountain, Bogside, Brandywell and Creggan areas in Derry/Londonderry and the Lower Shankill, Lower Falls and Grosvenor Road areas in Belfast. Local delivery plans are now being developed and I hope that work will begin on the ground in the near future.”
Live Better will build on the good work developed by the Public Health Agency and the Health and Social Care system over the years and will seek to pull existing initiatives and programmes together so that they can be delivered intensively in communities to make a real and lasting difference. It will also provide targeted information and initiatives directly to specific communities, as well as signposting to existing areas of support.
Aidan Dawson, Chief Executive of the Public Health Agency (PHA), said:
“The Live Better initiative complements and contributes to the ongoing work by the PHA to improve health and wellbeing and tackle health inequalities.”
“It will provide an opportunity for organisations to come together to collaborate, share information and generate ideas through a community-centred approach to support people who are impacted the most by health inequalities.”
In the initial demonstration areas, activities will focus on three core outcomes – Starting Well, Living Well, and Ageing Well. Primary Care and other data will be used to choose the outcomes we are seeking to improve within these core themes – for example, if levels of immunisation among children are low in the area, then this will be a key focus under Starting Well, or if a condition such as diabetes has key disparities, then under Living Well there would be a focus on diabetes prevention, supporting people to be active, improve their diet and manage their weight. Active local engagement is now underway with local communities, GPs, multi-disciplinary teams, and Health and Social Care Trusts to decide on the priorities and more detail will be provided in the very near future.
Live Better is also being considered in terms of its alignment with other developments, such as the Integrated Care System NI and the roll out of multi-disciplinary teams, and with other Departments in the longer term to embed and mainstream this approach.
The Minister added:
“Addressing health inequalities will take a long term, cross-sectoral approach, however I hope that Live Better will be a crucial step on that journey and will begin to improve health outcomes in these areas. I would also like to stress that, although the two initial sites are urban areas, Live Better may apply to both rural and urban areas in the future. From a practical perspective, however, it makes sense to begin with smaller, defined urban areas.”
“My Department will also be working up plans on a wider approach to addressing health inequalities and I plan to further engage with my Executive colleagues on this issue, given its prominence in the Draft Programme for Government.”
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11/10/2024: Update: Surgery, Paediatrics and Women’s Health
Mark Gillespie, Director of Surgery, Paediatrics & Women’s Health#
Update on New Structure
The Directorate is currently undertaking the final stage to recruitment of its new structure which sees a number of new posts. Within the Healthcare division this includes new posts including an Assistant Director for Midwifery and Gynaecology services, service managers to Neonatal, Acute & Community paediatrics. Within Surgical service this includes a new Service Manager for Urology and Outpatients. The new directorate will also have a Lead Nurse for Governance post.
This new structure will be key to ensuring there is oversight of Quality, safety and governance, Performance, finance and workforce.
Update on Recruitment
There has been significant focus on recruitment with respect to Medical staff across the Surgical, Obstetrics, Gynaecology and Paediatric Specialities across the Trust. Those new appointments are detailed below;
- Obstetrics and Gynaecology
New consultant appointment in SWAH in September which brings the team to six substantive permanent post holders. However, due to illness we have two on long term absence, one of which we hope to return in November, with the gaps filled with locums so the service remains stable. There has also been offers of employment at Specialty Doctor level at SWAH.
- Paediatrics
New International Consultant hoping to start next March/April in SWAH. Current instability in the team due to long term absence leaving us dependent on two additional agency locums. Lack of a robust retrieval team is an additional pressure on a small team when there is no team available out of hours and at weekends. Following the recent recruitment exercise in India a Specialty Dr post has also been accepted at SWAH.
There has also been significant focus within the following two service areas in surgical services:
General Surgery
Since moving to Trust wide positions the Trust has been successful in stabilising its Surgical workforce at both Consultant and middle grade level. These new appointments will are key to the delivery of Trust wide surgical services.
Update on Elective
SWAH and Omagh are now at their funded levels of operating. At SWAH the Trust recently introduced Breast Surgery and will introduce ENT paediatric vents and tonsillectomy surgery in the coming weeks. The Trust is also exploring with Southern Trust the potential of undertaking thyroid surgery in SWAH.
The Trust is engaged in regional outpatient modernisation work focusing on PIFU (patient initiated follow up) and pathway development of patients going direct to test eliminating the need to an initial outpatient Consultant appointment.
Update on temporary change in Emergency General Surgery at SWAH
With respect to the temporary change in EGS at SWAH hospital we have undertaken improvement work in relation to patients who transfer going direct to an inpatient bed.
From December 2022 to end of April 2024, 26% of those patients transferred went directly to an inpatient bed. In response to this, the Trust reset its internal processes in May 2024 to increase the number of patients transferring from SWAH ED going directly to a surgical inpatient bed or the Ambulatory Care Unit (ACU) and not via Altnagelvin ED.
From 6th May 24 to 15th September 24 we have achieved an average of 76% of patients being directly admitted to a ward. This included some weeks achieving between 93% and 100%.
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11/10/2024: Update: HR, Recruitment & Workforce
Karen Hargan, Director Human Resources & Organisation Development
Update: Bespoke International Recruitment Project
Aim
To stabilise the medical workforce and reduce medical agency spend through a Bespoke International Medical Recruitment Project.
Background
The International Recruitment Project has brought great success to the Western Trust. Last year 39 doctors were appointed through the project. Although there have been a considerable number of international medical staff arrive through this avenue, there were still a number of posts that we were unable to source applicants for using the current model.
The Trust has a long standing relationship with Xander Hendrix Healthcare (XHH) who have successfully placed doctors at all grades and specialities at the Trust for approximately 9 years. However it was felt that “hard to fill” consultant posts required a new approach.
The Bespoke Campaign focused on consultants through the following mechanisms:
- Targeted adverts and outreach;
- Attendance at senior doctor events;
- Offering CESR as an incentive;
- Partnerships with academies, Indian hospital groups and teaching institutions; and
- A triage process to ensure candidates being shortlisted were at the final stage of their journey to work as a consultant in HSC Trusts and are committed to the relocation to the Trust area.
It was inevitable that through the outreach XHH would receive applications from non-consultants, which as a Trust we accepted and reviewed for vacant positions also.
Campaign
XHH coordinated a bespoke three month marketing campaign to build interest and facilitate a successful event.
Two webinars where taken forward with guest speakers from the Trust to discuss, working in the NHS at the Western Trust, how the recruitment and relocation process works, information and support available, CESR and job opportunities.
The Trust developed three promotional videos which consisted of senior staff and previously placed doctors talking about their experiences, what they like about working at the Trust and living in the west of Northern Ireland. These were powerful promotional tools for candidates to be able to see the hospitals, local areas and hear from staff and they were shared widely across XHH networks.
Main video:
CESR Video:
Psychiatrist Video:
Events
XHH in partnership with the Trust hosted the “Meet us in Mumbai” recruitment event which took place on Friday 27th, Saturday 28th and Sunday 29th September in Mumbai. Mumbai was chosen as it is a prominent, large city in a central location with a good transport hub and English is widely spoken.
Four staff from the Trust attended comprising of two clinicians and two HR professionals alongside 8 staff from XHH. This provided an opportunity to meet candidates face to face, to talk to them about their aspirations, and advise them on how the Trust is a “Great Place to Work and Live”. Reassurance was also provided regarding pastoral support and on boarding when they come to work in the organisation.
Seminars
On each of the three days of the event, seminars were coordinated with approximately 70 doctors attending to hear about working in the Trust. XHH, clinicians and HR all delivered presentations at the events and time was made for a question and answer session. The aim of these seminars was to develop the talent pipeline for future vacancies. These proved very successful with good engagement from all attendees and CV’s have been received from attendees, with further to follow.
Bespoke Activity as at 8th October at 12 noon
CV’s reviewed 119 Interview panels set up 30 Offered posts 34 Accepted posts 18 Considering Offer 7 Declined offer 9 Commenced employment 2 Pending offers being considered 4 The appointments that are made through this project will support the Trust in stabilising our medical workforce across a number of specialties. This will bring benefits in patient care and will enable us to reduce our reliance on expensive locums in a number of these specialties.
Significant work will also be required to support the newly appointed doctors who take up post in the Trust, to ensure their successful transition to working within HSC and settling in Northern Ireland. The Trust has a good track record in this regard through the many years of international recruitment we have undertaken.
St Johns Medical School in Bangalore Visit
There was an opportunity to link in with St John’s Medical School in Bangalore while in India to explore a longer term collaborative approach with medical sub specialty trainees. The approach was to understand the likelihood of these doctors being placed in the Trust for two years during their training. They would return to complete studies in Bangalore however the view would be to attract them back to the Trust to work as consultants in specialties that would work mutually. Two clinicians made the onward journey to Bangalore from Mumbai to explore this further.
Conclusion
There has already been noticeable benefit in this project which was only approved by the Corporate Management Team on the 4th April 2024. 18 posts have been accepted at consultant and middle grade level. A post event evaluation report is pending completion and will be considered by the Corporate Management Team by 31st October 2024. This will bring all the learning and achievements together. There is still much work to be taken forward following the India visit, this will include a smaller project with junior doctors and the monitoring of agency reduction and workforce stabilisation as a result of the recruitment success.
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11/10/2024: Update: Nursing
Donna Keenan, Executive Director of Nursing, Midwifery & AHP Services
Updated Briefing Statement regarding Western Trust plans to offer employment to nursing graduates 2024.
As previously stated in our brief on 1 August 2024, the Western Trust is delighted that so many newly graduated student nurses have expressed a first preference interest to join our team. This is a very welcomed development to see such a high level of interest, which is significantly higher than in previous years. This certainly reflects the very positive experience, which students have highlighted during their placements within many service areas in the Trust and is testament to the excellent ongoing work by Trust staff across all service areas.
In considering the many enquiries which have been received by the Trust, it is very important to emphasise that our team have maintained a totally consistent approach each year in terms of dealing with the very welcomed demand for employment in the Western Trust. The process of allocation for graduate student nurses begins in June each year and, as always, would be ongoing throughout the remainder of the year for varying reasons.
Since the process of allocating student nurses began in June 2024, the Trust has now seen 110 graduate nurses offered/accepted a post. From those 110 student nurses, the Trust has now provided offers to 100% of those who had highlighted Paediatric services, Learning Disability Services and Midwifery services as their first preference. To date the Trust has also provided offers to 53 students in Mental Health services and 36 students in Adult services.
The Trust is also embarking on part 2 of the strategy to reduce the reliance on agency nursing. Part 1 was off-contract agency nursing which has been completed and part 2 will concentrate on contract agency nursing. This process will be carefully managed to ensure that clinical teams can continue to provide safe patient care when they reduce the use of agency nursing. We anticipate that this process may create some additional employment opportunities that we would also be able to offer to the graduating student nurses.
The Trust diligently manages its recruitment processes, so in addition to the stated 110 offers made, further posts will become available for graduates through annual turnover of staff throughout the year. Therefore, whilst the Western Trust has now issued 110 offers, the total number of posts which will actually become available for graduate students in the months ahead will continue to increase.
Again, the Trust re-iterates that this stated position is all part of a process which transpires every year and will continue in the months ahead. All students who have expressed an interest in joining the nursing workforce within the Western Trust have been communicated with. They have been advised of the position and will be kept informed of the Trust’s actions to identify employment opportunities for them over the next number of months.
Training and recruitment of graduate nurses are regional processes and there is never any guarantee given that everyone will be allocated their first preference. Recruitment is an ongoing process with the number of vacancies continually changing. The Trust will continue to work intensively to recruit as many students as is possible.
A further update brief will be provided on this in November 2024.
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11/10/2024: Update Adult Mental Health
Karen O’Brien, Director Adult Mental Health & Disability Services
Improving Pathways for Mental Health Patients at Western Trust Emergency Departments
Over the past year the Western Health and Social Care Trust (Western Trust) has taken significant steps to improve mental health patients experiencing long waits in our Emergency Departments waiting for an assessment or access to an inpatient bed.
In October 2023 an Adult Mental Health Improvement Board was established to proactively take measures to address emerging pressures and risks within the system.
Patients experiencing a mental health crisis were spending much longer than we would like in our Emergency Departments (ED) waiting for an assessment or access to an inpatient bed. A number of workstreams were established overseen by the Improvement Board to try and address these challenges. These focused on stabilising our workforce, exploring alternative pathways for our patients waiting in ED, establishing better administration and IT processes and testing different ideas to improve flow in the patient journey from ED, through inpatient wards and out to the community.
Whilst this improvement journey is ongoing there have been some marked developments that have improved our patients’ experiences and outcomes.
A number of initiatives have included:
- Rathview House in Omagh has been repurposed as a 7 day assessment facility. This provides an alternative pathway for patients waiting in our Emergency Departments who may require a period of further assessment or short term support. This model is working well and feedback from patients has been extremely positive. Since the introduction of Rathview as an assessment facility there has been a noted reduction in the number of patients who require an adult mental health inpatient bed and the number of patients waiting in our Emergency Departments.
- Mental Health Ward staff have also been working more closely with community colleagues to support patients to return home in a safe and timely way. This has greatly improved flow and reduced the number of patients who may become delayed discharges in our hospitals.
- Significant work has also been undertaken to stabilise the workforce and ensure safe staffing levels in our mental health wards.
- New IT systems have been introduced within our adult mental health hospitals to ensure there is better access to information that supports timely bed allocation for patients waiting in our Emergency Departments to access a bed.
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11/10/2024: Independent Sector Domiciliary Care Tender
Dr Maura O’Neill, Director of Community & Older People’s Services
The Western Health & Social Care Trust has procured contracts in place for the provision of independent sector domiciliary care. These current contracts are due to expire incrementally over the coming number of months. In line with the Public Contracts Regulations the Western Health & Social Care Trust has commenced competition to re-procure these contracts. This tender opportunity will be advertised on eTendersNI.gov.uk
It is the Trust’s intention to award a contract to 3 Providers in each of the 9 lots – 27 contracts will be awarded in total. Contracts will be awarded for 4 years from the Service Commencement Date plus the option for one 12 month extension.
It is the Trust’s intention to award a contract to 3 Providers in each of the 9 lots – 27 contracts will be awarded in total.
The estimated contract value over the possible 5 year term is £286.5 million.
The DoH has directed that the Trust shall make payment of £20.01 per hour to Providers under any tendered Contract subject to any increase(s) thereto which are envisaged to be in respect of inflation and any statutory requirements and which will be at the further direction of the DoH and subject to available funding. As such the Trust will NOT be competing price as part of the tender process. The tender will be evaluated on award criteria – quality set at 90% and award criteria – social value set at 10%.
In accordance with the Procurement Policy Note PPN 01/21 – Scoring Social Value, payment by Providers of the Living Wage (calculated by the Living Wage Foundation) as a minimum shall be included as a condition of Contract. (This is currently £12.00 per hour.)
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11/10/2024: Update Community & Older People’s Services
Dr Maura O’Neill, Director of Community & Older People’s Services
Update on Hospital At Home Service, Fermanagh
Hospital at Home provides Consultant led, hospital level care for acute conditions in a patient’s own home. It is a community-based, secondary care service providing intensive high-level care for a short episode through multidisciplinary healthcare team-working. It aims to deliver care to patients in their usual place of residence, whether a domiciliary setting or care home, for conditions that would normally require inpatient care in an acute hospital bed.
The commissioning of services, and the strategic focus of provider organisations, recognises the need to better reflect the emerging local and international evidence of the patient groups who benefit most from investment in Hospital at Home services in comparison to historic acute hospital-based care models. Since the inception of the Hospital at Home team in the Southern Sector of the Western Trust in April 2021, the service has provided an acute hospital standard of care to almost 700 people from the local community.
In considering this evidence, alongside the positive patient experiences of the team, the Trust has now put in place recurrent funding to this service for the Fermanagh area. By providing an expert level of acute care and treatment will ensure that where it is safe to do so, patients may remain at home and receive their care.
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11/10/2024: Update on Short Break Services
Tom Cassidy, Director of Women & Children’s Services/Exec. Dir. of Social Care Services
Short break services in the Western Trust were provided in two facilities, Rosebud Cottage covering the Northern Sector of the Trust and Avalon House covering the Southern Sector. Both of these facilities have had to be temporarily repurposed to provide medium to long term placements for children where longer term placements have been needed.
The Trust is in the process of reopening Jasmine Lodge following a period of closure for refurbishment. Plans are in place to move young people currently placed in Rosebud to Jasmine Lodge in order for us to reopen Rosebud for Short Break provision and young people across the geography of the Trust will be able to avail of this short break service. Avalon House will continue to provide medium/long term care for a number of children and social work staff will continue to work with all our families to provide alternative short break arrangements through Self Directed Support.
The Western Trust is working closely with the Department of Health to identify any immediate opportunities that can be implemented to improve access to short breaks across the Trust and also contribute to the strategic planning to ensure the needs of families are better met in the longer term.
The Trust continues to provide respite through self-directed support arrangements and is based on an individual assessment for each family. The assessed need of any family can change over time and regular reviews are built into the process.
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11/10/2024: ICS Update
Teresa Molloy, Director of Planning, Performance & Corporate Services
- What is ICS NI?
DoH has set out the overarching vision of ICS as one system working in an integrated and coordinated way to plan and deliver health and care services to improve the health and wellbeing of our population and address demand by:
- placing a focus on people keeping well in the first instance, providing timely, coordinated care when they are not, and supporting people to self-care when appropriate – through working in partnership with others at a local level to focus on prevention, early intervention and community health and wellbeing;
and
- ensuring we are maximising the resource we have available to deliver the best outcomes for our population, optimising our effectiveness and efficiency and reducing duplication through working in partnership within HSC to ensure we are planning, managing and delivering health and social care to best effect
- Correspondence from Permanent Secretary (28th June)
Confirming establishment of “shadow AIPBs, pending ICS legislation. This set out a phased approach starting with shadow AIPBs in the Southern area (transitioning from Test status), South-Eastern and Western areas and establishing the Regional ICS Partnership Board during 2024/25. Belfast and Northern Trusts will move into shadow status in 2025, and have been delayed due to their encompass system go-lives.
- Area Integrated partnership Boards (AIPB)
Local vehicle & coterminous with Trust footprint. Focus on prevention, early intervention, community health and well-being. (Western Membership now confirmed – Annex A)
- Regional ICS Partnership Forum (RICSPF)
Will allow collaborative partnership within HSC and wider, strategic leadership and support, AIPB alignment, a challenge function, opportunity for collaboration, and a shared learning platform. The first meeting of the Forum was held in September 2024.
- Trust Preparation
In 2023/24 the Trust re-structured to bring together into one division a range of population health services, including: Health and wellbeing projects sponsored by the Trust and Public Health Agency, Community Planning, and ICS. An Asst Director of ICS was appointed. An ICS Implementation Board was established during 2024, involving all Trust services, and reporting to Strategic Change Board.
- Measuring Outcomes
Work ongoing on Strategic Outcomes Framework along with System Oversight measures, as part of changing focus to population health planning for the future.
- Roles & Responsibilities
- The Department sets strategic direction, outlines expectations and allocates budgets.
- The Strategic Planning & Performance Group (SPPG-DoH) and Public Health Agency (PHA), as partners, hold strategic oversight for planning of health and social care services.
- Trusts are responsible for planning and delivery of services at local level.
- AIPB Role
- Identify need (based on data, info and evidence)
- Agree priorities (based on identified need align with RICSPF direction
- Develop plan to meet that need
- Support delivery against that plan
- WHSCT as an AIPB Partner
- Co-chair, contribute as a partner, build relationships
- Add to the health needs assessment – Represent the challenges from a provider perspective
- Align the Trust’s work in Community Planning with AIPB priorities and objectives
- Work through the accountability and governance challenges
- Reflect the priorities of the AIPB ambitions in future strategic plans of the Trust
- Induction
For AIPB members is scheduled for Monday 21st October in Strule Arts Centre, Omagh 9.15 – 4.30pm
- Area Integrated Partnership Board (AIPB)
First meeting is scheduled for Friday, 22nd November 2024 2pm in Gransha Park House.
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11/10/2024: Encompass & ICS Update
Teresa Molloy, Director of Planning, Performance & Corporate Services
Encompass Update
1.Regional Context
The encompass Programme was established to implement the EPIC system with the vision of supporting the delivery of long term, sustainable digital transformation of our health and care services by replacing a number of aging patient administration system and the dependency on paper records.
2. Risk Summit
Following a successful joint encompass Risk Summit, Western Trust and Southern Trust have formally announced their concurrent Go Live date of
8 May 2025. This date will mark the completion of the programme implementation for HSCNI. This is the first time in the NI implementation that two Trusts will go live together.
At the Risk Summit, the Trust SROs, supported by their encompass Leads, Professional Leads, IT and HR Leads presented their readiness position, risks and mitigating factors. These risks will be monitored at regular Trust encompass Programme Board meetings which include the regional encompass Programme Director. The risks are (1) Reporting; (2) Face to face EPIC support at Go Live, given that 2 Trusts will go live concurrently; (3) agreeing Business as Usual structures and resources for post-go-live; (4) Final agreement of number and type of End User Devices; (5) Loss of Digital Dictation and Voice Recognition as Encompass does not yet have this functionality; (6) scale of Manual Data Migration; and (7) Pharmacy Support requiring additional support and resources regionally and in the Trust.
3. Governance
Appropriate Governance is in place to ensure programme oversight, reporting and accountability. This includes encompass Programme Board meetings, encompass Readiness Assurance meetings, encompass People Change Readiness Group meetings and encompass Operational Readiness Boards in each service delivery area.
4. Funding
In addition to core encompass roles funded by the regional encompass programme, Western Trust identified a number of additional posts, deemed necessary to ensure the successful implementation of its encompass Programme.
The Trust is working to support the additional resources which we judge are needed for a successful go-live with the emphasis on delivering more by reallocating existing resources, and prioritising encompass in our current Teams.
Funding for additional resources is a challenge for the Trust given the savings targets which we have been set by the centre this year.
5. Enabling Works
Enabling Works are well progressed along with the procurement of End User Devices (EUDs). These include mobile devices, laptops, printers and Workstations on Wheels (WOWs). Both these activities are crucial to ensure a successful Technical Dress Rehearsal (in-situ testing of devices) and constitute a 54% uplift in the digital assets of the Trust.
In addition, the refurbishment of some existing locations has been used to establish encompass learning Hubs at Gransha and Beech Villa (Omagh). Works to complete the encompass Hub at Altnagelvin are well underway. Along with a location in SWAH, these facilities will be used for training, a base location for regional and Western Trust staff during preparation / Go Live and to provide Bronze Command Centres.6. Go Live Planning
Joint Go Live planning meetings have commenced involving the Western Trust SIRO, Deputy SIRO, encompass PMO and their Southern Trust equivalents, and along with the Regional encompass SRO and EPIC colleagues.
7. Support for Regional Go Live Events
Western Trust has provided extensive staff support to other regional encompass implementation at South Eastern Trust and Belfast Trust, as well as preparing to provide crucial support to Northern Trust as part of their
7 November 2024 Go Live.
8. Go Live Readiness Assessments
Western Trust Go Live Readiness Assessments will commence from 150 days prior to Go Live (end December 2024) and be held every 30 days until Go Live with senior management from the Trust, encompass regional team and Epic colleagues all involved to ensure a safe implementation.
The Trust will plan to downturn areas of work during go-live, and for elective and unscheduled services will agree mutual aid arrangements with other Trusts in NI.
- Benefits
The benefits to patient care of moving to a modern integrated patient record will be significant after the pressure of the go-live readiness and the actual period of go-live. These will include the availability of a patient portal available as an app to patients and clients across NI.
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11/10/2024: Unscheduled Care Update
Geraldine McKay, Director of Unscheduled Care, Medicine, Cancer and Clinical Services
ED Pressures
Year to date there has been 20,244 attendances at Altnagelvin – 28% of these attendances required admission to hospital (DTA – 5,696 patients). This is a decrease of 2,530 attendances when compared with the same period last year
4,631 patients waited longer than 12 hours in the department.
Year to date there has been 13,838 attendances at SWAH – 27% of these attendances required admission to hospital (DTA – 3,691 patients). This is an increase of 550 attendances when compared with the same period last year
2,058 patients waited longer than 12 hours in the department.
Delayed Discharges
On Friday 27th September 2024 there were a total of 134 delays throughout the Western Trust.
By Hospital site:
- Altnagelvin 53
- SWAH 56
- Omagh 12
- Waterside 13
Activity
- MIU – 6,881 patients since 1st 98% seen within 4 hours
- ACU – Year to date 3,356 patient contacts. Compared with the same period last year (April – August) Additional 865 patients seen year to date
- 1,372 New attendances (+ 585)
- 1,984 review (+280)
- SDEC service in SWAH + 55 patients April – August
- Phone First – 9,545 calls. Unprecedented increase in calls this year due to the opening of the MIU.
- Discharge Lounge – 1,578 patients seen year to date. Average of 60 patients per week
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11/10/2024: FINANCE Update BRIEFING 2024/25
Eimear McCauley, Executive Director of Finance, Contracts & Capital Development
In May 2024 the Western Trust submitted our financial plan for 2024/25 to the Department of Health (DoH). This financial plan was set in the context of a reduction to the DoH budget for the period, equating to a 2% reduction against 2023/24 expenditure. Taking this reduced income into consideration and factoring in existing financial pressures coming into 2024/25, as well as demographic growth in demand anticipated during 2024/25, the Trust opened the year with a forecast deficit of £59m.
Included in this figure are costs associated with escalated beds across the acute hospital and mental health hospital sites, medical and nursing agency costs required to ensure safe and effective services and costs of unavoidable and unfunded demographic growth across all of our populations.
Assumptions and risk factors to this forecast position:
- Pay award for 2024/25 is not included in this deficit;
- Significantly escalated levels of operational capacity is required in our acute and community hospitals and this position could become a lot more challenging as we move into the winter period. Our patient and client profile is higher in acuity and complexity resulting in longer hospital spells and challenges with hospital flow. There are a range of unavoidable financial pressures attached to how we manage this.
- A continuation of unprecedented growth of cost associated with addressing medical gaps for safe staffing of rotas across a range of specialist services. The price that we have to pay in this Trust for locum cover for these vacancies continues to disproportionately outstrip other Trusts – we are forecasting that we will spend some £34m on locums in 2024/25.
- Independent Sector market forces pricing factors – we are dealing with a serious capacity issue in the Trust area Independent Sector for packages of care, including for some very complex vulnerable clients. This results in limited negotiation power in relation to the price that we pay which is compounded by the limited budget provided for demographic growth in year.
- The implementation of Encompass comes at a considerable cost. DoH have been in a position to fund only part of this.
- HSC has always operated with a level of financial slippage being available across the system. The scale of this has reduced considerably in recent years.
As part of our financial plan submission for 2024/25, we also provided DoH with a Contingency plan in relation to savings measures that we would take forward.
- For the Trust to deliver £59m of savings, we would need to have taken actions, some of which would have very serious consequences to the services, patients and clients of the Trust.
- Our assessment of savings potential from low and medium impact risk areas was £24.1m. These savings have emerged from the ongoing Delivering Value Programme which we established in the Trust in 2018 as the vehicle through which we would implement a programme of financial recovery. This planning assessment is at the most ambitious level in the history of the Trust. It indicates our serious considerations in response to the pressures that we have experienced to reduce costs this year.
- This figure is double what we achieved in savings in 2023/24. Savings of this scale do not emerge easily from service areas where demand is growing exponentially, in complexity if not also in volume. The scale of this is extremely challenging for managers and staff across all parts of our services who are dealing with so many other complex service demands.
- With our priority to maintain safe and effective services and with a duty of care to staff who continue to go above and beyond for our services and our population, we are endeavouring to ensure that we balance the scale of savings accordingly.
- We received approval from DoH that we should proceed with the £24.1m of low and medium impact savings measures only.
- As a consequences we adjusted our forecast to £35m.
DoH have recently provided additional funding to the Trust of £31.5m towards our deficit and so in our most recent review, taking account of actual expenditure materialising year to date as well as savings and other opportunities, we have been able to adjust our forecast deficit to £1.3m. This remains a very high risk assessment for the Trust as we face into the winter period which is highly challenging for our front-line and continue to deal with the unpredictable factors attached to the risks indicated earlier.
We have a statutory obligation to develop a financial recovery plan and at the scale of savings which will be required, we expect this to be a five-year plan. We are working with SPPG and DoH colleagues in the development of this plan which will have a local and regional system-wide aspect to it. Local savings will continue to build on the well-embedded Delivering Value Programme which has remained in place in the Trust since we completed the implementation of our last recovery plan in 2022/23.
To effect full financial recovery, we will be dependent on regional, HSC-wide actions and agreements to help us resolve some of the risk factors which are driving costs upwards, e.g. medical workforce stabilisation, Independent Sector tariffs etc. However, the scale of savings required are likely to require considerable HSC-wide system change and impact to services.
It has been a very challenging year for the Trust, staff and services to date, we do not expect this position to ease between now and the end of this financial year which is a concern for the Trust’s ability to deliver financial break-even.
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01/10/2024: Our hospitals are better together - Nesbitt
DEPARTMENT OF HEALTH, 01 October 2024:
Hospitals have a brighter and more secure future as part of a Northern Ireland network of care, Health Minister Mike Nesbitt has emphasised.
The Minister today launched a reconfiguration framework for hospitals, setting out the key principles to underpin service reorganisation.
Entitled ‘Hospitals – Creating a Network for Better Outcomes’, the document will be the subject of a public consultation.
Mr Nesbitt said:
“Too often, our hospitals are viewed as standalone units. Some have faced prolonged challenges with recruiting staff and maintaining services, leading to understandable concerns in communities.”
“We need to see each of our hospitals as part of something bigger and wider – fitting into a network in which each plays a key part. This is essential if we are to deliver better outcomes for patients and staff.”
“Reconfiguration of some services is required. The roles of some hospitals will have to change – to keep pace with modern medicine and deliver better patient outcomes.”
“While every hospital cannot provide every service, each hospital will still play a vital role, not just in their local communities but as a valued part of a planned regional system.”
“This document can help assure communities that reconfiguration of services is not about cutting costs or closing hospitals. It’s about managing change in a controlled way and demonstrating the benefits. It’s about showing how each hospital can fit into the network and best serve patients.”
“Change is happening. We see that with the increasing shift towards centres of excellence such as standalone elective care hubs.”
“This is reform in action but there is much more to do. A collaborative approach can better sustain our network to the benefit of patients and staff.”
“I encourage everyone to take part in the public consultation and make their voice heard.”
The framework categorises NI hospitals into four main types:
- Local Hospitals, which is a diverse group delivering primary, secondary and community services in support of the area and general hospitals.
- General Hospitals, delivering defined secondary care services including unscheduled care, geared to a specific, more isolated geographical location. These hospitals also play an important part in the delivery of elective care to the region.
- Area Hospitals, delivering a full range of secondary care services, both unscheduled (un-planned) and elective (planned) treatment, to the communities within a geographical area currently defined by the distribution of integrated services delivered by our five geographic Health and Social Care Trusts (HSCTs).
- Regional Centres, delivering specialist regional inpatient services for the whole population of Northern Ireland.
Some hospitals by nature of their locality or range of services may be included in more than one category, as listed in the document.
Local Hospitals: Ards Hospital, Bangor Hospital, Dalriada Hospital, Downe Hospital Downpatrick, Lagan Valley Hospital, Lurgan Hospital, Mid-Ulster Hospital, Moyle Hospital, Omagh Hospital and Primary Care Complex, Robinson Hospital, South Tyrone Hospital, Waterside Hospital, Whiteabbey Hospital.
General Hospitals: Causeway Hospital, Daisy Hill Hospital, Southwest Acute Hospital.
Area Hospitals: Altnagelvin Hospital, Antrim Area Hospital, Craigavon Area Hospital, Belfast Hospitals Campus (includes Royal Victoria Hospital, Mater Hospital, Royal Jubilee Maternity Hospital and Royal Belfast Hospital for Sick Children) and Ulster Hospital.
Regional Centres: Altnagelvin North West Cancer Centre, Belfast City Hospital including the Cancer Centre, Musgrave Park Hospital, Royal Belfast Hospital for Sick Children, Royal Jubilee Maternity hospital, Royal Victoria Hospital, Ulster Hospital Regional Centre for Plastic Surgery and Maxillofacial Surgery.
A key aim is to identify the core services in each of these types of hospitals and address the key challenges to sustainably deliver these.
Modern medicine – not least increasing levels of clinical specialisation and sub specialisation – means change cannot be avoided. The challenge is to deliver change on a planned basis rather than through service collapse.
In key specialties, when hospitals have lower patient numbers, this can create significant issues for professionals working in key specialties. These include rota/on-call pressures inherent in smaller clinical teams, as well as insufficient case mix to support specialisation, training and skill development. These issues inevitably have consequences for recruitment and retention, adding to the challenges of maintaining services.
The Framework also sets out 5 enablers and 13 actions to support reconfiguration and the delivery of a connected Hospital Network.
Hospitals – Creating a Network for Better Outcomes can be read here – https://www.health-ni.gov.uk/publications/hospitals-creating-network-better-outcomes
The public consultation goes live on October 2, 2024.
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24/09/2024: Update on Hospital At Home, Southern Sector of Western Trust
Hospital at Home provides Consultant led, hospital level care for acute conditions in a patient’s own home. It is a community-based, secondary care service providing intensive high-level care for a short episode through multidisciplinary healthcare team-working. It aims to deliver care to patients in their usual place of residence, whether a domiciliary setting or care home, for conditions that would normally require inpatient care in an acute hospital bed.
The commissioning of services, and the strategic focus of provider organisations, recognises the need to better reflect the emerging local and international evidence of the patient groups who benefit most from investment in Hospital at Home services in comparison to historic acute hospital-based care models. Since the inception of the Hospital at Home team in the Southern Sector of the Western Trust in April 2021, the service has provided an acute hospital standard of care to almost 700 people from the local community.
In considering this evidence, alongside the positive patient experiences of the team, the Trust has now put in place recurrent funding to this service for the Fermanagh area. By providing an expert level of acute care and treatment will ensure that where it is safe to do so, patients may remain at home and receive their care.
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23/09/2024: Green light for new Lisnaskea Health and Care Centre
DEPARTMENT OF HEALTH: 23 September 2024
Nesbitt gives green light for new Lisnaskea Health and Care Centre
Construction of the new health and care centre in Lisnaskea, Co Fermanagh, is set to commence within weeks having received final sign off from the Health Minister.
Once operational, the new hub will support a network of 16 GPs and provide services to around 30,000 people in the Lisnaskea and surrounding East Fermanagh area.
Minister Nesbitt said:
“I was delighted to confirm with the Lisnaskea practice team this morning that the necessary approvals are now in place for the development of the new health and care centre. This means the Western Health and Social Care Trust will now be able to move ahead with awarding the construction contract, allowing work to begin on site within weeks.”
“I appreciate that primary care services are under particular strain in the Lisnaskea and East Fermanagh area and recognise that people have been waiting for some time on this news. However, it was imperative that the necessary checks and balances were completed before proceeding.”
“This significant investment will provide a central hub in Lisnaskea, enabling patients and service users to benefit from improved accessibility and increased multi-disciplinary provision in areas such as; Podiatry, Speech & Language Therapy, Physiotherapy, Mental Health Services and Older People services.”
Minister Nesbitt added:
“There are significant pressures across our health and social care system, and while our primary care teams are at the frontline in facing this challenge, I was incredibly disappointed to learn of the completely unacceptable behaviour that the Lisnaskea practice team have recently experienced. There is no place for such behaviour, and I reiterated my full support for the team when speaking to them today. As Health Minister I remain committed to investing in primary care infrastructure to support the transformation of health and social care and help improve services for the population of Northern Ireland.”
Eimear McCauley, Western Trust Director of Finance, Contracts and Capital Development added:
“We welcome this project moving to construction as another step in providing an appropriate setting for the delivery of services in South East Fermanagh, both from opening of the new facility and for many years ahead. This milestone has been achieved through the collaborative working of GP representatives, Trust staff and DoH personnel with a focus on meeting the needs of patients and clients of Lisnaskea and the wider area.”
The Western Health and Social Care Trust will now move to award the new construction contract in the coming weeks. Planning permission for the facility has already been approved following the completion of the detailed design for the new building.
It is anticipated that the new health and care centre will open in 2026.
Notes:
- The capital cost of the project is estimated at around £32 million. A number of factors, including: adverse site conditions, construction price inflation, and new statutory requirements has led to the estimated cost of the project increasing beyond the original projection.
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16/09/2024: Western and Southern Trusts to Complete encompass Rollout across Northern Ireland
The Western and Southern Health and Social Care Trusts will make history on 8 May 2025, as they become the final two Health and Social Care (HSC) Trusts in Northern Ireland to Go-Live with encompass, the ground-breaking digital health and care system. This milestone marks the completion of a regional-wide digital transformation, ensuring that every citizen in Northern Ireland will have their own digital health and social care record.
encompass, which has been progressively implemented across Northern Ireland’s Trusts since November 2023, is a clinically and operationally led programme that will replace outdated paper records with real-time, up-to-date digital information accessible to all those involved in delivering care.
Both the Western and Southern Trusts have closely observed the earlier rollouts of encompass in the South Eastern Trust on 9 November 2023, Belfast Trust on 6 June 2024, as well as the preparations ahead of Northern Trust which are due to Go-Live on 7 November 2024. Western and Southern Trusts are learning from their experiences to ensure a smooth transition for their own staff and service users.
The successful rollout in these Trusts has demonstrated the system’s potential to enhance the delivery of health and social care services across Northern Ireland.
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12/09/2024: Update: Re-organisation of Older People Assessment and Liaison Service Trust wide and Re-profiling of Hospital at Home in the Northern Sector following Internal Consultation
As initially advised to Public Representatives in May 2024, please note the following update in respect of the conclusion of the internal consultation for the ‘Proposed Re-profiling of Hospital at Home in the Northern Sector and the Re-organisation of Older People Assessment and Liaison Service Trust wide’
The Western Trust Community and Older People’s Services Directorate has now concluded the internal consultation process regarding the re-organisation of the Older People Assessment and Liaison Service (OPALs) Trust wide. Following a comprehensive consideration of the competing service and corporate demands, the OPALs team staff have been re-deployed into roles within the Hospital at Home team and other suitable alternative posts during this week commencing Monday 9 September. The overall change is effective from Thursday 12 September 2024. All stakeholders, including NIAS and Primary Care colleagues, have been notified and advised to consider the alternative pathways provided for patients.
If you have any enquiries on this then please contact Public Affairs Manager, Chris Curran, as per contact details on the Public Representative’s Online Hub, where this and other Public Representative updates are provided:
If you have urgent enquiries during the weekend ahead you can contact Oliver Kelly, Head of Communications, on our out of hours number at 075 2589 7187.
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04/09/2024: Change to the Provision of Vascular Service on the Altnagelvin Hospital site
August 2024
Patients living in the Western Trust area who require Vascular Services will now receive this service in a different location. The current Vascular Service is being provided by visiting consultants from the Belfast Health and Social Care Trust as an outreach service. Whilst current patients under the care of vascular service attend the outpatient service at Altnagelvin Hospital, they are under the care of a Belfast Trust vascular consultant.
All existing patients and new patient referrals living in the Western Trust area will have their appointments and services delivered at Belfast Trust clinical facilities and this change will happen in the coming weeks.
It is anticipated that this change will improve access for Western Trust patients as access times for assessment and treatment will improve.
All new patients referred from Primary Care for vascular services and to those review patients currently maintained on an outpatient review waiting list will receive their service in this way.
The total number of patients currently on the waiting list or receiving treatment is 572 patients (391 review patients and 181 new patients)
The Western Trust is working with Belfast Trust to establish a virtual pathway for some patients to receive vascular services. This will enable a vascular clinical opinion for inpatient presentations at Western Trust clinical facilities. This will minimise the need for patients to attend their appointments in Belfast.
All 572 patients, will receive a letter from the Western Trust describing the change to the vascular service in early September 2024..
If you require any further information please contact Belfast Trust Public Liaison Service by telephone on 028 9504 5888 or via email publicliaison@belfasttrust.hscni.net or Chris / Oliver in the Corporate Communications Office.
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07/08/2024: Western Trust Reaffirms Commitment to Equality, Compassion, and Respect Amidst Growing Concerns Over Violence Against Ethnic Minorities
The Western Trust has expressed its deep concern over the recent violence against ethnic minorities across Northern Ireland and the UK. Western Trust Chief Executive, Neil Guckian (OBE) has emphasised the Trust’s steadfast commitment to the principles of equality, compassion, and respect for all.Mr Guckian said,
“Our Trust is founded on values of equality and respect, with compassion and collaboration at the heart of everything we do. As healthcare professionals and members of the community, it is our duty to stand firmly against any form of hatred or discrimination.”
The Trust recognises the invaluable contributions of its diverse workforce, particularly those from ethnic minority backgrounds.
Mr Guckian affirmed,“To our staff, especially those from ethnic minority backgrounds, I want to express our unwavering support. You are valued members of our team, and your safety, dignity, and well-being are paramount.”
The Trust is dedicated to ensuring that all staff members feel safe and respected in their workplace.
“No one should feel unsafe or unwelcome in their workplace or community. We are committed to fostering an environment where everyone is respected and protected.”
As part of ongoing engagement on the matter, Mr Guckian met on Wednesday with local MLAs and elected representatives to discuss the Trust’s commitment and actions, and for them to hear directly from staff about their concerns. Further visits from MLAs and local representatives to Omagh Hospital and Primary Care Complex and South West Acute Hospital were completed on Friday.
Mr Guckian continued:
“The Trust has a zero-tolerance policy towards racism and discrimination. Staff members are encouraged to report any behaviour that does not align with the Trust’s values, and we are reaching out to staff through our well established internal channels and offering support with transport and any other issues should they arise.”
“In these challenging times, we must reaffirm our commitment to diversity and inclusion, and stand together as one community.”
Mr Guckian urged.“Our community should be judged by how we support each other including those feeling the most vulnerable. I want to pay tribute to our staff for their continued dedication and for upholding the values that make the Trust a place of care and respect. I would also like to acknowledge our local representatives who stood with us today to reassure our staff that we are with them at all times. Finally I would like to our MLAs and local representatives, local agencies, namely the PSNI, Fermanagh and Omagh District Council, Derry City and Strabane District Council and our local community groups that are working tirelessly to support our staff, their families and the communities in which they live in.”
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July 2024
29/07/2024: Updated Briefing Statement regarding Western Trust plans to offer employment to nursing graduates 2024
The Western Trust is delighted that so many newly graduated student nurses have expressed a first preference interest to join our team. This is a very welcomed development to see such a high level of interest, which is significantly higher than in previous years. This certainly reflects the very positive experience, which students have highlighted during their placements within many service areas in the Trust and is testament to the excellent ongoing work by Trust staff across all service areas.
In considering the many enquiries which have been received by the Trust, it is very important to emphasise that our team have maintained a totally consistent approach each year in terms of dealing with the very welcomed demand for employment in the Western Trust. The process of allocation for graduate student nurses begins in June each year and we are currently in the early stages of the 2024 process, which will be ongoing for a number of months ahead.
Training and recruitment of graduate nurses are regional processes and there is never any guarantee given that everyone will be allocated their first preference. Recruitment is an ongoing process with the number of vacancies continually changing.
The Trust diligently manages its recruitment processes, so in addition to the stated vacancies, further posts will become available for graduates through annual turnover of staff throughout the year. Therefore, whilst the Western Trust currently has indicated 100 vacancies at Band 5 level, the total number of posts which will actually become available for graduate students in the months ahead will be greater.
Again, the Trust re-iterates that this stated position is all part of a process which transpires every year.
In considering the level of first preference interest by students in 2024, the Trust will continue to work with students to accommodate those first preferences wherever possible. The Trust will continue to work intensively to recruit as many students as is possible.
The development of further plans are underway outlining the recruitment of the graduate students into areas which can accommodate their skill-set. These proposals are currently being reviewed by the Trust’s Corporate Management team.
This follows our previous statement to Public Representative’s on 24 July 2024 (see below)
27/07/2024: Written Ministerial Statement – NI Cervical Screening Programme
Please note the following Written Minister’s Statement in respect of the NI Cervical Screening Programme
25/07/2024: Elective Care Centres helping to reduce waiting lists – Minister
DEPARTMENT OF HEALTH
Health Minister Mike Nesbitt has highlighted the role of Elective Care Centres in helping to reduce our lengthy waiting lists.
Dedicated capacity for elective surgery has been enhanced through continued development of these surgical hubs across Northern Ireland. A key benefit is that this planned surgery is less likely to be cancelled due to emergency pressures.
There are three Elective Overnight Stay Centres (EOSCs) at the Mater Hospital, Belfast, South West Acute Hospital (SWAH) in Enniskillen, and Daisy Hill Hospital In Newry, for intermediate complexity surgery that may require an overnight stay in hospital. Between April 2023 and March 2024, more than 12,000 patients have been treated across all three sites.
In addition, Day Procedure Centres (DPCs) are operational at Lisburn’s Lagan Valley and Omagh Hospitals, supporting a range of surgical specialities. From October 2020 to March 2024, approximately 20,000 patients were treated at the DPCs.
There are also Cataracts Centres at Downe (Downpatrick), South Tyrone (Dungannon) and Mid Ulster (Magherafelt) Hospitals, and an orthopaedic hub at Belfast’s Musgrave Park Hospital which includes the Duke of Connaught Unit, a dedicated orthopaedic Day Procedure Centre.
Health Minister Mike Nesbitt said:
“The latest waiting list statistics show a sustained and very welcome reduction in the number of patients waiting. This is the seventh quarter in a row where the treatment waiting lists have reduced – the longest sustained reduction since at least 2008.”
“Of course waiting lists are still unacceptably long, particularly in orthopaedics and gynaecology, however I am very encouraged to see a reduction which is partly due to the innovative, efficient and focused efforts of staff working in our Elective Care Centres across Northern Ireland, ensuring that patients have equitable access to the care they need, irrespective of where they live, and helping to deliver better outcomes for patients.”
The Minister was speaking during a visit today to the Elective Overnight Stay Centre at South West Acute Hospital. Elective general surgery, gynaecology, breast surgery, paediatric surgery and paediatric dental procedures are carried out at SWAH for long waiting patients from the region, with consultants visiting from other hospitals.
He said:
“SWAH is delivering more elective surgery than ever and I am delighted to see the excellent facilities here and to meet the talented and enthusiastic workforce. The EOSC is providing much needed services for our long waiting patients. I am grateful for the support and enthusiasm of everyone involved in this initiative.”
“I can clearly see the potential of SWAH and I do not doubt the valuable role it will play in driving down our waiting lists. I want to ensure that SWAH can fulfil its full potential and I will continue to engage with my Executive colleagues to secure the required funding to further develop our Elective Care Centre model.”
Neil Guckian, Chief Executive of Western Health and Social Care Trust, said:
“We are delighted to welcome Health Minister Mike Nesbitt on his first visit to the South West Acute Hospital to meet with key medical, nursing and social work staff. This is a wonderful opportunity to highlight the fantastic work of our staff and to showcase the first-class facilities at SWAH, in particular the EOSC which is providing high quality care to patients throughout Northern Ireland.”
24/07/2024: Statement following enquiries regarding Trust plans to offer employment to nursing graduates 2024.
The WHSCT has engaged with the other four Health and Social Care Trusts in the regional process to recruit the student nurses expecting to graduate from September 2024.
This process was administered by the BSO Regional Recruitment Team on behalf of the five HSC Trusts. Student nurses were invited to apply and register a first preference Trust.
The first preference choices were shared with the Trust on 14 June 2024 and the Trust Human Resources and Senior Nurses prepared for professional discussion style interviews that were held on 22 June 2024 in the WHSCT. Other Trusts have followed similar processes.
The Trust was delighted to receive a high volume of first preference choices.
A total of 221 candidates across all the specialities – Adult Nursing, Paediatric, Mental Health and Learning Disability participated in professional discussions which determined their rank on each respective waiting list.
Vacancy Position.
Band 5 registered nurse vacancies emerge throughout the year.
The Trust is familiar with the process that a large volume of students graduate in September each year and has managed the employment of the nurse graduates over a period of months in previous years.
At the end of June 2024 the Trust has 100 Band 5 nurse vacancies. These are a mixture of Hospital and Community across all fields of practice.
- 57 of these are located within the Northern Sector
- 43 of these are located within the Southern Sector
The Trust has confirmed 50 offers of employment at this time. A limiting factor in this process is that some students prefer to wait until a vacancy emerges in a clinical area that they prefer to start their career in.
Annual Turnover
The Trust is exploring the other demands for nursing workforce that occur through the year including annual turnover. Our data has highlighted that the Trust would experience a turnover of approximately 160-170 Band 5 nurses each year.
Contract Agency
The Trust has managed to sustain its position on stopping the use of off-contract agency nursing staff from July 2023. The focus is now on the level of contract agency nursing that the Trust is experiencing. We are exploring the opportunity of creating employment opportunities for new graduates in clinical areas that do not have a demand for specific skills, knowledge and expertise that newly qualified nurses would not be in a position to meet.
Children’s Nurses, Learning Disability Nurses and Midwives.
The WHSCT is in a position to offer employment to all Children’s, Learning Disability and Midwifery graduates who have expressed a first preference for the Trust.
This together with vacancies and anticipated turnover should allow the Trust to offer a significant proportion of the Mental Health nursing graduates employment.
Feedback from the students during the professional discussions highlighted that a percentage are interested in deferring the start date of taking up employment to December 2024 and January 2025. These choices helps the Trust prioritise the offers of employment to students wishing to take up employment soon after completing their course and allow for a small supply for vacancies that emerge later in the year.
16/07/2024: Whooping cough vaccine clinics in Western Trust for pregnant women as cases rise
The increase in PERTUSSIS ( Whooping cough) cases continues and PHA are seeing unprecedented numbers of notifications. Current levels of pertussis in circulation in the community increases the risk of serious illness in vulnerable infants and unvaccinated pregnant women. Between 1st January and 7th July 2024, there were 2322 laboratory-confirmed cases.
There is updated guidance to the national UKHSA public health guidance on the management of pertussis cases. The new guidance can be found on the gov.uk website: Guidance on the management of cases of pertussis (publishing.service.gov.uk)
The Western Trust have announced that the pertussis (whooping cough) vaccine is now available through Western Trust clinics in addition to GP practices, making the vaccine even more accessible to pregnant women.
Northern Ireland has continued to see a rise in whooping cough (pertussis) cases, a highly contagious and sometimes serious bacterial infection, which can make babies and young children in particular very ill. There have been 1,788 confirmed cases of whooping cough (pertussis) so far this year in Northern Ireland compared with just two between 2021 and 2023.
We are urging pregnant women to get the pertussis vaccine to help protect their newborn babies after a significant rise in cases of whooping cough. Young babies are at greatest risk of developing more serious disease, so it is very important that women take the offer of pertussis vaccine during each pregnancy so that their baby is protected against whooping cough after they are born.
Whooping cough is a disease that can cause long bouts of coughing and choking, which can make it hard to breathe. The evidence shows that babies born to vaccinated mothers are 90% less likely to get the disease than babies whose mothers were unvaccinated.
Women can have the vaccine from 16 weeks of pregnancy and ideally between 20 and 32 weeks of pregnancy, but the vaccine can be beneficial even if given later then 32 weeks. Whooping cough vaccines are now available through Western Trust clinics as well as at GP practices, speak to your midwife to find out more.
The Western Trust are hosting clinics at several venues throughout the summer, full vaccine clinic details are as follows:
CLINIC LOCATION MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY ALTNAGELVIN Level 5 Tower Block
9.00am – 4.30pm
ALTNAGELVIN Anderson House
9.00am – 4.00pm
9.00am – 1.00pm
1.00pm – 4.00pm
9.00am – 1.00pm
SHANTALLOW Health Centre
1.00pm – 4.00pm
1.00pm – 4.00pm
1.00pm – 4.00pm
1.00pm – 4.00pm
OMAGH Omagh Hospital & Primary Care Complex Outpatients
9.00am – 4.30pm
ENNISKILLEN South West Acute Hospital Key Workers Accommodation
9.00am – 4.30pm
The whooping cough vaccine is also given as part of the childhood vaccination programme to children at 8, 12 and 16 weeks of age and at aged 3 years 4 months. If you are unsure if your child is up to date with vaccinations, the easiest way to check is to look at your child’s red book or speak to your health visitor or GP practice.
Parents should be alert to the signs and symptoms of whooping cough, which include severe coughing fits accompanied by the characteristic ‘whoop’ sound in young children, and by a prolonged cough in older children or adults. It is also advisable to keep babies away from anyone showing the signs or symptoms of whooping cough.
Whooping cough can spread very easily. It is best to call your GP practice or GP Out of Hours service before you go in person. This will help to reduce it spreading to others. In an emergency, dial 999.
10/07/2024: Minister sets out series of key initiatives
Tackling health inequalities must be at the heart of health reform in Northern Ireland. That’s the message from Health Minister Mike Nesbitt today, as he announced a series of planned initiatives over the next six months.
These include:
- A ‘Live Better’ initiative on health inequalities, designed to bring targeted health support to communities which need it most.
This will seek to pull programmes together so that they can be delivered intensively in specific communities. It will cover areas such as: increasing uptake of health screening and vaccination; mental health and emotional well-being support; blood pressure and cholesterol checks; building health literacy; improving social connections; providing nutritional advice; and providing opportunities to be more physically active.
- A plan for hospital reconfiguration will be published for public consultation this summer. The paper, ‘Towards a Hospital Network’ will provide the basis for current and future reorganisation of hospital services.
- A three-year strategic plan for health and social care will be published in the autumn, covering the remainder of the current Assembly mandate.
- To help refocus and “reboot” health reform, Professor Rafael Bengoa will return to NI in the autumn for a keynote conference and a series of other engagements. An international health expert, Professor Bengoa chaired the panel that produced the 2016 “Systems not Structures” report on changing health and social care.
The Health Minister today stated:
“I am very pleased Professor Bengoa has accepted my invitation for a visit in the autumn. This is not about yet another review of our health service. It’s about helping us assess the important work already undertaken and underway and identifying the key strands of action now required. It is about finding the best ways to accelerate the process of change.”
“I believe Professor Bengoa will help reboot the public debate on health reform. Unfortunately, that debate has become increasingly distorted, with reform too often misconstrued as a cost cutting programme, or a plan to close hospitals. This is damaging the objective of genuine reform which is to deliver better outcomes.”
Mr Nesbitt continued:
“Addressing health inequalities must be at the heart of health reform and a priority across all parts of Government.”
“They are a symptom of the wider inequalities that exist in society. Research indicates that only about 20% of health outcomes are related to clinical care. Other crucial factors include economic disadvantage, environment, education and housing.”
“Based on data from England, it is estimated that health inequalities cost Northern Ireland up to £1.7 billion every year including health costs, lost productivity, economic inactivity, poor educational outcomes.”
“Above all, my concern is about the impact this has on people in our community.”
“To give one shocking example, how can it ever be acceptable that women in our most deprived communities can expect to live 14 fewer years in good health than those in the least deprived communities? A quarter of the way into the 21st Century, this is simply not acceptable in a first world country.”
The Health Minister has detailed his initiatives for health and social care in a Written Ministerial Statement to the Assembly.
The Ministerial Statement also provides an update on the Department of Health’s response to the Independent Review of Children’s Social Care Services in Northern Ireland.
The Department is today publishing a summary and analysis of the responses to the public consultation on this Review.
This will be followed in the autumn by publication of the Minister’s formal response to the Review’s recommendations.
The Minister will also be engaging with Executive colleagues on the Review’s recommendations that are cross-cutting and relate to the policy responsibilities of other Departments. These include recommendations relating to the establishment of a Children and Families Arm’s Length Body (ALB), the appointment of a Minister for Children and Families, the expansion of the Sure Start Programme and the Gillen Review of Civil and Family Justice.
02/07/2024: £3.1 million lost to health and social care due to people not attending their outpatient appointment last year in the Western Trust
Almost 18,500 outpatient appointments were wasted in the Western Health and Social Care Trust (Western Trust) last year due to patients/clients not turning up for their appointment. This is lost capacity and it impacts on the efficiency and productivity of the Western Trust’s Outpatient’s Service.
From 01 January 2023 to 31 December 2023 the total number of patients who did not attend their Consultant outpatient appointment, or failed to give staff sufficient notice to make the appointments available to other patients, in our hospitals across the Western Trust area was 18,498 . Each missed appointment costs the Trust £170, which equates to £3.1 million lost to our health and social care budget.
To help reduce non-attendance, the Trust has in place a system for booking outpatient appointments, where patients are given a choice of dates and times and they can select one that best suits them. Patients attending outpatient appointments across the Western Trust area receive a SMS text to their mobile phone or an automated voicecall to their landline, reminding them of their outpatient appointment three days prior to their appointment.
The Trust also has launched a programme of work to review ‘Did Not Attend’ (DNAs) appointments across six specialities areas in Urology; ENT; Orthopaedics; Diabetes; Nephrology and Neurology with the overall aim of reducing the DNA rate, patient on the day cancellations and ensuring patients are treated in a timely manner.
Paul Doherty, Operational Assistant, Directorate of Surgery, Paediatrics & Women’s Health said:
“We understand that there are many genuine reasons why people are not able to make an appointment however, as these figures show every missed appointment is a lost opportunity for someone else to be seen. The appointment slot is an actual time with a member of our clinical and nursing staff who are dedicated to patient care.”
“We are asking for the public’s cooperation in reducing non-attendance for hospital outpatient appointments so that valuable resources and staff time is not wasted, as this will have a significant impact on already overstretched health service.”
Paul continued:
“Where possible we would ask patients with an appointment to let the hospital know if they won’t be able to attend and to do this at the earliest opportunity and at least 24 hours beforehand.”
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June 2024
18/06/2024: Statement Brief re Autism and Learning Disability Services
In Learning Disability Services the Trust is not commissioned to provide day care provision for needs on the basis of autism alone but based on individuals with a learning disability. This would be similar to all Trusts in Northern Ireland. We understand that day care can be challenging for some of our service users particularly with more complex needs, however, we endeavour to make day provision environments as bespoke as possible with the input of our multi-disciplinary teams.
The Trust’s Adult Autism Service, is a service for those who do not access Intellectual Disability Services. The Adult Autism Service is not commissioned to meet the needs of individuals with significant co-morbidities due to the limited workforce. The Adult Autism Service is primarily resourced for diagnostic assessment and short term support and intervention. When an individual is assessed as requiring a support package based on substantial / critical need and risk, they are provided with same. This is mainly associated with day opportunity. There is also a resource for Cedar Contracts which promotes community access and social inclusion.
The Adult Autism Service recognises the increasing complexities and needs of those who have a diagnosis of Autism and is working closely with colleagues in the Department of Health on this issue.
18/06/2024: Update regarding Osteoporosis service at SWAH
This is an update on the Western Trust Osteoporosis service at South West Acute Hospital (SWAH), following the previous statement in respect of one specific clinic which was a Care of the Elderly clinic at SWAH.
The Fracture Liaison and Osteoporosis Service operates on a trust-wide basis and since 2013 has seen patients all across the Trust, including Fermanagh. The large majority of patients with osteoporosis in the Trust are seen under this service, which has seen a doubling of the number of clinics in the last 5 years.
Fracture Liaison Nurses working within the service continue to visit SWAH regularly, as they have done since 2013, to administer injections for osteoporosis to patients. The service screens and manages 1000s of patients per year across the Trust, and the number of patients seen and clinics operated has increased during this period, rather than decreased. GPs from Fermanagh have referred patients to the service for many years and can continue to do so. Some of these patients may be seen at Rheumatology Osteoporosis clinics.
A Care of the Elderly clinic in SWAH was also seeing a number of osteoporosis patients, administering a limited number of treatments, with just over 100 patients under review. This particular care of the elderly clinic had been temporarily stood down due to the clinician within that service reducing their working hours.
Not all osteoporosis treatments were available at the Care of the Elderly clinic in SWAH. Patients who attended this Care of the Elderly osteoporosis clinic will now be seen under the Trust’s Fracture Liaison and Osteoporosis Service, where a full range of up to date treatments is available. Many treatments can also be administered in the patient’s own town or village by the treatment room nurse in the Health Centre, in keeping with practice across the WHSCT and NI. Patients eligible for the newest anabolic injections, which had not previously been available at the Care of the Elderly Osteoporosis clinic, will be trained by the nurses to self-inject. This is in keeping with current HSC practice and protocols across the rest of Northern Ireland.
Fermanagh patients previously attending the Care of the Elderly Osteoporosis clinic in Enniskillen will therefore have access to a greater range of the most up to date treatments, in many cases administered closer to home, as a result of the reorganisation of services.
It should be understood that, despite reports in the media, no pain killing injections are administered at osteoporosis clinics, and never have been. This applies to both the Trust-wide service, the previous Enniskillen clinic and Osteoporosis Clinics in general in Northern Ireland. Tablets, infusions and injections for osteoporosis work only by increasing bone strength to reduce the risk of broken bones, and have no effect on pain. Pain is managed in Primary Care, at specialist Pain Clinics or, if related to new fractures, by the Orthopaedic service or Fracture Clinics. Claims that patients are in pain because of the reorganisation of osteoporosis services are therefore misleading and it is important to emphasise this point.
06/06/2024: Publication of FPS General Medical Services for Northern Ireland, Annual Statistics 2023/24
This Accredited Official Statistics report contains high level summary information on activity and payments in relation to General Practitioners (GPs), GP Practices and Registered Patients. Information is provided at NI level with further breakdowns presented at Local Commissioning Group (LCG), Local Government District (LGD) and GP Federation level. A number of UK comparisons are also included.
The publication is available on the Business Services Organisation’s website at: General Medical Services Statistics – Business Services Organisation (BSO) Website (hscni.net)
Key Points
The key points from the 2023/24 Report are:
General Medical Services
- There were 312 active GP practices in Northern Ireland at 31st March 2024. This is a reduction of 5 practices since 2023 and a reduction of 38 (11%) since 2014. As the number of practices has decreased and the total number of registered patients has increased, the average number of registered patients per practice has increased, by around one-fifth, from 5,500 to 6,586 in the same time period.
- At LCG (Health Trust) level, Western had the largest proportionate decrease in GP practices between 2014 and 2024 (18%). The smallest decrease in GP practices during this period is in the Southern LCG (7%).
- Despite the reduction in GP Practices, the number of GPs (excluding locums) has increased by 23% to 1,454 since 2014. Of these, six in ten (60%) are female, a notable shift in gender profile since 2014 when the majority (54%) were male. It is important to note that figures presented for GPs are headcount rather than full-time equivalent so take no account of differences in hours worked or changes to practitioner working patterns over time.
- There were 2,055,000 individuals registered with a GP practice at 31st March 2024. The LGD with the largest patient population was Belfast (439,000) while Lisburn and Castlereagh had the lowest number of registered patients (123,000).
- During the 2023/24 financial year, there were approximately 52,000 new (first time) patients registered to, and 41,000 patients transferred between, Northern Ireland GP Practices. The equivalent figures for 2022/23 were 54,000 new patients and 39,000 transfers.
- Of the new (first time) patients registered in Northern Ireland during 2023/24, approximately one quarter (26%) were non-UK nationals. This proportion of non-UK nationals ranged from over one third (35%) in the Belfast LGD to less than one fifth (17%) in Lisburn and Castlereagh.
- During 2023/24, BSO processed £347m of payments towards the overall cost of GP services in Northern Ireland. The average BSO payment processed per registered patient was £169, an increase of £6 per patient, or 4%, since 2022/2023 and over one-third (36%) more than in 2017/18 when the figure stood at £124.
- The overwhelming majority of registered patients (98%) live within 5 miles of a GP practice. In some of the more urban LGDs (Belfast, Antrim & Newtownabbey, Lisburn & Castlereagh and Ards & North Down), at least 92% of registered patients live within 3 miles of a GP practice.
- At UK level, Scotland has the highest number of GPs (headcount) per 100,000 registered population (75) followed by Northern Ireland (71). This compares to 62 GPs per 100,000 registered population in Wales and 57 in England. Again, this takes no account of any inter-country differences in working patterns.
Notes:
- This is the fifth year that General Medical Services Statistics for Northern Ireland has been released as a standalone report. This information was previously included as part of the FPS compendiums published in 2017/18 and 2018/19. This report was produced by the Health and Social Care’s Business Services Organisation (BSO) which was specified as an Official Statistics producer body under the Official Statistics Order (Northern Ireland) 2012. It provides the definitive source of figures on BSO FPS General Medical Services activity and finalises the provisional quarterly figures which have been released over the course of 2023/24.
- These official statistics were independently reviewed by the Office for Statistics Regulation (OSR) in May 2022. They comply with the standards of trustworthiness, quality and value in the Code of Practice for Statistics and should be labelled ‘accredited official statistics’. All accredited official statistics should comply with all aspects of the Code of Practice for Statistics. The OSR considers whether the statistics meet the highest standards of Code compliance, including the value they add to public decisions and debate. These statistics were considered as part of a wider assessment of the BSO Family Practitioner Services statistics.
- Family Practitioner Services (FPS) is responsible for annual payments to primary care contractors including GP Practices, Dentists, Opticians and Community Pharmacists on behalf of the Strategic Planning and Performance Group of the Department of Health.
- Primary care statistics on the number of General Practitioners are taken from lists of performers registered to provide these services. The lists maintained by BSO provide a headcount rather than full-time equivalent figures so take no account of differences in hours worked or changes to practitioner working patterns over time.
- GP Practice characteristics vary in terms of Full Time Equivalent (FTE) number of GPs assigned to a practice, number of sites a practice operates from, and number of patients registered to a practice. In cases where a GP Practice is split over more than one site it is only counted as one practice and data presented including average patient counts per practice and distance to nearest practice are based on the Primary Practice. Figures presented are as at 31st March and include only those practices which will be open on 1st April.
- GP Registered Patient counts by Local Commissioning Group (Health Trust), Local Government District and GP Federation are based on the location of the practice the patient is registered to as opposed to the patient’s home address. There are differences between the figures for GP Registered Patients and residential population. At March 2022, the number of individuals on the index of registered patients was almost 6% higher than the 2022 Northern Ireland mid-year population estimate. This discrepancy can arise from a number of factors, for example, time lags in removing patients from GP lists following death or emigration, Cross Border Workers registered with a Northern Ireland GP etc.
- BSO Payment towards GP Services presented in this report refers to the payments that BSO has processed on behalf of the Department of Health Strategic Planning and Performance Group towards the overall cost of GP Services in Northern Ireland. It is important to note that, unless otherwise stated, figures relate to the year in which a payment claim was processed by BSO and this may not necessarily coincide with when the actual activity took place (i.e. some claims from a previous year may be processed in the current year whilst, conversely, some claims relating to activity in the current year may not be processed until a later year).
- Whilst a number of UK comparisons have been included in the report, there can be important differences in how services are delivered between countries that can impact on the figures. The relative size of the private sector in the delivery of primary care services within each country will be a particularly important factor in this regard, as will hours worked, so care needs to be taken when interpreting any inter-country differences in HSC activity levels.
- The report itself presents high level summary information in a web-based format with chart data easily downloadable. Further detailed data tables are consigned to the accompanying Excel appendices. The figures are prepared and released by independent NISRA statisticians working within BSO’s FPS Information Unit.
- Quarterly updates for 2024/25, for key report tables, will be released on a provisional basis on the FPS section of the BSO website: General Medical Services Statistics – Business Services Organisation (BSO) Website (hscni.net). These will be added to the historic quarterly series. The timetable for the release of the quarterly updates will also be published on the BSO website and all publications, both quarterly and annual, will be formally announced on the GOV.UK release calendar https://www.gov.uk/government/statistics/announcements
- Electronic copies of the Bulletin and associated Excel tables are available free of charge from: General Medical Services Statistics – Business Services Organisation (BSO) Website (hscni.net)
Accredited Official Statistics
These are Accredited Official Statistics and therefore comply with the standards of trustworthiness, quality and value in the Code of Practice for Statistics. Accredited official statistics are called National Statistics in the Statistics and Registration Service Act 2007.
05/06/2024: Industrial Action Junior Doctors 6 & 7 June 2024
We are expecting disruption to our services as a result of planned industrial action by junior doctors from 7.00am on Thursday 6 June to 7.00am on Saturday 8 June 2024.
Our focus will be maintaining safe services for our acutely unwell patients within our hospitals and inpatient facilities.
Our message to patients and service users is that they should attend all scheduled appointments unless contacted by the Trust to advise otherwise.
If you require urgent medical or mental health help during the duration of the strike action, then you should attend the Emergency Department or call 999. Please be aware that it may be busier and you may have to wait longer. Patients will be triaged and seen in order of clinical priority.
To help us to cope with the expected impacts of the industrial action we strongly encourage those with an urgent or minor matter, which is not life-threatening, to use the Phone First service. Please call 0300 020 6000 (8.00am to midnight). Alternatively, please consider other healthcare options, such as your GP, GP out-of-hours or our Urgent Care and Treatment Centre.
Postponed services:
- 1,312 Outpatient appointments
95 inpatient / Day case procedures
04/06/2024: Latest Public Representative Update E-Brief
Dear MLA,
Please note on the PDF link below the latest Public Representative E-Brief for MLA, including today’s statement and information on the upcoming Junior Doctor’s Industrial Action – link below.
CLICK HERE to view the Public Representative’s EBrief June 2024
04/06/2024: Junior Doctor Industrial Action on 6 & 7 June 2024
Junior doctors across Northern Ireland are taking part in industrial action from 7am on Thursday 6th June for 48 hours, until 7am on Saturday 8th June.
The Western Trust are currently proceeding with our industrial action command and control and business continuity arrangements to support affected services with their response to the expected disruption at our acute, community and mental health hospitals, where junior doctors provide services. We are committed to patient safety during the industrial action period and a protocol has been agreed to support in-patient and clinically critical services.
It is anticipated that there will be significant disruption and a number of procedures and appointments will be postponed across our hospital sites. Any patients affected by the industrial action will be contacted directly and an alternative date will be arranged in due course. All patients with scheduled hospital appointments should attend for their appointment unless they have been directly contacted to advise it has been rescheduled.
We are working with senior staff to ensure emergency in-hours and out of hours cover is maintained for patient safety. Emergency care will be provided by senior doctors (consultants) and speciality doctors during this time. All admissions and calls will be routed via our hospital switchboards as normal during industrial action.
Dr Brendan Lavery
Medical Director
04/06/2024: Dept of Health Statement on industrial action
Further disruption to health services will be experienced this week, due to the latest strike action called by the BMA Junior Doctors’ Committee
This will run from 7am on Thursday 06 June to 7am on Saturday 08 June.
Patients are advised to expect widespread disruption to normal services.
Health & Social Care (HSC) Trust websites will provide more information later this week on affected service areas.
When the ballot for this industrial action was launched, junior doctors, like the rest of Northern Ireland’s health service staff, had received no pay award for 2023/24.
This is no longer the case. A backdated 2023/24 pay award for junior doctors will be paid this month, with its terms in line with the recommendations of the national pay review body, the DDRB.
This pay award involves an average pay increase of 9.07% for junior doctors in Northern Ireland, with those in their first year receiving a 10.68% uplift.
04/06/2024: Care of the Elderly Clinic in SWAH
Two clinics, which sit under the care of the elderly umbrella of services in the South West Acute Hospital have been temporarily stood down due to the clinician within that service reducing their working hours. The clinic details are as follows:
- Osteoporosis Clinic, held one session per week, in SWAH.
- Parkinson’s Clinic (which also includes Movement Disorder), held one session per week, in SWAH.
While the Trust has not issued any public comment on this, the service is actively working on alternative measures to limit any possible impact at this time. This will include communication with patients and GP Practices in the coming weeks.
03/06/2024: STATEMENT FROM THE CHAIRS OF HSC TRUSTS
STATEMENT FROM THE CHAIRS OF HSC TRUSTS
As health and social care leaders, we are deeply concerned at the financial outlook for the frontline services which our organisations deliver.
We have no wish to be involved in political controversy and are very mindful of the growing budgetary pressures on all parts of the public sector.
Our focus has to be on everyone in Northern Ireland who needs the health and social care services that our organisations provide.
It is our duty to warn of the very real potential for avoidable and serious harm being caused to people in our community who require our help, as a result of inadequate budgetary provision.
HSC Trusts have, of course, an onerous responsibility to make efficient use of all public resources. Intensive efforts are ongoing to deliver a significant level of savings this year, as detailed in the financial assessment published on 28/05/2024 by the Department of Health.
As this document makes clear, even with these savings, a projected very significant shortfall remains that could only be filled by measures with high and catastrophic impacts.
Such cutbacks would inevitably include bed closures as well as reductions in outpatient care, operating lists, domiciliary care and nursing care packages. This would impact damagingly on the whole community in Northern Ireland, particularly the most vulnerable.
We are keenly aware of the need to reform services and invest in new technology. We know too that health drives our economy and contributes on numerous levels to well-being in society.
The reality is that without significant additional funding this year and longer-term financial security, the Health Service will be further destabilised and the public will bear the brunt.
We have a collective responsibility as leaders to highlight these concerns, on behalf of our dedicated workforce and all those who rely on the vital services our organisations provide.
We will continue to work constructively with staff, elected representatives and other stakeholders to pursue the best outcomes for patients and service users.
Health and social care services have endured a prolonged period of instability and pressure. The escalating budgetary situation represents another destabilising factor.
Chair Jonathan Patton SEHSCT
Anne O’Reilly NHSCT
Ciaran Mulgrew BHSCT
Eileen Mullan SHSCT
Tom Frawley WHSCT
Michele Larmour NIAS
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May 2024
30/05/2024: Publication of the Quarterly Northern Ireland Outpatient, Inpatient And Day Case, and Diagnostic Waiting Times Statistics
DEPARTMENT OF HEALTH – Position on 31 March 2024
The Department of Health today published the quarterly Northern Ireland Outpatient, Inpatient and Day Case, and Diagnostic Waiting Times Statistics, relating to the position on 31 March 2024.
The Waiting Times Statistics releases provide detailed information on the number of people waiting for a first consultant-led outpatient appointment, inpatient/day case treatment or a diagnostic test at hospitals in Northern Ireland.
On 9th November 2023 the South Eastern Health and Social Care (HSC) Trust launched “Encompass” – a new electronic patient record system. Its roll out across the other Trusts will follow on a phased basis throughout 2024/25. Consequently, the data for South Eastern as at 31 March 2024 was not available at the time of this publication, as the Trust transitions to completely digitised health records. Therefore, charts and figures presented throughout this report have excluded patients waiting for an admission to or appointment in the South Eastern Trust to allow comparisons to be made for the four remaining HSC Trusts compared with previous time points. As such, any NI level figures presented throughout this report only include those for Belfast, Northern, Southern and Western HSC Trusts.
Waiting Times for a First Outpatient Appointment
- Figures in this section exclude the South Eastern Trust as data was not available for the position as at 31 March 2024.
- The draft 2023/24 target relating to outpatient waiting times states that by March 2024, at least 50% of patients should wait no longer than nine weeks for a first outpatient appointment, with no patient waiting longer than 52 weeks.
- 356,229 patients were waiting for a first consultant-led outpatient appointment at hospitals in the Belfast, Northern, Southern and Western HSC Trusts on 31 March 2024, 4.2% (14,319) more than on 31 December 2023 (341,910), and 12.9% (40,673) more than on 31 March 2023 (315,556).
- The median waiting time was 51.3 weeks and the 95th percentile waiting time was 262.6 weeks.
22/05/2024: Northern Ireland Health and Social Care Active Recruitment Statistics & Northern Ireland Health and Social Care Workforce Statistics March 2024
DEPARTMENT OF HEALTH
The Department of Health today released details of Northern Ireland Health and Social Care (HSC) vacancies actively being recruited and HSC staff in post as at 31 March 2024.
These statistical publications present analysis of active recruitment vacancies and active staff in post by staff group and HSC organisation, and includes trend information.
The Northern Ireland HSC Workforce publication covers the majority of HSC hospital, community and social services workforce. Bank/sessional staff are excluded, as are members of staff on career breaks, Chairpersons/Members of Boards and those recorded with less than 0.03 WTE. Domiciliary care staff have also been excluded, as their recorded whole-time equivalent currently does not reflect their contribution to the service.
The Northern Ireland HSC Active Recruitment Statistics publication covers any position that is currently with the recruitment team and being actively recruited to, including those going through pre-employment checks, up to the point of a start date being agreed.
Key Points
- At 31 March 2024, the HSC workforce stood at 65,984 whole-time equivalent (WTE) (excluding staff on career breaks, bank staff, Domiciliary Care workers, staff with a WTE of less than 0.03, Chairs/Members of Boards and Out of Hours GPs). This represented an increase of 2.0% (1,296 WTE) from 31 March 2023, and a 13.3% increase (7,738 WTE) since 31 March 2019.
- Just over a quarter of the HSC workforce at 31 March 2024 was in the Registered Nursing & Midwifery staff group (17,746 WTE, 26.9%). This staff group reported an increase of 2.2% (384 WTE) from 31st March 2023, and an increase of 16.0% (2,443 WTE) since 31 March 2019.
- The Belfast HSC Trust had the largest workforce, with 19,047 WTE at 31 March 2024. This level is 1.3% higher than 31 March 2023, and 5.9% higher than 31 March 2019. All regional HSC Trusts reported an increase in WTE staff since 31 March 2019.
- At 31 March 2024, the leaving rate of HSC staff was 7.7% during the prior year. This is a decrease from the rate of 8.4% reported in 2023. The joining rate of HSC staff at 31 March 2024 was 9.3%. This is an increase from the rate of 8.8% reported in 2023.
- At 31 March 2024, there were 5,380 vacancies actively being recruited across HSC in Northern Ireland. This equated to an active recruitment vacancy rate of 6.4%.
- The total number of vacancies under active recruitment at 31 March 2024 (5,380) is 27.2% lower than at 31 March 2023 (7,392) and 24.1% lower than at 31 March 2019 (7,091).
- At 31 March 2024, the Social Services staff group made up the highest proportion of all vacancies actively being recruited, at 25.7% (1,381 vacancies). The second highest proportion of vacancies was in the Registered Nursing & Midwifery staff group, at 21.0% (1,129 vacancies), and a further 8.6% (465 vacancies) were in the Nursing & Midwifery Support staff group.
- The Belfast HSC Trust had the highest number of vacancies actively being recruited at 31 March 2024 (1,536). All regional HSC Trusts reported a decrease in vacancies between 31 March 2023 and 31st March 2024, with the largest annual percentage decrease in the Northern HSC Trust (42.8%), followed by Western (32.5%), Belfast (25.0%), Southern (21.6%), and South Eastern (18.8%) HSC Trusts.
17/05/2024: Department of Health Statement on industrial action
DEPARTMENT OF HEALTH
The Department of Health has advised patients that the health service will experience widespread disruption next week due to industrial action.
A two-day strike has been called by the BMA Junior Doctors Committee from 7am on Wednesday 22 May to 7am on Friday 24 May.
HSC Trusts will work to mitigate the impact as much as possible and will publish more information next week on affected service areas. Significant disruption is expected not only on the two strike days but over following days.
The Department stands ready to continue discussions with the Junior Doctors Committee and does not accept that talks have “collapsed”. There are important issues of substance to be progressed, including reform of the current junior doctor contract in NI. The Department has offered a process of independent arbitration, but this has not been taken up to date.
When the ballot for industrial action was launched, junior doctors – like the rest of the NI health service staff – had received no pay award for 2023/24.
That is no longer the case. The 2023/24 recommendations of the national pay review body, the DDRB, have now been implemented in NI. The award will be paid in the June pay run, landing in pay packets next month.
For junior doctors in Northern Ireland, it will bring an average pay increase of 9.07%, with those in their first year receiving a 10.68% uplift.
The Department cannot resolve the BMA demand for pay restoration – for a pay settlement that reverses public sector pay limits over the past decade and more.
That’s an issue that has impacted public sector employees across the UK as a result of UK Government policy. It is a national issue that cannot be resolved locally.
Note:
- Junior doctors in England have a different contract, which involves a higher basic pay rate than in NI but lower additional payments such as banding allowances. Comparisons between junior doctor basic pay across the two jurisdictions do not therefore provide the full picture.
- The vast majority of our junior doctors work on rotas which attract an additional 50% of their basic pay, while a significant number have higher banding allowances. Taken as an average, foundation doctors will earn an additional 58% of their basic pay each year, and junior doctors as a whole will earn on average an additional 53% of their basic pay.
- The average total salary of a Foundation doctor in NI during 2023, and before the 2023/24 pay uplifts were applied, was £45,777.
- The average total salary of junior doctors as a cohort in NI during 2023, and before the 2023/24 pay uplifts were applied, was £62,423
17/05/2024: Junior Doctor Industrial Action 22 and 23 May
Junior doctors across Northern Ireland are taking part in industrial action from 7am on Wednesday 22 May for 48 hours, until 7am on Friday 24 May.
We are currently proceeding with our industrial action command and control and business continuity arrangements to support affected services with their response to the expected disruption at our acute, community and mental health hospitals, where junior doctors provide services. We are committed to patient safety during the industrial action period and a protocol has been agreed to support in-patient and clinically critical services.
It is anticipated that there will be significant disruption and a number of procedures and appointments will be postponed across our hospital sites. Any patients affected by the industrial action will be contacted directly and an alternative date will be arranged in due course.
All patients with scheduled hospital appointments should attend for their appointment unless they have been directly contacted to advise it has been rescheduled.
We are working with senior staff to ensure emergency in-hours and out of hours cover is maintained for patient safety. Emergency care will be provided by senior doctors (consultants) and speciality doctors during this time. All admissions and calls will be routed via our hospital switchboards as normal during industrial action.
Dr Brendan Lavery
Medical Director
16/05/2024: Hospital car parking update
DEPARTMENT OF HEALTH
Normal arrangements for hospital car parking charges will resume from Friday 17 May.
The Department is aware that patients and visitors at some hospital sites have experienced congestion and delays, as a result of free parking this week. We apologise for any inconvenience caused during this period.
New legislation will be in place from tomorrow which reinstates hospital car parking charges until 2026. This will allow the Department of Health and Trusts the necessary time to implement a traffic management system to control parking, preserve blue light routes and protect designated routes to facilitate free car parking across NI’s hospital sites.
It was originally anticipated that the traffic management system would be in place by now, however unforeseen delays in the procurement process and subsequent legal challenges meant this was unfortunately not possible.
Car parking permits for eligible healthcare staff will be provided free of charge throughout the two-year deferral period.
Note: The Department is announcing the resumption of charges, having received official confirmation that Royal Assent for the deferral legislation takes effect from 00:01 on Friday 17 May.
10/05/2024: Western Trust Human Milk Bank Service makes a fresh appeal for more donor mums to help provide lifesaving breast milk to premature and sick babies across Ireland!
The Western Trust’s Human Milk Bank service based at the South West Acute Hospital, Enniskillen is making a fresh appeal for more donor mums to come forward and help to provide essential lifesaving donor breast milk for babies in Neonatal Units in hospitals throughout the whole of Ireland.
Susan Rogers, Lead Nurse for Public Health at the Western Trust expressed her thanks to all our Human Milk Bank donors for their support. She said:
“We are indebted to our donor mums who have continued to provide essential donor breast milk for babies in neonatal and surgical units in hospitals throughout the whole of Ireland. The Human Milk Bank staff are working very hard to ensure this vital service remains available to all our vulnerable premature and surgical babies as the demand for donor expressed breast milk at this time is exceptionally high.”
Susan said:
“We are continuing to experience a high demand for human milk. Last year the Human Milk Bank provided 973 litres of donor breast milk to 31 units across 27 hospitals throughout Ireland. This precious lifesaving donor milk has helped 773 premature babies, of which 233 were either a twin or a triplet. Breast milk gives premature and sick babies the best possible start in life as it helps build their immune system, their eye and brain development and prevent Necrotising Enterocolitis (NEC), which is a devastating intestinal disease affecting premature or low birth weight babies. We have been very busy processing requests for donor milk to neonatal units across the province and in the Republic of Ireland over the past number of months. It is essential that we recruit donors on a continual basis. I would appeal to expectant mums to consider becoming a donor and for our donor mums to spread the word about the Human Milk Bank as this is the best way to help us recruit new mums! We are also extremely grateful for the support of the Voluntary Blood Bikers, who continue to help support the transport our much needed donor breast milk in all weather conditions.”
Susan continued:
“We have so many wonderful donor mums who kindly help us raise awareness of our Human Milk Bank service that also share their gift of donor milk on our social media channels. This helps us to spread the word to expectant mums throughout Ireland to keep in mind the need for donor mums to come forward to keep this vital service going.”
“If you would like to find out more about the Human Milk Bank and becoming a donor please contact the Human Milk Bank on Tel: (028) 6862 8333 or email tmb.swah@westerntrust.hscni.net. Thank you for your continued support.”
08/05/2024: Hospital car parking service information
Department of Health
Patients, visitors and staff are being warned of possible disruption at hospital sites from next week and are advised to leave extra time to get to appointments or when accessing hospital sites.
Free hospital parking provision had been passed by the Assembly in 2022, with car parking charges due to end on 12 May 2024.
However, it was subsequently agreed by the Executive last month that the planned introduction of free parking should be deferred for two years to allow for the necessary infrastructure to be implemented at hospital sites.
The legislation deferring this measure will not be in place by 12 May 2024, meaning there will be a limited period when car parking charges will not be in force.
The process of securing the two-year deferral legislation has required a series of stages including Executive discussion and agreement; scheduling of Assembly time for debate and votes; four separate Assembly readings of the legislation; granting of Royal Assent for the legislation. The fourth and final reading in the Assembly was on 7 May and the Department remains hopeful that the Royal Assent process will conclude over the following weeks meaning the required legislation should be in place by the end of May.
There are concerns that an increase in demand for parking during this limited free of charge period could lead to congestion at some hospital sites, potentially contributing to delayed or missed hospital appointments.
In order to minimise disruption and protect car parking capacity for those most in need, we are asking for cooperation and understanding from all car parking users.
- Patients and visitors are advised to allow extra time to get to appointments.
- Consideration should also be given to alternative travel arrangements, including the use of public transport if possible.
- Staff are also being asked to maintain their normal parking arrangements in order to maintain capacity in hospital car parks for patients and their visitors.
- To protect access to hospitals for legitimate users, there should be no unauthorised use of hospital car parking by the public.
Trusts are working to minimise the level of disruption and we apologise for any inconvenience caused and appreciate your patience.
The Department of Health and Trusts are currently working to implement a traffic management system to control parking, preserve blue light routes and protect designated routes to facilitate free car parking from May 2026.
It was originally anticipated that the traffic management system would be in place by now, however unforeseen delays in the procurement process and subsequent legal challenges meant this was unfortunately not possible.
Car parking permits for eligible healthcare staff will be provided free of charge throughout the two-year deferral period.
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April 2024
25/04/2024: RE-ISSUE: Emergency Care Waiting Time Statistics (January – March 2024)
DEPARTMENT OF HEALTH
The Department of Health (DoH) today published statistics on the time spent in emergency care departments (ED) throughout Northern Ireland during the months of January, February, and March 2024.
The statistical bulletin presents information on all new and unplanned review attendances during January, February, and March 2024. It details information on the time spent in EDs during each of these months including; the monthly performance against the DoH emergency care waiting times target for EDs and the time waited for key milestones during a patient’s journey through ED, whilst they are being cared for in an ED, including the time to triage and time to start of treatment.
Urgent and emergency care data for clinical care episodes completed on or after 9 November 2023 in South Eastern Health and Social Care (HSC) Trust are still being developed following the Trust’s transition to completely digitised health records. Therefore, South Eastern HSC Trust data has been excluded from all analysis in this report to allow for comparisons to be made with the four remaining HSC Trusts at previous time points. As such, all Department Type and Northern Ireland level figures presented throughout this report only include those for Belfast, Northern, Southern and Western Health and Social Care Trusts. In the interim, some provisional figures have been produced for South Eastern HSC Trust covering only the current quarter January – March 2024. These are considered to be ‘official statistics in development’. Caution must be exercised when using these figures as they may be subject to change and should not be used to make comparisons over time.
Please note that this statistical release includes information on two new urgent care services (i) PhoneFirst and (ii) Urgent Care Centres, which were introduced in late 2020, to assess patients’ needs before arrival at an ED, and ensure they receive the right care, at the right time, and in the right place, outside ED if appropriate. These new services may in part help explain the reduction in the number of patients attending EDs.
This information release is published on the Emergency Care Waiting Times Website.
Key Points
Attendances at Emergency Care Departments:
Urgent and Emergency Care Attendances:
- In March 2024, 12,910 calls / attendances were received by PhoneFirst and Urgent Care Centre services, from patients who may previously have attended an ED. A total of 2,171 (16.8%) resulted in an attendance at an ED, whilst 10,739 patients did not go on to attend an ED.
- During March 2024, 52,931 patients in total attended an ED, and 10,739 attended PhoneFirst / Urgent Care Centre services without further referral to an ED; a total of 63,670 patients attended all urgent and emergency care services.
Emergency Care Attendances:
- During March 2024, there were 52,931 attendances at EDs in Northern Ireland, 307 (0.6%) less than in March 2023 (53,238).
- Of the 52,931 ED attendances during March 2024, 47,763 (90.2%) had attended a Type 1 ED, 834 (1.6%) attended a Type 2 ED and 4,334 (8.2%) attended a Type 3 ED.
- Between March 2023 and March 2024, attendances decreased at Type 1 EDs (672, 1.4%), and increased at Type 2 EDs (151, 22.1%) and Type 3 EDs (214, 5.2%).
- There were 150,382 attendances at EDs during the quarter ending 31 March 2024 (January, February, March), 2.5% (3,624) more than during the same quarter in 2023 (146,758).
Left before Treatment Complete:
- During March 2024, 9.0% of all ED attendances left before their treatment was complete, compared with 8.0% in March 2023.
Unplanned Re-Attendances within 7 Days:
- During March 2024, 3.8% of the 52,931 ED attendances were unplanned review attendances who had returned to the same ED within 7 days of their original attendance for the same condition.
Referrals by GP:
- During March 2024, almost one in five (18.9%) attendances at EDs had been referred by a GP, compared with 19.8% in March 2023.
Time Spent in Emergency Care Departments:
Performance against Targets
- Almost two fifths (38.1%) of attendances at Type 1 EDs in March 2024 spent less than 4 hours in ED, compared with 78.3% at Type 2 EDs and 98.8% at Type 3 EDs.
- During the quarter ending 31 March 2024 (January, February, March), less than half (42.7%) of patients spent less than 4 hours at an ED, less than in the same quarter in 2023 (47.2%).
- Over three quarters (78.3%) of patients attending a Type 2 ED in March 2024 were treated and discharged, or admitted within 4 hours of their arrival, compared with 76.0% in March 2023.
- Almost all (98.8%) patients attending a Type 3 ED in March 2024 were treated and discharged, or admitted within 4 hours of their arrival, a decrease from 99.0% in March 2023.
- Between March 2023 and March 2024, the number waiting over 12 hours increased from 8,730 to 9,443, accounting for 17.8% of attendances in March 2024.
Time to Triage:
- During March 2024, the median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 13 minutes, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 1 hour 14 minutes of arrival.
Time to Start of Treatment:
- During March 2024, the median waiting time from triage to the start of treatment by a medical professional was 1 hour 33 minutes, with 95 percent of patients receiving treatment within 8 hours 15 minutes of being triaged.
- Almost three fifths (57.3%) of patients attending EDs in March 2024 commenced their treatment within 2 hours of being triaged, more than in March 2023 (57.0%).
Total Time in Emergency Care Department:
- The median time patients who were discharged home (not admitted) spent in a Type 1 ED was 4 hours 29 minutes in March 2024, 13 minutes more than the time taken during the same month last year (4 hours 16 minutes).
- The median time patients who were admitted to hospital spent in a Type 1 ED was 15 hours 11 minutes in March 2024, 59 minutes more than the same month last year (14 hours 12 minutes).
- During March 2024, Craigavon Area reported the longest median time spent in ED from arrival to admission (20 hours 23 minutes), whilst the RBHSC reported the shortest time (5 hours 58 minutes)
24/04/2024: Update: Cytology/Cervical Screening in the Western Trust
It is essential that women keep coming forward for their cervical smear test when invited to do so. This will continue to save lives.
The Cervical Screening Programme:
The Cervical screening programme does not diagnose cancer. The purpose of a smear test is to identify changes to the cervix which may lead to cancer. These are then investigated and treated if necessary. Please note that the chance of pre-cancerous changes in the cervix at any time remains low and 9 in 10 people have a negative screening result.
Cervical screening looks at healthy women who do not have symptoms of cancer and aims to identify any pre-cancerous changes in their cervix so that further investigations can be arranged. Women are invited every three years between the ages of 25 and 49, and every five years up to the age of 65.
“A cancer could also develop between screening tests, or there is a small chance that the test misses some changes to your cervix. No matter what age you are, if you are concerned about symptoms such as abnormal bleeding, or pain or discomfort in the lower pelvis, you should seek advice from your GP, even if you attend regularly for screening.”
In 2022/23 the Western Trust reported almost 20,500 samples as part of the Northern Ireland Cervical Screening Programme and has full confidence in its screening programme and procedures.
The public should be reassured that quality control and quality assurances systems are in place in the Trust and we undergo both formal quality assurance visits and data visits by the Public Health Agency to ensure the Trust is meeting the standards set – which the Trust has done and continues to do.
The WHSCT record any cervical screening process issues through multidisciplinary discussions at the monthly colposcopy review in line with the Northern Ireland framework for the Audit of Invasive Cervical Cancers and Disclosure of Findings (PHA 2019).
As detailed in the framework such issues include: False negative cases or minor process or management shortcomings, but considered to be within the limitations of the screening programme or false negative cases or minor process or management shortcomings, that constitute a patient safety incident.
Any identified patient safety incident is taken through the appropriate SAI process. Between 2017– 2023 there have been 12 SAIs registered to date by the Western Trust in relation to cervical screening. These SAIs were for individual patients and the SAI process is followed in line with the Framework and patients are offered the opportunity to be involved in the process and informed of the review outcome.
Whilst the Western Trust has had a higher number of Cytology SAIs than other Trusts, our recent unannounced inspection by UKAS stated the review of serious incidents reported showed due diligence by the laboratory in both reporting (reading of smears) and record keeping. The laboratory are reporting SAI’s at a higher threshold than the approved guidance, stating that ‘this should be commended’.
The inspection team reported, “From the information reviewed and discussions held, there was no evidence of persistent poor performance. There was confirmation within SAI reports that screening performance data had been reviewed and was not a contributory factor in any of the 12 SAIs recorded. There was verification that this had been confirmed by PHA”.
Following this inspection, UKAS accreditation was maintained by the Western Trust. The Trust has also undergone a routine inspection in February 2024 of this year with accreditation also maintained.
As part of quality assurance checks the Western Trust, in conjunction with the PHA, asked colleagues at a screening laboratory in Wales to carry out a peer review on the 12 SAIs reported. The purpose of this is to inform whether these are ‘true’ SAIs or if there has been some over-categorisation. This does not represent part of any wider review.
Overall, there is a high level of concordance within this review. This information has now been shared with the PHA.
We would ask Public Representatives to help continue to emphasise this very important message with the Western Trust – It is essential that women keep coming forward for their cervical smear test when invited to do so. This will continue to save lives.
12/04/2024: MLAs visit Altnagelvin Hospital Stroke Unit
The Western Trust welcomed MLA/MPs, and members of the Stroke Association, to our Stroke Unit in Altnagelvin Hospital on Friday 12 April as part of a walk-around and updated them on the work being done. Below are some of the key points to highlight in respect of the Stroke Unit and to note we will be arranging a similar MLA/MP Visit/Walkaround to the SWAH Unit as part of the All Party Visit in the months ahead. An invitation and further details will be sent in advance of that.
- The National Guidelines for Stroke has had updated guidance from 2023
- The NICE Stroke Rehabilitation Guidelines for Adults published 2023.
- There are new amendments within stroke rehabilitation guidelines.
- Ward 40 is a 23 bedded unit, 1 thrombolysis designated bed and 2 SAB Stroke assessment beds.
- Ward 5 SWAH has 20 beds.
- We have a responsibility to ensure the guideline is applied when individual professionals and people using services wish to use it.
- One example of the guideline states that stroke wards should have 1 speech and language therapist for every 5/7 patients.
- The speech and language therapists in both SWAH/ALT in-reaches from community 3 days per week to our wards.
- Staffing Complement Ward 40:
- 1 lead Stroke Consultant, Dr Healy, 4 other consultants, who cover Stroke and 2 who would also support when needed they are geriatricians. They all take cover on the thrombolysis rota/in hours and out of hours.
- Ward 5, 1 lead consultant, 3 stroke consultants 2 which are Locum.
- Both wards are seeing transition with new ward mangers to be appointed.
- We have appointed a new Stroke Clinical Educator within the teams. We are the second Trust to appoint to this role.
- We are the only Trust with a Clinical Psychologist for Stroke, who works in the community only.
- We have had 14 staff nurses leave 2 years ago to join agency and other jobs. 10 International Nurses were recruited into ward 40 with the absence of a clinical educator. It was challenging to get the new nurses trained up in thrombolysis care/transfers to RVH, GTN infusions and general stroke care. 1 nurse was 1 month qualified in her own country prior to attending ward 40. They have been a huge part of developing a successful stroke team.
- The PHA have temporarily stopped the FAST Campaign therefore Trusts are looking at ways to bring public awareness in relation to FAST Stroke symptoms. ALT /SWAH have completed communication pieces in relation to FAST. Most recently we featured in the Trusts NOW magazine and completed a thrombectomy patients lived experience of our stroke service. She and our stroke nurse and Stroke consultant was asked to speak on Radio Foyle last week.
- Attached is the SAB QI project we completed and the Community QI project that was showcased at the Stroke Network QI Event held recently 1st March in the Civic Centre in Lisburn. We had great representation from WHSCT,
- We are currently in the final stages of a QI project called PITSTOP, involving Northern Ireland Ambulance Service, NIAS. The aim of the project is to have the NIAS crew stay with the stroke patient and transfer to the RVH if thrombectomy is needed.(Previously NIAS would leave the patient with the team and this meant time lost recalling another crew to transfer the patient to the RVH. We are the first Trust regionally to implement this project.
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March 2024
28/03/2024: Western Trust will take on the GP contract for the Medical Practice in Fintona from the 1 April 2024
Dear Public Representative,
Please see below a communication from the Department of Health which has been issued publicly today. The Western Trust has agreed with the Department of Health to take on the GP contract for the Medical Practice in Fintona from the 1 April 2024.
The Trust has again agreed to this request and note that it is the fourth GP Practice temporary contract which the Trust will now be holding going into the 2024/25 year.
On that basis I would like to highlight the fantastic work led by our Community and Older Peoples Directorate and supported by our Corporate Directorate teams, who have worked tirelessly to stabilise GP services to date in Dromore and Trillick, Racecourse Medical Centre and Brookeborough and Tempo.
This work of our collective Trust team, and their continued collaboration with the SPPG, has ensured a continued service in these GP practices which is vitally important for the local population. I thank everyone involved for their continued efforts to date and going forward as they embark on the same journey for Fintona Medical Centre. I can assure you that the Senior Team will continue to keep the impacts of this work under review in the months ahead.
Regards
Neil Guckian
Chief Executive
DEPARTMENT OF HEALTH
28 March 2024
Fintona Medical Centre | Department of Health (health-ni.gov.uk)
Fintona Medical Centre
The Department of Health can confirm that the Western Health and Social Care Trust has agreed to take on the contract of Fintona Medical Centre.
Under this new temporary arrangement, which will take effect from 1 April 2024, the Trust will work with the Department to secure ongoing GP cover for the practice.
It follows extensive work to identify a new GP contractor to take over the practice, following the resignation of the current GP Partners.
Patients do not need to take any action. Patients of the practice can be assured that its services will continue under the new arrangement. They will receive letters on the situation over the coming days. Patients needing GP services should continue to contact the practice as normal.
27/03/24: Swann invests £9m in dental access
Department of Health
Health Minister Robin Swann has today announced a £9.2million investment in dental access initiatives for 2024/25.
The investment is aimed at bolstering support for dental practices and protecting public access to health service dental care.
In addition, the Minister has confirmed a 6% pay uplift for dentists for the current financial year. This increase will be backdated to April 2023 and is in line with the recommendations from the DDRB (Doctors’ and Dentists’ Review Body). The uplift comes with a 7.3% uplift to non-staff expenses for 2023/24, with a 3% recurrent award in future years.
The £9.2m investment package for dental services includes:
· £1m for newly registered child patients through the reestablishment of the Enhanced Child Examination Scheme. This scheme provides children aged 0-10 who have not been registered with a dentist with an examination, individualised oral health advice and age-specific fluoride application to teeth to assist with preventing dental decay.
· £4.3m to fund a 30% enhancement to fees paid to dentists for health service fillings, extractions and root canal treatment for 2024/25. This will support public access to priority treatments.
· £3.9m for the treatment of high priority unregistered patients through a Dental Access Scheme;
The Minister said:
“It is important that people in Northern Ireland have access to a dentist when needed. These interventions are designed to remove some of the barriers that are limiting that access.”
“I am extremely grateful for the commitment and effort shown by General Dental Practitioners and their teams through the challenges faced over the last few years. I hope that this investment eases some of the pressures on practices and emphasises the importance of the service being provided. It is essential that we have a service that works for both the profession and patients.”
Mr Swann continued:
“I am also pleased to be announcing the pay uplift for dentists. As with other health service workforces, this had been delayed by the absence of an Executive. I am happy to be able to now put that situation right.”
The Minister also provided an update on the proposed changes to the EU laws relating to dental amalgam and his concerns regarding the implications for Northern Ireland.
He stated:
“These changes would significantly restrict dentists from placing amalgam fillings, increase costs for patients and have a significant impact on the capacity of a service that is still struggling since the pandemic.”
“My view remains that a phase down in line with the wider UK position, rather than a phase out, of amalgam is in the best interests of patients in NI. This is a matter for the new Windsor Framework Democratic Scrutiny Committee to consider in detail, in terms of impacts in Northern Ireland.”
“Thereafter, Members of the Assembly will wish to consider whether the initiation of the Stormont Brake process is necessary and justified. My Department has already written to the Committee to advise of concerns around the significant and persisting impact of the new laws and I will continue to help the Committee in any way I can.”
25/03/2024: New Minor Injuries Unit opens at Altnagelvin Hospital
This week sees the opening of a new Minor Injuries Unit at Altnagelvin Hospital, the Western Health and Social Care Trust (Western Trust) has confirmed.
- Click Here to view the Video of the New Minor Injuries Unit at Altnagelvin Hospital
With an average of 200 people per day attending the hospital’s Emergency Department, it is hoped that the new minors stream will be able to cater for around one in three attendances, relieving pressure on the main ED and allowing its Clinicians to focus on the most life-threatening injuries and ailments, providing a quicker turnaround and more comfortable environment for those with less urgent conditions.
The new unit, which opened on Monday, will be led by Emergency Nurse Practitioners and other nursing staff, with oversight from Clinicians from the main Emergency Department, and will be operational from 8.00am to 9.00pm each day.
Some of the most common injuries which can be treated in the new Minor Injuries Unit include:
- Minor head injuries.
- Facial injuries including foreign bodies in the eyes or nose.
- Upper and lower limb injuries including fractures, dislocations, bruises and sprains.
- Uncomplicated wounds.
- Bites, burns and scalds.
The Minor Injuries stream will be a Phone First led service. The Phone First service is designed for patients, including children, who are feeling unwell and considering travelling to an Emergency Department or Minor Injury Unit with an injury that requires urgent treatment but is not immediately life threatening.
When you call the Phone First service your condition, or that of the person you are calling on behalf of, will be clinically assessed and arrangements made for you to access the most appropriate service to your needs. This will also include recommending a time to attend, helping minimise waiting times and allowing clinicians to provide the best levels of care for those attending.
The ‘Phone First’ number to ring is 0300 020 6000 while the ‘Phone First’ text relay number is 0870 240 5152. Phone First operates from 8.00am to midnight each day, including weekends and public holidays.
Commenting on her hopes for the new service, Western Trust Director of Unscheduled Care, Medicine, Cancer and Clinical Services, Geraldine McKay, said:
“It is well known that our Emergency Department at Altnagelvin Hospital, like all others in the region, has been under extreme pressure. Unfortunately this has resulted in lengthy delays for those attending with less serious medical conditions as our clinical staff have been busy dealing with the most life-threatening illnesses and injuries. This new Minor Injuries Unit will allow these people to attend, get treated, and discharged from the new unit in a more timely manner”.
“This new unit has been planned for some time following significant investment as part of the No More Silos programme, and we are delighted to see it come into operation. My thanks go to all the staff across the organisation who have brought us to this point, and I know our new Minor Injuries stream will have a positive impact for those who need to avail of it.”
The creation of the new Minor Injuries Unit has been funded as part of the No More Silos project, which aims to reduce the volume of people visiting Emergency Departments by providing alternative pathways to treatment.
The opening of the new unit at Altnagelvin means that there are now separate Minor Injuries streams at all three of the Western Trust’s hospital sites, with Altnagelvin taking its place alongside existing services at South West Acute Hospital and at Omagh Hospital and Primary Care Complex.
12/03/2024: Winter Planning Update Briefing
Please see the below Update Briefing provided to Elected Representatives in respect of Winter Planning update, the Regional Control Centre and Emergency Departments Nurse Stabilisation Project.
Click Here to view the full PDF Brief (link to the attached PDF)
05/03/2024: Update on Industrial Action on 6 March 2024
We are expecting disruption to our services and it is anticipated that a number of procedures will be postponed across our hospital sites. Any patients affected by the industrial action will be contacted directly and an alternative date will be arranged in due course. All patients with scheduled hospital appointments should attend for their appointment unless they have been directly contacted to advise it has been rescheduled.
Our focus will be on patient safety during the industrial action period and a protocol has been agreed to support in-patient and clinically critical services.
There is a more detailed Department of Health statement HERE
Further information and updates will be provided on our Online Public Representative’s Hub for your information, together with all other updates:
Also, please note the below dates/times for upcoming MLA/MP Briefing Sessions in 2024.
I will be in contact with all MLA/MP Offices in the coming weeks to also schedule Individual Party Briefing Sessions.
05/03/2024: Industrial Action 6 March 2024 Update
We are expecting disruption to our services and it is anticipated that a number of procedures will be postponed across our hospital sites. Any patients affected by the industrial action will be contacted directly and an alternative date will be arranged in due course. All patients with scheduled hospital appointments should attend for their appointment unless they have been directly contacted to advise it has been rescheduled.
Our focus will be on patient safety during the industrial action period and a protocol has been agreed to support in-patient and clinically critical services.
Read the Department of Health statement HERE
This page will be kept updated with further information.
01/03/2024: Industrial Action – Significant Disruption to Planned Services
DEPARTMENT OF HEALTH
Patients are advised that there will be significant disruption to hospital services on Wednesday March 6 due to industrial action by junior doctors.
The focus of the Health and Social Care system will be on maintaining safe services for acutely unwell patients.
Due to the requirement for senior medical staff to cover roles normally carried out by junior doctors over this period, there will be substantial disruption to planned hospital activity both on the strike day itself, and subsequently as services recover from the strike day.
Most scheduled activity – planned operations and outpatient clinics – across all five Trusts will not take place March 6 in order to free up the senior medical workforce.
Surgical operating lists will therefore largely be confined to emergency surgery.
Patients and other service users are advised to check HSC Trust websites for further information next week.
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February 2024
28/02/2024: MS Helpline
Due to staffing challenges, the Western Trust helpline for MS patients is currently unavailable. We apologise for any inconvenience this may cause.
The service continues to focus on providing our MS patients with high quality safe care.
Any patient who requires advice should contact their GP. Patients wishing to discuss disease modifying therapies, bloods or blood pressure will be contacted by the service.
Recruitment efforts continue.
20/02/2024: Swann Sets out Waiting List Task
DEPARTMENT OF HEALTH
Health Minister Robin Swann has emphasised that hospital waiting lists cannot be tackled in isolation from other fundamental issues facing health and social care.
Responding to an Assembly debate, the Minister warned that “piecemeal interventions” alone will not be sufficient.
He stated:
“Tackling our lengthy waiting times is undoubtedly a long-term issue that requires sustainable and recurrent funding, workforce development and system wide transformation. The health and social care system is complex, and waiting lists are just one component. As such, they cannot be addressed in isolation.”
“Other fundamentals of the system must be considered and addressed simultaneously, including issues such as workforce pay, pressures and capacity in secondary, primary and community care, and ensuring we maximise the capacity we have within the system.”
“I know that when we see these shocking figures and appalling waiting lists, there is an understandable desire to see them reduced immediately.”
“That will require a whole system approach, and not piecemeal interventions that can only deliver small improvements in the short term, and in isolated areas. That does not mean that there are not short-term measures which can be effective, but the key is to achieve the appropriate balance between short term effective measures and longer term sustainable developments for optimum effect.”
Minister Swann’s full speech for the Assembly debate – which had to be reduced due to time constraints – is available online.
20/02/2024: Confirmed case of measles a timely reminder to get MMR vaccine
The Public Health Agency (PHA) is emphasising the importance of getting the MMR vaccine as it confirmed that one case of measles has been diagnosed in Northern Ireland.
Close contacts have been notified and all appropriate public health actions have been completed
The PHA is urging children and young adults who have not received both doses of the measles, mumps and rubella (MMR) vaccine to do so as soon as possible, to reduce their risk of catching and spreading measles. The agency has recently activated a mass vaccination drive in collaboration with health trusts and GP surgeries for all those aged between 12 months and 25 years who missed getting one or both of their MMR vaccines first time round.
Dr Joanne McClean, Director of Public Health at the PHA, said: “Identification of a case of measles in Northern Ireland was not unexpected, as we have seen a significant rise in cases in England and across Europe. However, in order to help prevent any additional cases here and possible outbreaks, it is vital that those who have not had their two doses of the MMR vaccine to act now and reduce the risks from this highly contagious and potentially deadly disease.
“We have seen a decrease in the numbers of children receiving the MMR vaccines. It is therefore important that unvaccinated children and young adults get any missed MMR vaccines as soon as possible.
“If you are unsure if your child has received their two doses of the MMR vaccine, check their ‘red book’ or contact your GP practice to find out.”
The vaccination catch-up programme that is currently under way in Northern Ireland is offering first and second doses of the MMR to anyone aged between 12 months and 25 years who missed getting the vaccines first time around. Those who have never received any doses of MMR vaccine should book early to allow one month between dose one and dose two before the end of March.
Measles is highly infectious and is caused by a virus that can easily spread between unvaccinated people. It used to be very common in children, but following the introduction of the MMR vaccine, cases became very rare with no confirmed cases in the last seven years. Two doses of the MMR vaccine provides the best protection against these diseases.
As measles is very infectious it is important that anyone with suspected measles avoids any situation where they can spread the disease, such as a GP waiting room or an emergency department. People should phone in advance and get advice rather than turning up to a healthcare setting (except in an emergency).
The initial symptoms of measles can include:
- a high temperature (fever);
- a runny or blocked nose;
- sneezing;
- a cough;
- sore, red eyes that may be sensitive to light;
- a few days later, a red-brown blotchy rash will appear. This may start on the head or upper neck, before spreading outwards to the rest of the body.
Most childhood rashes are not measles but you should consult your GP without delay if:
- you suspect it is measles;
- symptoms worsen;
- temperature increases to above 38°C;
- temperature stays high after other symptoms have gone.
For information on the MMR vaccination catch-up programme, see www.nidirect.gov.uk/mmr-catch-up
For further information on measles see www.nidirect.gov.uk/conditions/measles
15/02/2024: Increase in Funded IVF Provision
Health Minister Robin Swann has announced that publicly funded IVF treatment will increase to one full cycle for eligible women.
Speaking during a visit to the Regional Fertility Centre, the Health Minister said:
“I recognise how difficult it is for people who long to have a child but who are unable to do so without intervention and this initial increase to one full cycle for eligible women should represent a positive step forward. There is also a retrospective eligibility date to allow more women to avail of further treatment under this new change.”
Currently, those women eligible for publicly funded IVF treatment are entitled to receive one fresh and one frozen embryo transfer, even if they achieve a live birth with the first transfer. Under this change, any eligible woman who does not achieve a live birth with either her fresh or first frozen embryo transfers, and still has frozen embryos, will be entitled to further treatment until either she has a live birth or she has transferred all her frozen embryos.
A woman will be eligible if she meets the published access criteria for IVF and has been placed on the waiting list for publicly funded IVF/ICSI treatment on or after 1 October 2022.
Minister Swann continued:
“I am very conscious that there is a lot of anticipation around the full implementation of the New Decade New Approach (NDNA) commitment to provide up to three funded cycles of IVF treatment. However, there are several challenges that need to be addressed before second and third IVF cycles can be phased in, including increasing the physical footprint of the Regional Fertility Centre to enable capacity to be increased, as well as ensuring that we have the appropriate number of specialist staff in place to deliver this expanded service as planned”.
“Whilst this initial increase in provision has been possible from within the Regional Fertility Centre’s existing resources, it is clear that further expansion will require recurrent funding assurances which, unfortunately, it has not been possible to provide to date in light of the well documented financial pressures facing the entire health service at this time”.
“While work continues on planning for full implementation of the NDNA commitment, I want to recognise the team at the Regional Fertility Centre, who have worked incredibly hard to improve treatment waiting times following the COVID-19 pandemic, and to create the capacity to deliver initial increase to one full cycle within the current very limited budget.”
The entitlement will not change for women who achieve a live birth on either, or both, of their fresh and first frozen embryo transfers.
Additional recurrent funding was allocated to the Regional Fertility Centre in 2020/21 to fund the extended eligibility criteria introduced in June 2019 and in anticipation of the increase in provision. A proportion of this funding was utilised to stabilise the waiting lists following the COVID pandemic and is now able to be used to fund the increase to one full cycle for eligible women.
Today’s announcement follows confirmation from the Health Minister earlier this week that his Department is developing a Women’s Health Action Plan which will include fertility and pregnancy.
- A list of FAQs to help women determine if they are eligible for further treatment is available on the Regional Fertility Centre’s website. Alternatively, women can contact the Centre via email at rfctreatmentcriteria@belfasttrust.hscni.net or on the Centre’s phone line at 02896151292, which will be operational at the following times:
- Tuesday 17:00 – 19:00;
- Thursday 17:00 – 19:00; and
- Saturday 10:00 – 14:00
- Any woman who was placed onto the waiting list for publicly funded IVF/ICSI treatment before 1 October 2022 will not be eligi
ble
for additional publicly-funded frozen embryo transfers. The Regional Fertility Clinic will manage the waiting list as it currently does and will contact eligible women in due course. - Criteria for publicly funded IVF treatment can be accessed here: Publicly funded treatment | Belfast Health & Social Care Trust website (hscni.net)
01/02/2024: Western Trust Statement on: Getting it Right First Time (GIRFT) report on gynaecology services and reference to South West Acute Hospital Maternity Services
Please note the following Trust statement in respect of today’s media coverage highlighting maternity services at South West Acute Hospital:
The Western Trust notes the Getting it Right First Time (GIRFT) report published by the Department of Health on gynaecology services and the reference to maternity South West Acute Hospital Maternity Services. In respect of the report, the Trust would like to emphasise the following:
- The Trust fully agree that gynaecology waiting lists are unacceptably high.
- The Trust would like to reassure the public that there are no threats to maternity services at SWAH and we remain entirely committed to full maternity service provision at the Hospital.
- As part of that commitment to first class maternity care to mums and babies, we have further strengthened both our medical and midwifery permanent workforce in recent months.
Please note the following Western Trust submission, which is included on page 34 of the GIRFT Report:
Western Trust – Facilities
At Altnagelvin Hospital there are maternity, neonatal, gynaecology emergency and elective services with an inpatient bed area, day case and outpatient facilities. At Omagh we were told there are 2.5 day case sessions per week with outpatient facilities. At Enniskillen (SWAH) there are maternity, neonatal, elective and emergency gynaecology, day case and outpatient facilities in a relatively new build with extensive distances between services.
Although a relatively small maternity unit (1100-1200 births per year), there are no plans for reconfiguration and centralisation of maternity services in the Western Trust.
If you have any queries in relation to this or in respect of today’s media coverage on this issue, please feel free to contact me on the mobile number (below)
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January 2024
19/01/2024: Future of Extern Early Years Provision
The Western Trust is currently in the process of re-tendering for a Short Stay Break Service for children and young people (this is currently the ‘Time Out’ service provided by Extern). It is envisaged that this contract will be awarded to a successful Provider in April 2024.
Community based programmes provided by the current provider Extern, i.e. Passport/Early Year and Youth Support will terminate on 31st March 2024, including the Summer programme.
In order to continue to support families and reduce any impact this may have, we are currently in the process of increasing our Youth Work and Family Work staff within the Family Response Team. The Family Support Panel will review all 63 children and young people who are currently engaging in Extern Services to explore alternative services for these families.
We would like to recognise and thank our Extern Colleagues within the summer programmes and community-based programmes for their commitment and dedication our children and young people over the past 30 years.
If you have any queries please contact Public Affairs Manager, Chris Curran, in the first instance.
18/01/2024: Significant impact of Industrial Action on 18 January 2024
The Western Trust has received formal notification from a significant number of trade unions representing a wide range of staff groups of their intention to take industrial action on Thursday 18 January 2024. Our Trade Union partners are expecting that we will operate at ‘Christmas Day’ staffing levels across all areas and we therefore anticipate significant disruption to our hospital and community facilities and services during this time.
We recognise that industrial action will take place in other public services and that there is a yellow weather warning predicted. We expect this will present additional challenges to our ability to deliver urgent and emergency care in our hospitals and community services.
As a result of all of these factors a significantly reduced service will be in place on 18 January 2024. This will not just mean delays in accessing services, many services will not be available. We would encourage you to use our services appropriately to help us ensure care is available to those who will need it most.
The Western Trust has made direct contact with the patients and services users who would have expected to receive care services, including hospital appointments, day care and domiciliary care services, and those who will be impacted on this date.
Our message to patients and service users is that you should assume your appointment is cancelled, unless you are contacted by the Trust to advise otherwise.
It is also expected that services will continue to be affected after the day of industrial action, and into next week (w/c 22 January 2024) as the Trust makes efforts to return to normal business.
15/01/2024: Joint Statement from Chief Executives of HSC Trusts
JOINT STATEMENT FROM CHIEF EXECUTIVES OF HSC TRUSTS
We are deeply concerned that the planned industrial action on Thursday 18th January will have a profound impact on our services, which are already under enormous strain.
The disruption will be on a massive and unprecedented scale.
Minimal and emergency services only will be available throughout Northern Ireland, similar to Christmas Day, at best.
It is a tragedy that our colleagues, who are the backbone of our Health and Social Care service, feel they have no alternative but to take this action.
We would repeat our call for all staff to be properly rewarded for their work.
They understandably feel aggrieved that their counterparts in the rest of the UK have received a pay award, while they continue to work incredibly hard without receiving the same recognition, particularly during a period of high cost of living increases. To add to their immense frustration, they have been told publicly that funding for a pay award is potentially available, but not yet released.
As Chief Executives, we have repeatedly and publicly called for a long-term funding settlement for health and social care in Northern Ireland that addresses central issues including waiting lists, recruitment and pay in a sustainable manner.
We have been struggling with a system where funding has been allocated on a yearly basis, which makes it impossible to plan for the long term.
There is so much to put right in health and social care. Much-needed progress has been critically hampered by multiple years of political and budgetary instability.
As the extreme pressures on the Health and Social Care service continue unabated, the position is increasingly unsustainable.
We would like to sincerely thank all our staff for their continued dedication, in really difficult circumstances.
12/01/2024: Industrial action on Thursday 18 January 2024
The Trust has received formal notification from a significant number of trade unions representing a wide range of staff groups of their intention to take industrial action on Thursday 18 January 2024.
We anticipate industrial action will have a significant impact on many services provided in our hospital and community facilities. We have stood-up our industrial action planning, control and reporting arrangements and we are now actively supporting our services with assessment and planning to respond to significant expected disruption on this date.
All patients who will have appointments affected on this date will be notified directly and details on impact to services will be published live and ongoing on the Western Trust Website from Tuesday 16 January 2024.
Our message to patients and service users is that they should attend all appointments unless contacted by the Trust to advise otherwise.
11/01/2024: DoH – Significantly reduced health service on 18 January
Significantly reduced health service on 18 January
DEPARTMENT OF HEALTH: 11 January 2024
The Department of Health is extremely concerned about the potential impact of planned industrial action on Thursday 18 January.
While every effort will be made to mitigate the impact on the public, there will be widespread disruption to all aspects of health and social care services. This is expected to impact across a wide range of areas including planned and unplanned (urgent/emergency) hospital services, community services such as day centres, district nursing and domiciliary care as well as ambulance cover.
Trusts will work with trade union representatives to seek to protect emergency care.
We nevertheless believe that disruption to services will be on a scale not experienced with previous industrial action.
The strike action will be taking place at a time when services are already under sustained and very severe pressure.
Staffing shortfalls on the day are expected to be further exacerbated by industrial action in education and public transport.
We would therefore ask the public to be very conscious of the fact that a significantly reduced health service will be in place on 18 January. This would mean not just delays over and above existing levels but some services not being available at all.
Please use services appropriately and help ensure care is available to those who need it most.
Take all sensible steps to reduce your chances of requiring health service treatment on the day.
At the same time, if you need emergency hospital care on the day, you must seek it immediately.
The Department is very aware of the deep frustration of health service staff at the ongoing absence of a pay offer for this year.
We also understand that this frustration is further compounded by indications that funding for public sector pay increases is potentially available.
Under the current 2023/24 health budget, it has not yet been possible for the Department to make a pay offer to HSC staff.
That situation is neither sustainable nor defensible and cannot hold indefinitely.
11/01/2024: Dr Ciaran King, Respiratory Outpatients clinics Update
From the beginning of February 2024, Dr Ciaran King, Respiratory Consultant, will be changing the venue for his Respiratory Outpatients clinic from Altnagelvin Hospital to Omagh Hospital and Primary care Complex(OHPCC).
This change has been requested by the Consultant to facilitate a better work life balance and reduce the amount of travel each week.
There are 58 review patients who will be informed of this change in clinic location.
This will not affect their ongoing Respiratory care nor will it have any impact on waiting times for these patients.
08/01/2024: Appointment of two new Non-Executive Directors to Western Trust Board
Appointment of two new Non-Executive Directors
At January’s Trust Board meeting (Thursday, 4 January 2024), Chair of the Trust, Dr Tom Frawley welcomed two new Non-Executive Directors, Dr Aideen McGinley and Brian Telford to Trust Board.
Speaking about the new appointments, Dr Frawley said: “Aideen and Brian bring to the Board extensive knowledge and expertise derived from careers, Aideen in the public sector and Brian in the private sector. Aideen joins the Board “following a career in public service”. The early part of her career was spent in local government across the geography of the Western area, including leadership roles in both Tyrone and Fermanagh. The latter part of her career was spent in very senior levels in the civil service where she fulfilled the role of Permanent Secretary. Brian’s career has been spent in the banking sector and includes both finance and importantly governance and risk management. I am in no doubt that both Aideen and Brian will build on the current strengths of our Board adding new perspectives and insights to both our discussions and analysis.”
Dr Aideen McGinley OBE
Aideen Mc Ginley has over 35 years local and central government experience as CEO of Fermanagh District council ,Permanent Secretary in the Department of Culture, Arts and Leisure and subsequently Department of Employment and Learning. Seconded as CEO to ILEX, urban regeneration company for Derry-Londonderry, she was instrumental in building the Peace Bridge and securing the UK City of Culture 2013 title for the city.
She is a Trustee of the National Trust, Deputy Chair of Carnegie UK Trust ,on the DCMS expert Panel for U.K. City of Culture and was Northern Ireland Trustee on the BBC Trust. She holds a number of voluntary positions including trustee and former Chair of Fermanagh Trust and a Director of mental Health charity the Aisling Centre.
She was awarded OBE in the Queen’s Millennium honours, honorary doctorate University of Ulster ,honorary membership the Royal Society of Ulster Architects and Heart for Habitat for Humanity Award (2018).
She is particularly interested in Collective wellbeing and inclusion and has expertise internationally in Whole Systems thinking ,Community Planning, Coproduction and Stakeholder Engagement.
Brian Telford
Brian has spent almost 40 years working in the Financial Services sector. Brian was Head of Treasury Markets at Danske Bank until his retirement in 2019. His responsibilities included managing the Bank’s Money Market funding, Liquidity, and Interest Rate Risk activities on the financial Markets. Additionally, Brian was responsible for Business Markets, Institutional & Corporate Sales, providing, Foreign Exchange, regulated Interest Rate and Commodity risk management solutions for clients. As an Executive Banking Manager, Brian sat on the Bank’s Asset and Liability Committee responsible for Risk oversight.
Brian has extensive experience in change management, including restructuring business activities in relation to change of company ownership, Brexit, and changes to the financial regulatory framework after the global financial crisis 2007-11.
From 2013-22 Brian was a Trustee Director of the Northern Bank Pension Trust, chairing the Investment Committee, as well as being a member of the Governance Committee. Brian has extensive public speaking and media experience, conducting economic seminars in a range of business areas including Brexit, Financial Crisis, the introduction of the euro, to name a few.
08/01/2024: DoH approves permanent service change
DEPARTMENT OF HEALTH
08 January 2024
DoH approves permanent service change
The Department of Health has approved the Southern Health and Social Care Trust decision to permanently consolidate emergency general surgery services at Craigavon Area Hospital.
Emergency general surgery had been split across Craigavon and Daisy Hill Hospital until a shortage of general surgery consultants led to the temporary suspension of provision at Daisy Hill. Today’s decision makes that temporary position permanent.
The Department has concluded that the temporary arrangements demonstrated the merits of consolidation on a single site. It provided stability in clinical staffing, meaning safe services can be sustained in the longer term.
An average of three patients per day have been directed to Craigavon from Daisy Hill for emergency general surgery services. Assessment of these arrangements has found no indication of any patient coming to harm.
General Surgery specialises in abdominal organs such as stomach, gallbladder and bowel. Emergency general surgery is the overall term for unscheduled care in this field and can mean specialist advice, admission for tests and, for some patients, an operation.
DoH Permanent Secretary Peter May said: “The approval reflects the reality that all hospitals cannot provide all services. There has to be a level of consolidation and specialisation in light of advances in medicine.
“Daisy Hill Hospital will continue to provide a vital service to the local community, across a range of key specialities. The Department’s commitment to Daisy Hill is reflected in the decision to make it an Elective Overnight Stay Centre, caring for patients who may require an overnight stay in hospital after planned surgery.
“The Trust advises that since April 2023, over 6000 patients have been treated at Daisy Hill EOSC across a range of specialties including general surgery, gynaecology, ENT and endoscopy.
“The Department has also confirmed capital investment to upgrade the electrical infrastructure at Daisy Hill Hospital.”
Today’s approval on consolidating emergency general surgery at Craigavon Area Hospital aligns with the direction of travel set out in the Department of Health’s Review of General Surgery published in June 2022.
The Permanent Secretary continued: “The inability to recruit and retain consultant general surgeons to Daisy Hill was due to clinical factors, not any lack of effort. When hospitals have lower patient numbers, this can create significant issues for professionals working in key specialties. These include rota/on-call pressures inherent in smaller clinical teams, as well as insufficient case mix to support specialisation, training and skill development.
These issues inevitably have consequences for recruitment and retention.”
The Southern Trust decision followed a public consultation.
The Permanent Secretary also stated: “I am satisfied that my approval of the Trust’s decision is in accordance with Northern Ireland Executive Formation legislation and the associated Guidance published by the Secretary of State for Northern Ireland.
“It is also in step with the transformation agenda for health which emphasises that changes are required to maintain sustainable services.”
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December 2023
13/12/2023: DoH underlines scale of winter pressures
The Department of Health has appealed to the public to do all it can to help the health service get through this winter. It has highlighted the current pressures on health and social care services and the potential for these to escalate further in the coming weeks.
DoH Permanent Secretary Peter May said:
“Services are under severe pressure all year round. However, this intensifies further in winter months when there are greater levels of illness in the community.”
“The Department published a detailed Winter Preparedness Plan for the health and social care system in October, setting out a series of investments, initiatives and priorities. However, we were clear that while these measures can mitigate winter pressures, they cannot prevent them.
“Longer-term solutions are needed to bridge the gap between demand for care and existing capacity to provide that care.
“Sadly, the current gap means that many patients will face delays for care and far too many of these delays will be lengthy.
“Health and Social Care workers will work relentlessly to prioritise care according to need, treating the sickest quickest.
“I cannot praise or thank them enough and I would appeal to the public to be patient with staff and support them in every way they can.
“They have not created this situation and are doing the best they can to work through it.”
There are practical steps the public can take to support the health service this winter. These include getting your COVID-19 and flu vaccines if you are eligible.
Co-operating with hospital discharge processes is absolutely vital. Every bed occupied by a person who is medically fit to leave hospital is a bed not available to a patient waiting at home, or in an Emergency Department, or in an ambulance outside a hospital.
A range of healthcare services is available to the public including the Pharmacy First service in Community Pharmacies, Minor Injuries Units, GP services and NI PEARS (Primary Eyecare Assessment and Referral Service) participating optometry practices for eye problems.
If you have a mild or minor illness, you can also find information about a range of common illnesses using the NI Direct symptom checker.
Children who require urgent medical attention should attend their local Emergency Department. If your child is unwell and does not require urgent care please use the Belfast Trust Children’s symptom checker for advice and guidance.
13/12/2023: Western Trust Hospitals under Severe Pressure due to record numbers of inpatients
The Western Health and Social Care Trust (Western Trust), is facing unprecedented pressures due to the record number of patients in our local community needing hospitalised. This pressure is being seen across the entire HSC system.
As of midday on Wednesday (13th December), there were 112 people in Altnagelvin’s Emergency Department. 59 of these required admission to hospital for further investigations or treatment.
At the same time, in South West Acute Hospital there were 54 people in the Emergency Department, 35 of those patients required admission to the hospital which was already at 117% of its unscheduled bed capacity.
Both acute hospitals have been operating at well above 100% of their unscheduled bed capacity, with all available wards escalated to accommodate additional patients. However, large numbers of patients are still awaiting admission.
Speaking about the current hospital pressures, Western Trust Medical Director Dr Brendan Lavery said:
“There are very high number of patients waiting in our Emergency Departments at Altnagelvin and South West Acute Hospital who are requiring beds for further investigation and treatment. This is putting extreme pressure on the hospital system, and means that we are operating at the highest levels of escalation in our hospitals and in our community services which support patient discharge.
“It is very regrettable that we find ourselves in such a difficult position again and we are currently considering if we need to step down some services and redirect staff for a period of time, to ensure that we can manage the increasing pressures in a safe manner.
“Every single member of our staff across our hospital and community settings are yet again rising to the extreme challenges we are facing and we again thank them for their tremendous efforts.
“Plans have been put in place across the Health and Social Care system to manage increased pressures at this time of year. However, as a result of increased demand on top of an already very busy system, the level of complex and serious conditions, particularly amongst the growing frail and elderly population, the prevalence of flu and other respiratory conditions at this time of year, and the challenges of helping patients to return home after a hospital stay. We fully understand the upset and inconvenience this causes to patients and their families and apologise to them for it.
“Patients and families should also be aware that due to the ongoing pressure for hospital beds patients may need to be discharged without their full package of care being in place, or discharged to another care facility until the place of their choice is available and we would ask that families work with us and if their relative is deemed medically fit for discharge to arrange for them to leave hospital as soon as possible to free up beds for those who are acutely unwell and need hospital care.
“For anyone attending any of our hospitals or facilities, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times.
He concluded: “If you have a medical or mental health emergency, then ring 999 immediately or attend your nearest Emergency Department without delay. For all other urgent matters, please use the Phone First service on 0300 020 6000 (8am to midnight), where you will receive advice on the best location to attend. This may be the local Emergency Department, Minor Injuries Unit, Out of Hours GP, community pharmacy, or advice on self-care at home.”
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November 2023
30/11/2023: Publication of the quarterly Northern Ireland outpatient, inpatient and day case, and diagnostic waiting times statistics – position on 30 September 2023
The Department of Health today published the quarterly Northern Ireland Outpatient, Inpatient and Day Case, and Diagnostic Waiting Times Statistics, relating to the position on 30 September 2023.
The Waiting Times Statistics releases provide detailed information on the number of people waiting for a first consultant-led outpatient appointment, inpatient/day case treatment or a diagnostic test at hospitals in Northern Ireland.
Waiting Times for a First Outpatient Appointment
- The draft 2023/24 target relating to outpatient waiting times states that by March 2024, at least 50% of patients should wait no longer than nine weeks for a first outpatient appointment, with no patient waiting longer than 52 weeks.
- 428,858 patients were waiting for a first consultant-led outpatient appointment, 3.1% (12,836) more than on 30 June 2023 (416,022) 9.3% (36,571) more than on 30 September 2022 (392,287).
- The median waiting time was 53.1 weeks and the 95th percentile was 259.6 weeks (approximately 4 years and 43 weeks).
- 83.4% (357,760) of patients were waiting more than nine weeks for a first consultant-led outpatient appointment on 30 September 2023, compared with 82.1% (341,715) on 30 June 2023 and 82.3% (322,776) on 30 September 2022.
- 49.5% (212,374) of patients were waiting more than 52 weeks for a first consultant-led outpatient appointment 30 September 2023, compared with 49% (203,682) on 30 June 2023 and 50.4% (197,524) on 30 September 2022.
Waiting Times for Inpatient and Day Case Admission
- The draft 2023/24 target, for inpatient and day case waiting times, states that by March 2024, 55% of patients should wait no longer than 13 weeks for inpatient or day case treatment, with no patient waiting longer than 52 weeks.
- 115,929 patients were waiting for inpatient or day case admission to hospitals in Northern Ireland, 2.7% (3,166) fewer than on 30 June 2023 (119,095), and 8.4% (10,573) less than on 30 September 2022 (126,502).
- The median waiting time was 55.7 weeks and the 95th percentile was 280.7 weeks (approximately 5 years and 21 weeks).
- 78.6% (91,131) of patients were waiting more than 13 weeks for admission, compared with 77.8% (92,713) on 30 June 2023 and 79.8% (100,893) on 30 September 2022.
- 51.9% (60,161) of patients were waiting more than 52 weeks for admission, compared with 52.8% (62,856) on 30 June 2023 and 54.8% (69,321) on 30 September 2022.
Waiting Times for a Diagnostic Service
- The 2023/24 draft target for diagnostic waiting times states that, by March 2024, 75% of patients should wait no longer than nine weeks for a diagnostic test, with no patient waiting longer than 26 weeks.
- 188,850 patients were waiting for a diagnostic test, 0.0% (31) less than on 30 June 2023 (188,881), and 15.2% (24,912) more than on 30 September 2022 (163,938).
- 59.4% (112,261) of patients were waiting more than 9 weeks for a diagnostic test, a higher percentage than 55.5% (104,776) on 30 June 2023 and 52.7% (86,463) on 30 September 2022.
- 32.4% (61,116) of patients were waiting more than 26 weeks for a diagnostic test, a higher percentage than 28.2% (53,298) on 30 June 2023 and 27.0% (44,196) on 30 September 2022.
Diagnostic Reporting Turnaround Times
- The draft 2023/24 target for diagnostic reporting times states that, by March 2024, all urgent diagnostic tests should be reported on within two days of the test being undertaken.
- 440,159 diagnostic tests were reported on and dispatched to the referring clinician at hospitals in Northern Ireland during the quarter ending September 2023. Of these, 22.9% (100,833) were urgent tests and the remaining 77.1% (339,326) were routine tests.
- Of the 100,833 urgent diagnostic tests, 78.5% (79,112) were reported on within 2 days.
20/11/2023: Trust Homecare Optimisation project to begin in the Waterside Locality
The Western Health and Social Care Trust (Western Trust) established the Homecare Optimisation project in 2019 as part of its Delivering Value strategic priority. The objective of the project is to optimise domiciliary care services on a Trustwide basis ensuring a safe, effective, accessible and affordable service. The project has been unavoidably delayed due to COVID although has been successfully introduced in other areas of the Trust.
The project is predicated on generating additional service capacity within existing resources. This is achieved by consolidating service delivery arrangements within a locality based on clustered localised care teams. All independent sector domiciliary care providers with whom the Trust contracts with have formally committed to working with the Trust on this initiative. The project also includes the Trust’s in-house homecare service.
Commenting on the project Spokesperson Martin McGeady, Head of Homecare said:
“Many families and the wider public will be familiar with the ongoing pressures with the homecare sector. This project will help to stabilise domiciliary care services and also address emerging pressures within the sector, in particular workforce planning.”
“The additional capacity generated by the project will allow the Trust to respond to existing demand pressures including hospital discharges, waiting lists, hard to reach areas and future growth in demand.”
Some of the key performance indicators associated with the project to date include:
- 350 unmet need cases accommodated [including hospital discharges]
- 3170 Weekly Hours of unmet need accommodated within existing resources
- 4669 weekly hrs spot activity accommodated within existing block capacity
The Optimisation project will be rolled out next in the Waterside locality with a go-live date of 20 November 2023. Similar benefits to those indicated above are expected to be achieved in Omagh.
Martin continued:
“The Project Team have incorporated key learning from previous localities to help ensure that appropriate safeguards are in place ahead of the implementation.
“In rolling out the service changes there will be adjustments to many service user’s care arrangements. The Project Team working in partnership with Social Work colleagues will liaise closely with affected individuals and homecare providers to ensure that any disruption is appropriately addressed. It is important to note that service users will not have a reduction in services.
“The Trust’s Homecare Optimisation Project Team will continue to engage with all stakeholders to ensure a smooth transition to the new and improved service arrangements.”
15/11/2023: Presentation to Fermanagh and Omagh Council Health Committee
Full update and presentation to the Fermanagh and Omagh Council Health and Social Care Sub-Committee on:
- Winter Planning
- Update on: Omagh Hospital and Primary Care Complex &
South West Acute Hospital, Enniskillen – including activity, development and new recruitments
Click Here to view the PDF Presentation to Council
02/11/2023: Publication of ‘Healthy Child, Healthy Future – Health Review Statistics for Northern Ireland 2022/23′
DEPARTMENT OF HEALTH Release:
Publication of ‘Healthy Child, Healthy Future – Health Review Statistics for Northern Ireland 2022/23′
The Department of Health has today published ‘Healthy Child, Healthy Future – Health Review Statistics for Northern Ireland 2022/23’. This annual publication details the coverage and timeliness of preschool health contacts. It reports on the Healthy Child, Healthy Future framework which sets out a programme of child health contacts that every family in Northern Ireland can expect.
Key Facts and Figures:
- “Healthy Child, Healthy Future – Health Review Statistics for Northern Ireland 2022/23” is an annual publication that details the coverage and timeliness of pre-school health reviews. It reports on the Healthy Child, Healthy Future framework which sets out a programme of child health contacts that every family in Northern Ireland can expect.
- This publication includes coverage and timing of six pre-school health reviews; the New Baby Review (10-14 days after birth); 6-8 Week Review; 14-16 Week Review; 6-9 Month Contact; Health Review 1 Year; and the 2 – 2 ½ Year Health Review.
- During 2022/23, Health Visitors were expected to carry out 127,164 contacts to cover these six review types for children across Northern Ireland. Some 89% of the reviews were completed; 81% within the recommended timeframe and a further 8% were completed outside the recommended timeframe. Some 10% of the reviews did not take place.
- The publication does not capture information on why reviews were completed outside of the recommended timeframe or had not taken place, however, where issues are known these will be set out in the publication.
- The figures presented in this bulletin are derived from Child Health System extractions provided by each of HSC Trusts.
Notes:
- This information was collated by Community Information Branch within the Department of Health.
- Healthy Child, Healthy Future (HCHF) is a framework for the universal Child Health Promotion Programme within Northern Ireland. It is recognised as being central to improving child health across a range of issues and giving every child and young person the best start in life.
- A health review will take place in the family home; however, when appropriate, contacts can also take place in a health centre and/or in a group setting. Health Visitors are qualified nurses who have taken further training in Community & Child Health. Health Visitors work with individuals, families and groups whilst liaising closely with midwives, practice nurses and GPs.
- The statistics are collected quarterly from the Health and Social Care Trusts with a built in three month lag to ensure the administrative systems have been updated.
- This publication is available online at: Health review statistics for pre-school children | Department of Health (health-ni.gov.uk).
01/11/2023: UPDATE Attention Deficit Hyperactivity Disorder (ADHD) in Adults
Update in respect of developments in the provision of diagnostic assessment and treatment of ADHD within adult services in Western Health and Social care Trust (Trust).
Note: This service is not currently commissioned by SPPG for Trusts.
Despite the above fact that a ADHD service is not commissioned, there has been a steady growth in referrals from GPs for new diagnosis and treatment of adults. This has been particularly apparent in the last five years when referrals have significantly increased. While the Trust initially tried to absorb this additional workload within existing resources, this has become increasingly challenging and can no longer be sustained for a number of reasons:
- The substantial increase in demand, combined with growth across all adult mental health services means that continued delivery of the un-commissioned service is not sustainable without significantly impacting on services that have been commissioned.
- There are considerable resource implications associated with ADHD, particularly for Primary Care Liaison Services (PCLS) in terms of initial assessment and diagnosis, and for Recovery services in terms of ongoing review of patients once their diagnosis is confirmed and medication established.
- It is predominantly medical input that is required to address this demand. The Trust continues to experience ongoing challenges with medical staffing and recruitment across a range of service areas, including psychiatry workforce gaps. It is therefore not possible to support the adult ADHD diagnostic demand, while maintaining commissioned service delivery.
- The Trust Recovery Service has a continuous flow of ADHD patients transitioning from CAMHS and Community Paediatrics, who require continued specialist involvement for prescribed Amber list medication, and therefore potentially remain with the service for life.
- Assessment and management of ADHD is not currently a core part of psychiatric training or the mental health nurse core curriculum. Within the Trust there is only a small number of trained senior staff available at present, which is not sufficient to consistently meet current levels of demand, even with commissioned capacity.
Given these challenges and the need to ensure that we direct our available resources to deliver services that have been commissioned, the Trust will no longer accept new ADHD diagnostic referrals.
As this is not a commissioned service, it is not intended to maintain a waiting list and therefore patients who have been referred but have not yet been seen, will be returned to their GP and both the GP and patient will be informed.
It has been acknowledged more recently that due to limited availability of services in HSC, a growing number of adults are seeking private assessments for diagnosis, then requesting referral to the Trust for ongoing care and follow up. There is limited assurance through the many private providers that the diagnostic assessment is equivalent to that conducted by HSC. Therefore, if an adult has been diagnosed privately or elsewhere and requests onward referral for follow up, we will be unable to accept those referrals.
Transitions from CAMHS and Community Paediatrics, on medication, will continue to transfer to Recovery Services as normal. Adult patients who are currently on a treatment pathway within the service will be maintained.
The Trust regrets that it has become necessary to take these steps but, given the circumstances outlined above, believes there is no other available alternative. The Western LMC has been advised of the position.
The Trust will engage with the development of a sustainable model should a decision be made to commission an Adult ADHD services going forward.
If you have any questions please contact our Public Affairs Manager (details below) in respect of this and going forward, we will keep you updated with any further developments.
General Enquiries from Public Representatives should go to:
Chris Curran, Public Affairs, Relations and Engagement Manager
- Western Trust Single Point Of Contact for MLA, MP, Councils, Public Representatives; Communications & Digital Media Manager
- Tel: Mobile: 07825 378780
Out of Hours URGENT Contact: outside 9am-5pm, Monday to Friday
- Out of Hours URGENT CONTACT only: Moving forward and to ensure your contact is dealt with efficiently at a time outside the normal working hours above please contact the following Out of Hours Number on 075 2589 7187. (Out of Hours: outside of 9am-5pm, Monday to Friday)
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October 2023
14/10/2023: Western Health and Social Care Trust – Engagement on the review of Community Adult Mental Health Services
The Mental Health Strategy 2021-2031 sets the vision and future strategic direction for mental health services in Northern Ireland over the next decade. Action 31 of the Mental Health Strategy commits to the development of a Regional Mental Health Service, operating across the five HSC Trusts.
The WHSCT has engaged in the development of the Regional Mental Health Service Proposal Paper – Silos to Systems June 2022. The establishment of the Regional Mental Health Service has been targeted to remove unwarranted variances across the region and improve outcomes for people who use mental health services.
In relation to the roll out of the Regional Mental Health Service, the variance across the region in the way Trusts provide community mental health services is an area of particular focus and the proposal is to reduce the unwarranted variance to assist clearer navigation of services, reduce interfaces that may led to communication gaps and lack of consistency in service provision. This is to be achieved not by changing organisational boundaries but by ensuring we have structures in place to deliver regional consistency, quality and access across Northern Ireland.
In preparation for further engagement in relation to the Regional Mental Health Service the WHSCT are undertaking a comprehensive review of Community Adult Mental Health services, to identify areas of good practice and areas of potential change that will improve outcomes for people who use services.
In taking the review forward there has been engagement with staff representatives across Trust Directorates ensuring all professionals are involved and other key stakeholders including people with lived experience, their carers and advocates and staff side representation. Further engagement with primary care, NIAS, PSNI, independent sector providers as well as relevant community and voluntary sector organisations will be part of the review process.
The review includes all parts of the system including the reform and modernisation of Adult Mental Health Supported Living provision to develop a future model within the WHSCT area which meets the
needs of service users. The initial phase of the review following staff engagements and further engagement exercises with service users and families, Avoca was stepped down and all residents by the end June 2023 were relocated to a more appropriate facility to meet their care needs and they have all settled into their new place of residence which has been a positive outcome for these individuals and their families. Staff were redeployed to vacancies in nearby supported living facilities which ensured their skills are being maximised to improve outcomes for our service users.A paper will be developed to summarise the findings of the review and make recommendations for service improvement as necessary.
The Trust will continue to communicate to MLA/MPs through our Public Reps Briefs in respect of this review and once completed a presentation on the outcomes of the review can be shared at an appropriate next Briefing.
12/10/2023: Issue of signed Death Certificate from Hospitals
Issue of signed Death Certificate from Hospitals
A signed medical certificate of cause of death is required for the release of a deceased person’s body to an undertaker.
- Only a medical practitioner who has seen and treated the deceased in the previous 28 days can issue this certificate.
- This is a legal requirement which applies to all hospitals in Northern Ireland.
If no doctor is present in the hospital who has seen and treated the deceased in the previous 28 days, then the certificate cannot be issued.
It is regrettable that due to medical rotas that this can occasionally occur and all medical staff must work within the legal frameworks to issue death certification as soon as they are legally allowed to.
12/10/2023: Public Representative’s E-Brief October 2023
Download/Print Public Representative’s E-Brief (PDF)
09/10/2023: Altnagelvin ED Remedial works
Over recent months the floor in Majors 1 areas of the Emergency department at Altnagelvin has shown signs of pot holing across the length of the entire floor space. On further examination by the estates team one subsection of the floor has eroded across the modular build joists and caused dips in the flooring.
The dips in the floor are a major health and safety concern for patient and staff working in that area, the floor is a trip hazard with an uneven surface and if remedial works are not completed soon the potential for the floor to deteriorate further.
Following a walkabout his area and a conversation with the estate projects team, to complete the work will require Majors 1 area to be closed and vacant so the floor can be repaired. This work will take one week to 10 days to complete and will commence on 11th October 2023.
This will mean the loss of a third of the cubicle space available in the emergency department. A total of 7 cubicle spaces and a sub wait seating area of approximately 10 spaces.
Mitigations have been agreed with the re-provision of 7 spaces in Ambulatory Care Unit staffed by ED team for patients who have a Decision to Admit (DTA) and the Community Directorate have supported a reduction plan for delayed discharges to ensure patient flow is enhanced.
We will keep you updated at the time of the commencement of the works and would ask that you link with Chris if you receive or have any further enquiries on this.
04/10/23: Winter pressures plan published
Department of Health release:
A detailed winter plan has today been published for Northern Ireland’s health and social care system.
With severe pressures expected on services, the importance of all parts of the system working together has never been more critical.
Representatives from HSC Trusts, General Practice, community pharmacy, social care and the Department today attended a joint summit on the challenges ahead.
The 2023/24 Winter Preparedness Plan details a series of investments and initiatives, including:
- strengthening the Urgent and Emergency Care system to provide alternatives to Emergency Departments, including Urgent Care Centres/Urgent Streaming Services, Rapid Access Clinics and local Phone First services. These services operate alongside Trust Emergency Department services and existing minor injuries services.
- £3.4m in funding provided to General Medical Services (GMS) and Out of Hours Services (OOH) to support GP practices increase their capacity in light of the anticipated increase in demand over the winter.
- Northern Ireland Ambulance Service increasing the range and capacity of clinical expertise within Ambulance Emergency Control to help ensure cases are appropriately managed.
- Enhanced hospital capacity – for example, an additional 48 beds have been opened in Antrim area hospital in 2023 while 45 beds opened for last winter in the Ulster hospital will continue to be funded. The Royal Belfast Hospital for Sick Children, in recognition of ongoing service pressures, has increased its bed capacity by 5, which will help during the winter period.
- £4.3m provided to support GP practices across Northern Ireland to provide proactive support and care to those in nursing and residential care homes.
- Rolling out the Pharmacy First Pilot Service for Uncomplicated Urinary Tract Infection (UTI) in Women Aged 16-64 years. This will expand from the current pilot of 62 Community Pharmacies to the entire Pharmacy network of more than 500 Pharmacies across Northern Ireland, through an investment of £410,000. Over the winter period, it is estimated this will deliver 12,000 consultations, freeing up capacity in GP practices.
- Allocating £265,000 to a new Pharmacy First Sore Throat ‘test and treat’ service, which is being piloted this winter. This will be delivered in 40 pharmacies. It is estimated that around 8,000 consultations will be delivered this winter.
- HSC Trusts will jointly establish a Regional Control System which will have responsibility for ensuring system wide co-ordination for managing pressures.
- To make best use of available domiciliary care capacity, Trusts have been allocated recurrent funding of £697,000 to establish early review teams by October 2023. These teams will be responsible for completing reassessments of need within two to eight weeks of hospital discharge, with the aim of releasing capacity back into system if the patient’s needs have reduced following return home.
- Performance targets have been detailed in the winter plan, covering ambulance handover times and simple and complex discharges. Performance against these targets will be published every two weeks on the DoH website from 30 October 2023 through to March 2024.
The Department of Health’s Permanent Secretary Peter May, who attended today’s summit ,has welcomed the plan. He commented:
“Winter causes difficulties for all health services and we know that our system in Northern Ireland will face severe challenges. The measures set out today in this winter plan can undoubtedly help mitigate the pressures in NI but they cannot eradicate them.
“Addressing these challenges substantively requires long term planning and budgetary certainty. While the current environment does not provide these, we are taking the steps we can both for this winter and beyond within the severe budgetary constraints that exist.
“In the immediate future, the focus this winter has to be on all parts of the health and social care system working together.
“Even with these mitigation efforts, the system will inevitably be operating above capacity over a sustained period, leading to too many patients facing delays for care.
“Everyone in the health and care system will once again work relentlessly to prioritise and treat the sickest people quickest.
“I would appeal today to the public to support staff. They are working under conditions that are not of their making or choosing. Please assist them by being patient and kind and by using services appropriately. That includes cooperating with hospital discharge processes when you or a loved one are medically fit to leave hospital.”
03/10/2023: Update on Older People’s social work services in Omagh
Due to current pressures within Older People’s social work services, there will be a temporary change to the availability of the duty social worker in the Omagh Team.
From Tuesday 3 October, the duty social worker will be available to take calls between 10am -11am and 3pm-4pm on the following telephone numbers;
- Omagh – 028 82 835935 / 028 82 835937 (ext 237442 / 237441)
- The above highlighted reduced duty rota will commence with immediate effect.
Members of the public should continue to access their designated social worker in the usual manner.
This step has been taken to ensure that core social work services can be maintained during the period ahead and will continue to be reviewed on a regular basis. The Western Trust would like to apologise for any inconvenience caused.
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September 2023
18/09/23: Important Update: Service Impacts in respect of Industrial Action on Thursday 21 and Friday 22 September 2023
Please note the below very important update with regard to Service Impacts in respect of Industrial Action on Thursday 21 and Friday 22 September 2023.
It is important to note that The Trust anticipates significant disruption to hospital and community services during this time, more so than any previous industrial action days, given the interdependency of services involved.
A period of varying levels of Industrial Action by members of the NIPSA, UNISON, UNITE, GMB Trade Unions, as well as the Chartered Society of Physiotherapy, Society of Radiography and the Royal College of Midwives, will take place between 00:01hrs on Thursday 21 September through to 08.00hrs on Saturday 23rd September 2023.
The Trust’s Corporate Management Team and senior staff in all directorates have been working to put mechanisms in place to manage risks and ensure patient safety throughout this period of industrial action.
If you have any enquiries please contact me via email or on the mobile number below. If contacting outside normal hours then the ooh number to contact is: 075 2589 7187. (Out of Hours: outside of 9am-5pm, Monday to Friday).
Daily updates in respect of impact to services will be made available and updated daily on the Trust’s website from Tuesday 19 September.
Regards
Chris
Chris Curran
Public Affairs, Relations and Engagement Manager
Western Trust Single Point Of Contact for MLA, MP, Councils, Public Representatives
Communications & Digital Media ManagerMobile: 07825 378780
Impact on Thursday 21 September and Friday 22 September
Laboratory Services
GP non-urgent samples received at the laboratory after 3.00pm on Wednesday September 20 will not be carried over onto strike days, and will therefore have to be rejected.
On Thursday 21 September and Friday 22 September there will be no laboratory service for routine specimens. No routine GP deliveries or laboratory service is available due to industrial action. There will be a Strictly Emergency Only service, similar to current Christmas Day cover.
Radiography Services
Radiography services on all four hospital sites (Altnagelvin, SWAH, OHPCC, Roe Valley) will operate an ‘Emergency Only’ service, similar to Christmas Day cover, during the period of industrial action by the Society of Radiographers members.
This strike action will take place from 8.00am on Thursday 21 September until 8.00am on Saturday 23 September. Emergency patients will continue to be imaged during this time.
The Radiography Service will make direct contact with patients and service users impacted on these dates over the next few days.
Breast Screening appointments booked for 21st and 22nd September will be postponed, and all those affected will receive a new appointment in due course.
Non-emergency appointments currently booked for Radiography will be postponed and those affected will receive a new appointment in due course.
There will be no capacity for referrals to the Radiography service who do not have a pre-booked appointment agreed with the service.
Homecare Services
It is anticipated that there will be significant disruption to Homecare service provision. The Trust will endeavour to minimise the impact to care, however it is envisaged that a normal level of service will not be maintained.
If you or a family member is in receipt of Homecare, please consider alternative arrangements and support available to you. Homecare services delivered by our contracted providers are not expected to be affected.
Should an issue arise please call the local Homecare office on the following numbers: Northern Sector (Derry, Limavady, Dungiven) – (028) 7186 4385; Fermanagh (028) 6634 2414 or Strabane Castlederg and Omagh (028) 8283 5911.
The Homecare service will operate as normal on Saturday 23rd September.
Hospital appointments and procedures
A high volume of Outpatient appointments have been postponed and a significant number of planned procedures have also been postponed across our three hospital sites.
The Western Trust is in the process of making direct contact with patients and service users impacted on these dates. It is important to note that patients with a pre-booked appointment should attend unless we contact them to say that it has been postponed.
Day Centres and Day Opportunities
The following Learning Disability Day Centres and Opportunities will be closed on Thursday 21 September and Friday 22 September: Glenside ATC, Glenside Satellite, Evergreen, Omagh Centre, Dromore, Strathroy, Castlederg,Tir na Var and Kesh.
Oaktree, Fresh Focus Cross Street and Fresh Focus Tempo Road will be open as normal on Thursday 21 September but closed on Friday 22 September.
Valley Centre will operate a reduced service on Thursday 21 September and will be closed on Friday 22 September.
Primary Care and Older People’s Services
The following day centres will be open on Thursday 21 September but closed on Friday 22 September; Foyleville, Strabane and Creggan. Please note that transport will not be available to these centres, and service users of this centre will be asked to use their own transport.
The outreach service to Beragh on Friday 22 September will not be operating.
The following centres will be operating: Thackeray, Drumhaw, Tempo Road, Gortmore but transport will not be available for Thackeray and service users of this centre will be asked to use their own transport. Transport will be available for clients attending Drumhaw, Tempo Road, Gortmore.
Pharmacy
It is anticipated that there will be significant disruption in Pharmacy services during this period.
We will be running a very limited service that will be managed through an on call triage line and will be prioritising hospital discharges.
Patients will be unable to collect specialist medicines from any site on the days of Industrial Action.
Hospital Site Catering Facilities
There may be reduced catering facilities on Thursday 21 September and Friday 22 September. Patient meals will be prioritised. Staff are asked to note and make alternative arrangements.
Estates Management
Any requests for estates support, including medical equipment, will be prioritised in relation to overall patient/client/staff/visitor/facility safety. All requests will be triaged and responded to in line with a risk assessed approach.
Cleaning, Porters, Catering & Laundry Services
There will be a reduction in a number of Support Services. These services will be limited and prioritised based on supporting patient/client and staff safety. Business continuity planning arrangements are in place at each ward/department.
The Trust continues to work with Trades Union colleagues to protect our critical services and to try and minimise the impact of industrial action on our patients and service users
18/09/2023: Department of Health statement on Industrial Action
Department of Health statement
The Department of Health is expecting significant disruption to services as a result of industrial action on September 21 and 22.
Intensive work will continue this week with the aim of mitigating impacts on the public where possible, but some reductions in service are inevitable.
Information on impacts from industrial action will be provided on HSC Trust websites this week.
The Department understands the deep-seated frustration over the ongoing absence of a pay offer for this year but very much regrets that colleagues have decided this industrial action is required.
In setting out the implications of the budget it received for 2023/24, the Department said in May that it was facing an “impossible position” and that decisions are required that are not in the best interests of the health and social care system.
That remains the case today. As has been previously stated, the current budgetary constraints mean that matching the English pay offer for Agenda for Change health and social care staff would require large scale cuts on an unprecedented scale, with severe and lasting implications for services. That would be outside the scope of our decision making powers.
The Department continues to look for ways to address the pay challenge.
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August 2023
31/08/2023: GP/Primary Care update
The Department of Health requested the Western Trust take on the following APMS contracts in order to ensure the continued provision of GMS services to the patients in these practices:
- Dromore & Trillick Practice – 1 July 2022 to 31 March 2024
- Racecourse Medical Practice – 1 June 2023 to 31 March 2024
- Brookeborough & Tempo GP Practice – from 1 September 2023 initially
Provision of General Medical Services to the patients in both Dromore & Trilick and Racecourse Practices is currently delivered as per agreed Memorandum of Understanding which is supplemental to the APMS contract. Brookborough & Tempo Practice will also be managed under these arrangements from the 1st September.
In supporting the Practice Managers, the Trust oversees the GP rota for both practices, in doing so has developed a positive working relationship with GP locums ensuring the necessary cover is in place to provide GP services.
All permanent staff employed by each practice have been transferred to a Western Trust contract under Transfer of Undertakings (Protection of Employment) NI Regulations 2006. The transfer of employment for Brookeborough & Tempo practice staff will take place on the 1st September. All transfer of staff to the Western Trust is managed by the Western Trust HR Department and supported by the PCOP Community Nursing and Strategic Change Manager.
In order to support the delivery of the GMS, the Trust has appointed a full time Pharmacist, SW, SWA and MHP in Dromore & Trillick. Derry GP Federation MDT staff based in Racecourse Practice are also supported by the Trust.
As per current Trust processes, the Practice will continue to be the initial point of contact for acknowledging and responding to information under Freedom of Information and complaints. However, the Trust Information Governance Department is now available to the Practices to provide advice and support.
The Trust has convened a Governance Group which is chaired by the Assistant Director PCOP (Community Nursing). This group meets on a fortnightly basis to discuss and monitor the operational running of both practices currently, whilst issues regarding the Brookeborough and Tempo Practice will be included in this meeting from 1 September 2023.
In addition to this, a joint SPPG/Western Trust meeting is also convened on a fortnightly basis, chaired by the Interim Director of PCOP. Working in partnership, these proactive meetings provide an opportunity to discuss and resolve any issues which arise in a timely manner.
30/08/2023: Provision of Community Palliative Care Services
We are pleased to inform you that from Sunday 10th September 2023, Foyle Hospice will assume responsibility for providing Community Specialist Palliative Care Services across the whole of the Western Health and Social Care Trust area, which will include Omagh and Fermanagh District Council areas.
Please be assured that we are planning for a seamless transition, whereby existing services and support should be unaffected. Patients and staff will continue to receive the same high-quality service provided by the same Specialist Palliative Care Nurses now under the Foyle Hospice.
Referral to the Service will be via the current Regional Referral Form but directed to the Foyle Hospice Community Specialist Palliative Care Nursing Team if the patient resides within the Western Health and Social Care Trust. Further communication regarding the referral process and contact numbers for referrers will be issued prior to the 10th September 2023.
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July 2023
15/07/2023: Stepping down of Phlebotomy Hubs in Western Trust
The Western Trust was allocated funding to provide Phlebotomy Hubs during the COVID-19 pandemic. Two hubs were set up, the first was established in Gransha Park, Derry/Londonderry, in July 2020 and the second in Omagh, in February 2021.
The Trust continued with these hubs after the pandemic as it rebuilt and restored services to pre-pandemic levels. As services returned to normal and to support the rebuild of outpatients the hubs continued to deliver services for patients requiring blood samples in a timely manner to ensure continuity of treatment and for monitoring of conditions and treatments.
The hubs reduced footfall across the acute hospital sites and resulted in patients not having to attend the hospital unnecessarily.
COVID funding has now ended and the Trust is no longer able to provide the Phlebotomy services at the hub locations. This change will commence at the end of July 2023. Both phlebotomy hubs will cease and we will return to pre-Covid working.
Specifically, this means that all patients requiring these specific bloods will return to their pre-covid pathway.
All services are now working with relevant colleagues (including community colleagues) to ensure a streamlined transfer of patients back to their pre-covid pathways.
06/07/2023: Consultation Findings Report in respect of the Temporary Suspension of Emergency General Surgery at South West Acute Hospital
Below is a letter from Chief Executive, Neil Guckian, together with the Consultation Findings Report (pdf) in respect of the Temporary Suspension of Emergency General Surgery at South West Acute Hospital for issue to Elected Representatives and Council Executive.
This report has been presented to the Western Health and Social Care Trust Board today and will also be issued to Western Trust Staff, Trade Union Representatives and Media today. It will also be live on our Western Trust channels from this evening.
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June 2023
29/06/2023: Publication of NI Cancer Waiting Times Statistics: January – March 2023
Department of Health
Publication of NI Cancer Waiting Times Statistics: January – March 2023
The Department of Health today published National Statistics on cancer waiting times for the quarter ending March 2023.
This release gives details of the waiting times for patients accessing cancer services at hospitals in Northern Ireland during January, February and March 2023.
Key facts and figures are as follows:
Waiting times for first definitive treatment following a decision to treat (31 day target)
- In the quarter ending March 2023, 2,784 patients commenced their first treatment for cancer following a decision to treat being taken, 1.6% (44) fewer than in the previous quarter (2,828), and 5.5% (146) more than in the same quarter last year (2,638).
- 87.8% (2,445) of those patients started treatment within 31 days of a decision to treat, compared with 89.3% (2,524) in the previous quarter and 86.2% (2,275) in the same quarter last year.
Waiting times for first treatment following an urgent GP referral for suspect cancer (62 day target)
- In the quarter ending March 2023, 1,378 patients started treatment following an urgent GP referral for suspect cancer, 0.6% (9) fewer than in the previous quarter (1,387), and 9.5% (119) more than in the same quarter last year (1,259).
- 34.8% (479) of those patients started treatment within 62 days, compared with 36.5% (506) in the previous quarter and 41.0% (516) in the same quarter last year.
Patients first seen following an urgent referral for suspect breast cancer (14 day target)
- In the quarter ending March 2023, there were 3,637 patients seen by a breast cancer specialist following an urgent referral for suspect breast cancer, 1.2% (46) fewer than in the previous quarter (3,683), and 5.7% (220) more than in the same quarter last year (3,857).
- 84.2% (3,062) of those referrals were seen within 14 days of their urgent referral for breast cancer, compared with 77.7% (2,863) in the previous quarter and 50.8% (1,958) in the same quarter last year.
Referrals for suspect breast cancer
- In the quarter ending March 2023, there were 6,690 new referrals for suspect breast cancer, of which 64.8% (4,337) were urgent.
29/06/2023: Ceasing the Use of Agency for Social Work Roles in Health & Social Care Trusts in Northern Ireland – Update
Ceasing the Use of Agency for Social Work Roles in Health & Social Care Trusts in Northern Ireland – Update
The Chief Social Worker, Aine Morrison wrote to all HSC Social Workers on 2nd November 2022, advising of plans to cease the use of agency Social Workers in all Health and Social Care (HSC) Trusts by June 2023.
Since then, the 5 Trusts have worked together with the Department of Health and Trade Union colleagues to deliver on this plan and are due to meet this target on 30th June 2023. All five HSC Trusts have already ceased using Social Workers registered with an off-contract agency.
Whilst the Trust recognises the valuable contribution that agency social workers have made to services, it also recognises that effective social work services are built upon consistent, purposeful and trusting relationships between our social workers and those who use our services. The move to cease the use of agency social workers has been a significant step towards creating a more stable and sustainable social work workforce and has supported other initiatives by Trusts to improve the recruitment and retention of social workers.
Agency Social Workers who are not currently employed by the Trusts are welcome to apply for direct employment with the Trust should they wish to. HSC regularly recruit for social workers and all vacancies across HSCNI are advertised on our website at https://jobs.hscni.net
The Trust firmly believes that ceasing the use of agency social workers is the right thing to do. Our staff have told us that excessive agency use is destabilising, unfair and can negatively impact on morale. It is also the case that having stable and consistent social work teams leads to improvements in our service users’ experience.
16/06/2023: Hospital at Night Service, South West Acute Hospital – expansion into Hospital at Day Service
Hospital at Night Service South West Acute Hospital – expansion into Hospital at Day Service
(Weekends and 10 bank holidays)
From Monday 5th June 2023, the Hospital at Night Service for South West Acute will expand to provide a Hospital at Day Service over the weekends and 10 Agenda for Change bank holidays.
The current service provide a small nursing team of Clinical Co-ordinator and 2 Health Care Assistants from 17:00 to 01:00 7 nights per week.
The expanded service will provide a service on
Saturday and Sunday 09:00 to 17:00
Bank holiday cover 09:00 to 17:00
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- Easter Monday
- Easter Tuesday
- Early May Bank Holiday
- Spring Bank Holiday
- 12th July
- Summer Bank Holiday
- Christmas Day
- Boxing Day
- New Year’s Day
- St Patrick’s Day.
Hospital at Night (H@N) is a multi-professional, multi-specialty approach to delivering care at night and out of hours, with the aim of improving patient safety. It involves members of medical and nursing staff coming together to form a team that manages patients across many disciplines in a hospital.
The focus of the H@N concept is to provide safer clinical care in the out of hours setting through one or more multi-professional teams who have the full range of skills and competences to meet the immediate needs of patients.
The Clinical Co-ordinator of the Hospital at Night / Hospital at Day team will work in partnership with the Senior Doctor on duty to provide clinical leadership to ensure the effective delivery of patient care within the remit of the Hospital at Night Team. They will attend the clinical handover meeting to prioritise the care and treatment of ill patients throughout the hospital, and co-ordinate all non-emergency bleep activity. The Clinical Co-ordinator will assess ill patients and determining appropriate action, and supporting ward based and departmental teams in decision making regarding appropriate action for ill patients. The Clinical Co-ordinator will manage the team of Health Care Assistants to provide clinical support to patients that require care that ward staff are unable to offer by redeploying them to respond to meet the clinical demand for skills such as IV cannulation, phlebotomy, and recording of ECG’s and other duties as deemed appropriate.
Contact details:
Clinical Co-ordinator Bleep 6140
On Call Medical F2 can be contacted via Bleep 6080.
On Call Medical Ward F2 can be contacted via Bleep 6245.
On Call Surgical SHO/F2 can be contacted via Bleep 6131.
Health Care Assistants can be contacted via Bleep 6191 for Medical Directorate and Bleep 6192 for Surgical Directorate & MSAU.
The multidisciplinary handover meeting will take place at 09:00 in the Emergency Department Seminar Room.
13/06/2023: SWAH All Party Group meet with staff and patients at SWAH
Staff at the South West Acute Hospital were delighted to welcome the SWAH All Party Group as they took time recently to tour the hospital and meet with staff and patients.
The All Party Group, which is made up of Public Representatives from across Fermanagh and West Tyrone, were joined by Western Trust Chief Executive Neil Guckian, Deputy Medical Director Professor Ronan O’Hare and Mark Gillespie Director of Planned Care Services.
The tour included visiting a wide range of wards and services at the hospital including the Emergency Department to see first-hand the high quality care and clinical expertise provided to patients from Fermanagh, West Tyrone and beyond.
The group heard how the hospital has experienced one of its busiest periods ever, with 9,153 patients being treated in the Emergency Department in the first three months of the year, over 29,000 outpatient appointments having taken place and over 540 patients being operated on at the hospital.
This was an opportunity for the group to hear directly from staff and what matters to them. Speaking with one of the Emergency Department Consultants, they were informed of the “excellent 24/7 access SWAH ED has to diagnostics. They said:
“This is the best ED I have worked in and I have no doubt it is one of the best on the island of Ireland. We have highly skilled nurses working alongside our doctors and nurses treating and caring for patients with a range of acuities.”
Another Consultant Endocrinologist explained how
“welcoming and friendly staff were to them. The atmosphere has been great for me to work in, it has helped me settle in and relocate from a different country.”
Other members of staff took the time to share their views and concerns on the negative narrative that continues publicly on the hospital.
One frontline staff member said:
“Staff feel they are getting criticised every week when they look at some of the social media sites and in particular the newspapers. They were all quick to applaud us during Covid and things are challenging but now it is horrible to constantly read so many negatives, they do not represent our staff here on the ground. They aren’t looking at what we are doing. We all have to travel for healthcare nowadays to get the best service. For example, people are very happy to travel to Belfast for many things but won’t travel for their surgery. It’s hard to see the great work we are doing and it’s not being recognised by the papers and the media reporting. We have such a committed and wonderful team. It is heart-breaking we have went from heroes to villains with this sustained negative newspaper reporting.”
The group also took time to listen to patients and met with several who had travelled from throughout Northern Ireland to the hospital, stating “they were happy to travel to SWAH to receive their surgery and treatment.”
Chief Executive Neil Guckian, who set up the All Party Group said:
“We are delighted to have had the SWAH All Party meet our incredible staff at SWAH and see for themselves the first class services that our staff provide to our patients and clients. It was also very important for our staff to have the opportunity to share their views with their public representatives.
“The All Party Group also heard about the establishment of a new South West Acute Hospital Strategic Development Group which will be formed from a range of stakeholders to look at ways of consolidating and growing the hospital into the future.
“The South West Acute Hospital is a thriving hospital and the All Party Group can help us as we work towards maximising the potential of what is a fantastic facility. We will continue to engage with the group, as with all Public Representatives, and communicate closely on our developments.”
12/06/23: Update on the Trusts Homecare Optimisation Project
The Western Trust established the Homecare Optimisation project in 2019 as part of its Delivering Value strategic priority. The objective of the project is to optimise domiciliary care services on a Trustwide basis ensuring a safe, effective, accessible and affordable service. The project had been unavoidably delayed due to COVID although has been successfully introduced in the Enniskillen, Irvinestown and Limavady localities over the past year.
The project is predicated on generating additional service capacity within existing resources. This is achieved by consolidating service delivery arrangements within a locality based on clustered localised care teams. All independent sector domiciliary care providers with whom the Trust contracts with have formally committed to working with the Trust on this initiative. The project also includes the Trust’s in-house homecare service.
Homecare Optimisation will help to stabilise domiciliary care services and also address emerging pressures within the sector, in particular workforce planning.
The additional capacity generated by the project will allow the Trust to respond to existing demand pressures including hospital discharges, waiting lists, hard to reach areas and future growth in demand.
Some of the key performance indicators associated with the project to date include;
- 247 unmet need cases accommodated [including hospital discharges]
- 2250 Weekly Hours of unmet need accommodated within existing resources
- 1177 weekly hrs spot activity accommodated within existing block capacity
The Optimisation project will be rolled out next in the Omagh locality with a go-live date of 26 June 2023. Similar benefits to those indicated above are expected to be achieved in Omagh.
The Project Team have incorporated key learning from previous localities to help ensure that appropriate safeguards are in place ahead of the implementation.
In rolling out the service changes there will be adjustments to many service user’s care arrangements. The Project Team working in partnership with Social Work colleagues will liaise closely with affected individuals and homecare providers to ensure that any disruption is appropriately addressed. It is important to note that service users will not have a reduction in services.
The Trust’s Homecare Optimisation Project Team will continue to engage with all stakeholders to ensure a smooth transition to the new and improved service arrangements.
12/06/23: Adult Safeguarding Alert: Incidents in the Trust area (Omagh) and regionally
ADULT SAFEGUARDING ALERT
The Western Health & Social Care Trust is aware of incidents in the Trust area (Omagh) and regionally where an individual who is forbidden by the Catholic Church from presenting himself as a priest has done so to vulnerable older people in their own homes.
It is alleged that this individual has financially abused these people and matters are currently being investigated by the PSNI.
The Trust is working with the PSNI and the Catholic Church to safeguard individuals known to and currently in our services.
We would ask that you make contact with the PSNI (on 101 or 999) or the Trust’s Adult Protection Gateway Team if you have any concerns about any adult being abused in any setting in our communities. Tel: 02871 611366
Wednesday 14th June, 1-2pm: Invite to WHSCT Macmillan Health & Wellbeing Campus open day
The Western Health and Social Care Trust, in partnership with Macmillan Cancer Support, are delighted to invite you to our Macmillan Health & Wellbeing Campus open day. The day is aimed at NW Cancer Centre staff, Trust staff and community and voluntary organisations and will take place on Wednesday 14th June 2023.
Due to COVID safety measures numbers are limited so we are having a session specifically for elected representatives 1.00 – 2.00pm.
This is a celebration to showcase our beautiful campus and the services we provide.
Colleagues from North West Cancer Centre and some community and voluntary sector partners will also be in attendance to highlight the services they provide throughout the Western Trust area for people with cancer and their families.
A light lunch will be provided.
We have limited space in our premises. To help us manage numbers please RSVP to confirm your attendance by emailing:
HWB.Campus@westerntrust.hscni.net and including your:
Name:
Role:
Dietary or other special requirements:
We ask that you do a lateral flow test before attending and do not attend if you have symptoms of COVID 19 or have been a close contact of anyone who has tested positive for COVID in the last 10 days.
We look forward to welcoming you to Macmillan Health & Wellbeing Campus.
07/06/23: Western Trust Statement response to public mis-information quote
Western Health and Social Care Trust’s Medical Director Dr Brendan Lavery said: “The Western Trust would like to reassure the public and allay any undue fears and anxiety that may have arisen from a Tweet on an alleged death of a patient whilst being transferred from South West Acute Hospital to Altnagelvin for surgical input.
“It is very important to emphasise that this information is untrue. Such misinformation published publicly is dangerous and misleading for our patients, staff and the public.
“I therefore wish to re-iterate that no patients have died in an ambulance while being transferred to Altnagelvin Hospital since the temporary change to Emergency General Surgery at South West Acute Hospital was announced.
“As part of ongoing governance within the Trust all significant incidents are recorded and reviewed. To date, there is no evidence that the temporary change to the pathways at South West Acute Hospital has negatively impacted on patient clinical outcomes.”
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May 2023
26/05/23: Statement Re: Racecourse Medical Centre
The Western Health and Social Care Trust will be the new temporary contractor for Racecourse Medical Centre in Derry/Londonderry.
The Trust is stepping in to provide an interim solution following the unexpected withdrawal of the GP contractor who was awarded the contract earlier this month.
The new contract takes effect from 1st June 2023.
Patients at the practice do not need to register with another practice. They should continue to contact the practice as normal and will receive a letter in the coming days advising of their new GP arrangements.
There are approximately 4,800* patients registered with Racecourse Medical Centre.
25/05/2023: Department of Health – My Waiting Times NI
Department of Health – My Waiting Times NI
Patients in Northern Ireland can now use a new online system to check how long they are likely to wait for a specialist hospital appointment – My Waiting Times NI
The initiative has been developed to improve and centralise the information already publicly available to patients.
In this first phase, patients can find out the average waiting times for a first outpatients hospital appointment across the different clinical specialties in each Health and Social Care Trust area.
The webpage, known as My Waiting Times NI, will be expanded over time to also provide the latest waiting time information for procedures, treatment and diagnostics.
A Department of Health spokesperson said:
“Northern Ireland’s waiting lists are a result of years of sustained pressure with demand for care and treatment outstripping hospital capacity.
“Additional funding has been made available in recent years to support a range of waiting list initiatives and we were beginning to see some stabilisation of the situation. However the current budget deficit means that this additional investment will be at a lower level this year. Regrettably, this will have an impact on waiting times.
“We are acutely aware of the consequences of waiting times for patients and their families. We also recognise the additional frustration when people do not have easily accessible information on how long they will have to wait. This new webpage should provide some clarity to patients, their families and carers.
“GPs and other primary care teams, such as dentists and pharmacists, will also have access to the information which should help them have more informed conversations with their patients.
Western Trust Waiting Times will be listed here: Western HSC Trust – Outpatient – DOH/HSCNI Strategic Planning and Performance Group (SPPG) – formerly HSCB
22/05/2023: Department details 2023/24 Budget measures
The Department of Health has today set out the measures being implemented following the Secretary of State’s announcement of the 2023/24 Budget.
The plans are detailed in an Equality Impact Assessment (EQIA) which has been published for public consultation.
The Department is projecting a funding gap of some £732 million for this financial year.
In a letter today to party health spokespersons, Department of Health Permanent Secretary Peter May said:
“I wish to emphasise that, like all other Departments, we are in an impossible position of being asked to fulfil conflicting responsibilities. This involves trying to balance our responsibilities to live within the budget we have been given, act in the public interest and safeguard services. Decisions are required that we do not wish to take and that are not in the best interests of the health and social care system.”
The £732 million shortfall includes estimated pay pressures of £375 million, including the costs of fully implementing the English pay offer for Agenda for Change Staff.
Funding this pay offer under the current budget settlement would require large scale cuts on an unprecedented scale, with severe and lasting implications for health and social care services.
In his letter to party representatives, Mr May stated:
“Given the legislative basis supported by guidance from the Secretary of State, I have concluded that taking such a decision would be outwith my authority as Permanent Secretary.
“This means that, as things currently stand, it will not be possible to offer a pay award. I am very aware of the potential impact this could have on staff and on industrial relations.”
The Department had already made public plans for savings and efficiencies across the system totaling £260 million, which will reduce the funding gap to around £470m. While some impact from these measures is inevitable, measures up to this value may be achievable without long-term or irrevocable damage to services.
Given the scale of the budget shortfall, an additional £100m in savings is now planned.
The Department’s priority is to mitigate where possible both immediate impact on frontline services and long-term irreversible consequences for the health and care system.
Cost saving measures are not currently being proposed for domiciliary care packages, nursing and residential care placements, or reduction in expenditure on community aids and adaptations for clients living in their own homes.
The £100m in savings includes £55m additional savings for Trusts and a £34.6m reduction in Waiting List Initiative funding. The Department will still invest £61.4m in Waiting List Initiative funding this year to help protect provision for patients requiring red flag and other time critical assessments and treatments. Intensive efforts will be made to mitigate the impact of the reduced funding level. The ongoing drive to increase core health service activity should result in more assessments and treatments being provided in-house. A reduction in cancellations and Did Not Attend cases will support this goal. Importantly, Waiting List Initiative funding will continue at last year’s level initially, with the main impact of the reduction to be felt in the latter part of 2023/24. This will allow more time for the mitigation measures to make a difference.
The £100m savings also involve reductions in the Core Grant Scheme for community and voluntary groups; ceasing the COVID-19 Wastewater Surveillance Programme; and ending Covid-related support funding for dental services.
Download/Print the Letter to Health Spokesperson
05/05/2023: Update on South West Acute Hospital ICU
A Spokesperson for the Western Trust said:
“Works are already underway at South West Acute Hospital’s ICU to fix the damage caused by a water leak which occurred on 3 May 2023.
“As part of Trust contingency arrangements and to ensure the health and safety of our patients and staff, the ICU has temporarily relocated within the Theatre Department. ICU is fully staffed and functional in its temporary location.
“It is hoped works will be completed in the coming days.”
04/05/2023: Update on South West Acute Hospital ICUA
Spokesperson for the Western Trust said:
“There was a water leak from a burst pipe above an area of the South West Acute Hospital’s ICU yesterday morning (3 May 2023). Significant resources were deployed to address the incident and some patients were moved as part of the arrangements to assess the risk and manage it appropriately. Unfortunately the water damage to part of the ceiling left it unstable and further damage occurred late in the evening of 3 May 2023.
“No patients or staff were harmed in the incident.
“We are currently awaiting a specialist assessment and carrying out risk assessments with the contractor Mitie. The Trust will continue with appropriate contingency arrangements, and we will provide a further update of any potential service impact in due course.”
03/05/2023: New contractor appointed for Maple Healthcare GP Practice in Lisnaskea
From DEPARTMENT OF HEALTH
The Department of Health can confirm that a contractor has been appointed to provide GP services to the patients of Maple Healthcare Practice in Lisnaskea and Bernaghmore Medical Practice, Ballymena, with effect from 1 May 2023.
The new contractor is a subsidiary company of the FSU GP Practice Management CIC (Federation Support Unit).
It follows extensive work to identify a new GP contractor to take over both the practices, following the termination of the contract by the previous contractors.
All 14,109 patients of Maple Healthcare Practice and 3,807 patients of Bernaghmore Medical Practice have been automatically registered with the new practice.
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April 2023
24/04/2023: Dr Elizabeth Brady will now take up clinical responsibility for Adult Learning Disability Services
The Western Health and Social Care Trust (Western Trust) would like to thank outgoing Consultant Psychiatrist Dr Ryan McHugh who has worked in Adult Learning Disability Services, for his dedication and commitment to patient care across the Trust area, including his work at Lakeview Hospital and we wish him well in his future ventures.
Dr Elizabeth Brady will now take up clinical responsibility for Adult Learning Disability Services. Dr Brady has been in a clinical and senior leadership role within the Western Trust area for 11 years ensuring patients receive the highest standard quality of care.
24/04/2023: Professor Ronan O’Hare appointed to Deputy Medical Director for the Western Trust
The Western Health and Social Care Trust (Western Trust) is delighted to announce the appointment of Professor Ronan O’Hare to Deputy Medical Director for the Western Trust.
Professor O’Hare has been with the Western Trust for over 12 years, both in his clinical and senior leadership roles. He will continue to be based at South West Acute and Omagh Hospitals, but will also have responsibility for the entire Trust area.
Congratulating Professor O’Hare on his new appointment, Trust Chief Executive Neil Guckian said: “I would like to take the opportunity to congratulate Professor Ronan O’Hare on his new appointment. As Deputy Medical Director Professor O’Hare will provide strong professional leadership not just locally in SWAH and Omagh Hospitals but also across the entire Trust remit.
“Ronan will support the development and delivery of first class services across the Trust, ensuring our patients receive the highest standards of quality care.”
24/04/2023: Fire at Rossdowney House impacts health and social care clients
“A fire was discovered overnight at Rossdowney House, Glendermott Road. The Northern Ireland Fire and Rescue Service, alongside the PSNI attended the incident which is believed to have been started deliberately.
“Melrose Day Centre which is interconnected to Rossdowney House has been severely impacted by this deliberate fire. Melrose Day Centre delivers vital Adult Mental Health Day Care Services to 40 service users. The impact of this fire has resulted in 21 service users not being able to attend the Day Centre today (24 April 2023). These vulnerable service users rely on coming to our Day Centre for support from staff and to engage with other service users and take part in therapeutic activities.
“Staff are currently keeping in contact with service users today and we are assessing the impact over the coming week. The art therapy room used by our clients has been completely destroyed which will have an impact on what we can deliver to our service users over the coming weeks. This will be devastating for our service users as all their beautiful art work has been destroyed.
“A number of Women and Children’s Services supporting families and young people have also had to be cancelled due to the damage caused to the premises.”
“This is the second deliberate fire to have occurred at health and social care facilities in Londonderry in recent weeks.
“The Trust would appreciate the public’s cooperation with the police appeal for information in relation to this incident.”
PSNI Official Statement on Rossdowney Road – Arson Appeal:
Police in Derry/Londonderry are appealing for witnesses and information in relation to a fire at a building in the Waterside.
Police were alerted to the blaze on Rossdowney Road at around 1.20am today, Monday 24th April. NIFRS were also at the scene and had extinguished the fire. At this time the fire is being treated as deliberate, and investigated as an arson.
Anyone with information, or who was travelling in the area between 1am and 1.15am and has dash cam is asked to check their footage. The number to call with information is 101, reference number 65 of 24/04/23. You can also submit a report online using the non-emergency reporting form via http://www.psni.police.uk/makeareport/ or call Crimestoppers anonymously on 0800 555 111 or online at http://crimestoppers-uk.org/
17/04/2023 DoH Update: Appointment of five Health and Social Care Trust Non-Executive Chairs
The Department of Health has announced the appointment of five Health and Social Care Trust Non-Executive Chairs.
The Chairs will play key leadership roles at a time of considerable challenge and opportunity for the health service in Northern Ireland.
Mr Ciaran Mulgrew has been appointed as Chair of Belfast Health and Social Care Trust (BHSCT). Mrs Michele Larmour has been appointed as Chair of the Northern Ireland Ambulance Service Trust (NIAST). Both appointments commenced on 6 April 2023 and will end on a date not later than 5 April 2027.
Mr Jonathan Patton has been appointed as Chair of South-Eastern Health and Social Care Trust (SEHSCT). His appointment commenced on 15 April 2023 and will end on a date not later than 14 April 2027. Since March 2020, Mr Patton has been carrying out the role of Acting Chair of the Trust.
Ms Anne O’Reilly will be appointed as Chair of Northern Health and Social Care Trust (NHSCT) with effect from 20 April 2023 to a date not later than 19 April 2027 and Dr Thomas Frawley will be appointed as Chair of Western Health and Social Care Trust (WHSCT) with effect from 1 May 2023 to a date not later than 30 April 2027.
Permanent Secretary Peter May said:
“Health and Social Care Trusts deliver a wide range of essential public services to people across Northern Ireland and the Chair has a particular leadership role to champion and oversee the work of the Board.
“The Department is committed to developing constructive and effective partnerships with all our Arm’s Length Bodies. There are many challenges ahead, not least as we move to rebuild services and manage public expectations and confidence following the impact of the Covid-19 pandemic, but also in developing a new Integrated Care System for Northern Ireland. I can assure Chairs they will be supported by the Department as together we seek to respond to the many challenges, not least as we move to rebuild services and manage public expectations and confidence following the impact of the Covid-19 pandemic, but also in developing a new Integrated Care System for Northern Ireland. This is all in the context of an extremely constrained budgets. Trust Chairs are a critical part of the HSC system leadership which will respond to, navigate and address these challenges.
“I would like to congratulate the newly appointed Chairs and to thank them for taking on these very important roles. Their skills, experience and dedication to public service will prove invaluable in the years ahead. I would also like to take this opportunity to thank the outgoing Chairs for their valuable contribution. Their tenure has coincided with the most challenging of times for Health and Social Care and the Department is grateful for their commitment to the Trusts and to the community they served during those unprecedented times.”
For the full press release, please click HERE.
06/04/2023: Western Trust Buys Land for New Lisnaskea Health and Care Centre
The Western Trust is pleased to confirm it has purchased a circa 5 acre parcel of land on the former Lisnaskea High School site for the construction of the new Lisnaskea Health and Care Centre.
The new facility will be 4,000 m2 (approx.) with car parking spaces and will accommodate G.P., Trust Community and Older People’s Day Care services with all patient and client services located on the ground floor.
The purpose-built accommodation will provide improved accessibility, service delivery and increased multi-disciplinary working within South East Fermanagh. It will also address current spatial issues and enable increased provision of services in Lisnaskea such as Podiatry, Speech and Language Therapy, Physiotherapy, Mental Health Services and Older People’s Services.
In conjunction with this acquisition, the Western Trust continues to progress detailed design work, planning and statutory approvals and preparation for tender. It is currently anticipated that the construction works will commence in January/February 2024, with the new facility projected to open in early 2026.
Western Trust Chief Executive Neil Guckian said:
“This is an important milestone in a key development for the staff and community of South East Fermanagh. It represents another step towards providing services in a modern setting, designed with the essential input of local staff who deliver care and are focused on meeting the needs of their patients and clients.”
06/04/2023: Update on Neonatal Services at South West Acute Hospital
We are delighted to provide you with an update/changes to Neonatal Services at the South West Acute Hospital.
As you will be aware, the Trust reduced the gestational age from 36 to 35 weeks in mid-September 2022. We have continued to review our activity and the outcomes of those mothers/babies that have been transferred out. Alongside this, we have continued to recruit to our nursing posts and are now in a stable position. We are pleased to advise that there has been approval given to reduce the threshold of delivery in South West Acute Hospital to 34 weeks, as was our practice prior to our staffing challenges.
We are able to repatriate babies back to SWAH at an earlier gestational age, if they require special care only and do not require further neonatal eye screening. However, we are working hard to secure a neonatal eye screening service in SWAH .
This change is with immediate effect.
06/04/2023: International Medical Recruitment Programme
Presented verbally to Cuban Embassy & Council: 05.04.23
Background
In order to attract medical professionals to the Western Health and Social care Trust (WHSCT) to help deal with staffing pressures, a bespoke International Medical Recruitment (IMR) Project was established in 2015.
The WHSCT use a Regional and a Local Global Recruitment Framework for Medical Recruitment. These Frameworks have been established through robust procurement processes to ensure public money is used appropriately.
Through this IMR project, the Trust has been successful in attracting and retaining a growing pool of highly skilled and experienced doctors from across the world to support the development and sustainability of a wide range of specialist services within the South West Acute Hospital (SWAH).
At the 31st March 2023, 209 doctors have taken up post through the project within the WHSCT.
- 86 of these doctors have taken up post in the South West Acute Hospital.
- 22 of these Doctors are currently still in post. 3 are on a permanent basis.
- 35 doctors have started (to date) since 1st April 2022 (9 of these doctors commenced employment in SWAH)
- 17 doctors are currently progressing in the recruitment process (7 of these are for posts in SWAH).
The project works hard to continue to attract CVs from all over the world and co-ordinate interviews. There are a further 6 doctors planned to arrive in South West Acute Hospital before the end of June 2023.
Recruitment and GMC requirements
The agency the Trust works with will assess CVs for their experience and qualifications. The most important check is that that they have GMC registration with a licence to practice in the UK. If they do not have GMC registration with a licence to practice in the UK, then the agency will advise them on how they can gain their GMC registration and the likely timelines for this process.
The main ways for most international doctors to prove their professional skills in order to get their GMC registration are:
- Passing the PLAB test (Professional and Linguistic Assessments Board)
- There are two parts to complete. Part 1 is a written multiple-choice exam. It is available in several countries and the UK, so doctors can usually sit in their home country.
- Part 2 is a clinical exam. It is held at the GMC assessment centres in either Manchester or London. The process for completing both parts can take up to 9 months.
- An acceptable postgraduate qualification
- Candidates need to possess one of a certain number of approved postgraduate qualifications relevant to their speciality, for example, MRCP, MRCPI, MRCEM, MCPCH, FRCA, FRCR, etc.
- Only original/notarised qualifications and training certificates are accepted and verified on ENIC (previously NARIC) and GMC. Checks confirm the transferability of qualifications and experience and eligibility for international staff to practise in the UK.
- An acceptable overseas registration exam (recently approved since 12th January 2021)
- International doctors must have passed one of the following overseas registration exams: United States Medical Licensing Exam (USMLE), Medical Council of Canada Qualification Examination 2 (taken in English), MCCQE or Australian Medical Council Clinical Examination (AMC).
English Language
Candidates must complete either the IELTS (International English Language Testing System) exam or the OET (Occupational English Test) to demonstrate their English language skills are required to work in Northern Ireland. They must score 7.5 overall, with no less than 7.0 in each IELTS module (Reading, Writing, Listening, Speaking); results take ten working days.
For OET, they need to score ‘B’ in all four modules, with results taking take three weeks. Alternatively, if they have been working as a Doctor for a minimum of 2 years in a country where English is the first and native language, they may prove their English with an Employer’s reference.
The final part of GMC registration requires Drs to complete an identity check.
The link below outlines acceptable UK and overseas qualifications for GMC registration
Acceptable postgraduate qualifications – GMC (gmc-uk.org)
The agency will have constant contact with the candidate and provide information on what to expect with working in the UK and information on specific job roles.
No candidate is registered and sent to WHSCT unless all pre-screening components have been completed and the candidate meets all standards, specification and legislation. These checks would include:
- Identity Check
- Right to Work Check
- Professional Registration and Qualification Check
- Employment History and Reference Check
- Criminal Record and Barring Check
- Work Health Assessment Check
- English Language Competency Check
Certificate of Sponsorship
As a licensed sponsor the WHSCT need to sponsor any overseas worker we wish to employ if they are not a ‘settled worker’ or do not otherwise have the appropriate immigration permission to work in the UK. We must assign a valid Certificate of Sponsorship (CoS) to the worker via the Skilled Worker route so they can make a successful immigration application. Before assigning a CoS we must:
- check the role is eligible
- ensure we will pay the worker appropriately
- check the worker is eligible
- meet any other route-specific requirements
Throughout an International Doctor’s employment we are responsible for checking that the sponsored workers carry out the role for which they are being sponsored and for monitoring their attendance. We must Inform UKVI if they do not turn up for work, are absent without permission, or there are significant changes to their employment.
The overall process can take 3-9 months for each candidate, from the initial phase to placement. Based on various factors from the notice period, the new job’s start date, GMC and VISA timescales, availability of schools and accommodation.
Induction, Progress & Development
As a Trust we have a responsibility to ensure our International recruits who come from across the world to work in the WHSCT, which can be quite challenging in itself, have adequate support from HR, Service Manager’s and Clinicians to enable to as smooth of a transition to working within the WHSCT as possible. We offer an induction and professional support which is crucial when integrating staff into the WHSCT and setting out what is expected in a clear and consistent way to help the settling-in process. Effective mentoring, professional support and a supportive learning environment enable staff to be as productive as possible in their new roles.
The WHSCT has a supported integration programme. The relevant Clinical Lead is asked to complete this for each doctor recruited through the International Medical Recruitment Project, starting no later than one month after commencement. This progress and development process provides an opportunity to identify, as early as possible, any support required or any development or educational needs identified and ensure that appropriate measures and supports are put in place.
Additional Supports
In addition we also, were possible; assist our International Recruits by providing on site hospital accommodation for both them and their families for up to 12 weeks after arrival, to allow them time to explore the local property market and secure a long term rental properties. This can be challenging, as previously outlined to council.
The agency also have a representative available in the first few days and weeks after arrival to provide pastoral support, in the form of local orientation and assistance with collection of BRP’s, and help in making and getting to appointments such as registering which GP’s and schools.
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March 2023
30/03/2023: Industrial Action Friday 31st March 2023
Industrial Action will take place on Friday 31 March (00.01 to 23:59hrs) for UNISON members. It will also take place on Monday 3 April for UNISON and NIPSA members (00.01 to 23:59hrs) and Royal College of Midwives members (8am to 12pm). During these times there will be disruption to some Trust services.
The Western Trust is in the process of making direct contact with patients and services users impacted on these dates. It is important to note that if you have a pre-booked appointment you should attend unless we contact you to say that it has been cancelled.
Impact on Friday 31 March
Homecare Services
It is anticipated that there will be significant disruption to Homecare service provision, particularly in the Strabane and Derry areas. The Trust will endeavour to minimise the impact to care, however it is envisaged that a normal level of service will not be maintained. If you or a family member is in receipt of Homecare, please consider alternative arrangements and support available to you. Homecare services delivered by our contracted providers are not expected to be affected.
Should an issue arise please call the local Homecare office on the following numbers: Northern Sector (Derry, Limavady, Dungiven) – (028) 7186 4385; Fermanagh (028) 6634 2414 or Strabane Castlederg and Omagh (028) 8283 5911.
The Homecare service will operate as normal on Saturday 1st and Sunday 2nd April
Hospital appointment and procedures
A number of Outpatient appointments have been postponed and a small number of planned procedures have also been postponed across our three hospital sites.
Day Centres and Day Opportunities
The following Learning Disability Day Centres and Opportunities will be closed on Friday 31 March: Evergreen Day Centre, Willow Group, Roe Leap, Garden Project, Fresh Focus, Omagh Centre, Lackaghboy 1, Lackaghboy 2 and EPC, Lisnaskea.
The Drumcoo Centre for Physical and Sensory Disability will also be closed on 31 March.
Laboratory Services | South West Acute Hospital
Laboratory services will also be limited at the South West Acute Hospital. The Trust’s labs will be operating a bank holiday service arrangement with capacity only for urgent samples. Our GP colleagues have been informed.
Bloods / Sample collection (Northern Sector)
Our Transport Team will collect urgent bloods samples only. Our GP colleagues have been informed.
Cleaning, Porters, Catering & Laundry Services
There will be a reduction in a number of Support Services. These services will be limited and prioritised based on supporting patient/client and staff safety. Business continuity planning arrangements are in place at each ward/department.
The Trust continues to work with Trades Union colleagues to protect our critical services and to try and minimise the impact of industrial action on our patients and service users.
For more information visit – https://westerntrust.hscni.net/industrial-action-march-april-2023/
29/03/2023: South West Acute Hospital remains an Acute Hospital with a Type 1 ED (Dept of Health)
Official statement from the Department of Health:
“The suspension of emergency general surgery from South West Acute Hospital (SWAH) does not change its Type 1 ED status or the acute status of the hospital.
“The definition of a Type 1 Emergency Department is ‘A consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services 24 hours a day.’
“No hospital in Northern Ireland provide all types of emergency surgical services and the definition does not require this. Even the larger hospitals with very busy EDs do not provide everything.
“In line with the definition, emergency general surgery is not a pre-requisite. What is required is emergency surgical services. The temporary (as currently the case in SWAH) or permanent (as proposed for Daisy Hill Hospital) suspension of emergency general surgery is not a removal of emergency surgery and those changes will therefore not impact on the type of ED which it is.
“This is not a new policy position. It reflects existing policy.”
Update on Temporary Change to Emergency General Surgery at SWAH
The sustainability and continuing safe operation of the General Surgery Service in the South West Acute Hospital was identified as a key risk for the Trust since October 2021. That risk has been centred on the Trust’s ability to have a sufficient number of general surgeons, who can provide the required standard and continuity of care for our patients. This risk was highlighted again by our clinical teams as part of the Minister’s Regional Review of General Surgery. That review in itself highlighted additional risks with the SWAH General Surgery Service.
In October 2022 the Trust experienced a number of critical staffing changes, which meant that the 24/7 rota for Emergency General Surgery at SWAH could not be sustained after 18th December 2022. This resulted in an unplanned and temporary change to Emergency General Surgery services at the South West Acute Hospital from 5th December 2022.
The main priority for the Trust is to provide a safe, sustainable and effective Emergency General Surgery service for patients in the Western Trust area ensuring safe services and the best outcomes for all patients.
The Trust opened a public consultation on 17 January 2023 which will run for 12 weeks with the main objective to establish if an alternative viable means of delivering the service can be identified.
Official Information on Emergency General Surgery and Updates can be found here:
- Emergency General Surgery – South West Acute Hospital
- Visit our Fact Checker page to answer questions you may have about Emergency General Surgery at South West Acute Hospital
29/03/2023: Public Consultation on the Temporary Suspension of Emergency General Surgery at SWAH
The Trust has engaged with the public in consultation on the temporary withdrawal of Emergency General Surgery in South West Acute Hospital.
Full details and information in respect of the Public Consultation have been shared in public and this can be found on the link below:
- The information on all the public consultation events is currently being updated on the public website
- South West Acute Hospital – Emergency General Surgery Consultation
To date, seven public facing consultation events were hosted across the 7 District Electoral Areas in the Fermanagh and Omagh District Council Area. Two online Virtual Consultation events have also taken place. The events were setup to accommodate just over 4000 people. A total of 632 people engaged with the Trust at these events. To date the Trust have also received over 50 responses to the Consultation Questionnaire.
In addition the Trust have held three Staff Consultation Events and there has been ongoing Staff Engagement sessions for staff and staff-side reps since November 2022.
The Consultation period will close on Monday 10 April 2023.
Emergency General Surgery, SWAH: Patient Pathways – Data Analysis
To monitor the changes in flow of patients, the Trust and SPPG agreed a reporting process, using information provided by the Trust’s Information Team. This coding protocol was developed to track internal transfers of Emergency General Surgery patients from SWAH to Altnagelvin, and additional information provided by the SPPG Information Department.
It is important to note that Surgical Assessment Units (SAA) opened in Altnagelvin on 5 Dec 22 and SWAH on 12 Dec 22 with Altnagelvin SAA having 12 attendances from SWAH between 5 Dec 22 – 28 Feb 23 and SWAH SAA had 82 attendances from 12 Dec 22 – 28 Feb 23.
Summary
In planning for the change, we estimated based on regional dashboard information, that approximately five patients per day could be affected by the temporary suspension of Emergency General Surgery at SWAH. The figures to date would indicate that 203 patients were admitted to Altnagelvin with a surgical presentation between 5 Dec 22 – 28 Feb 23, who may have previously been admitted to a surgical ward at SWAH. This equates to 2.4 patients per day.
Staff Recruitment Update
The Trust completed a recent recruitment campaign for four full time Consultant General Surgeons, who, while based in Altnagelvin, will be required to work at hospitals across the Trust. This will provide further opportunity to reach across the Trust as we move to maximise capacity and capability at Omagh DPC and SWAH Overnight Elective Stay Centre.
Interviews have taken place, however the recruitment process is not yet complete.
Patient/Staff Wellbeing
The Trust has developed a plan to promote Care Opinion to gather qualitative data on patient experience. A link has been requested and set up with Care Opinion specifically for the emergency surgical services in SWAH. This will be shared on our social media channels and our website through our communications team.
Governance
Since the bypass protocol was implemented there have been no issues that affected either patient safety or clinical outcome.
29/03/2023: Elective Overnight Stay Centre (EOSC)
The Trust had a successful test of concept for the EOSC on the 8/9 March 2023. Professor Mark Taylor, Consultant General Surgeon, visited the Elective Overnight Stay Centre (EOSC) in South West Acute Hospital (SWAH) to undertake regional EOSC General Surgery lists and provide Consultant cover overnight to ensure patient safety and timely discharge.
A further 4 EOSC lists over 2 dates have been scheduled for a WHSCT Consultant Surgeon (30 March & 6 April respectively)
The rebuild plan highlights that the Trust, by June 2023, will get back to fully utilising our 10 commissioned inpatient sessions – 5 for Gynae and 5 for Surgery.
29/03/2023: Update Information in respect of ‘The Golden Hour’
The term Golden Hour was first used by Dr Adams Crowley a surgeon in Baltimore in 1975 in respect to trauma care. He stated that “the first hour after injury will largely determine a critically injured person’s chance of survival”.
This was in the context of no organised trauma care, medicine in the 1970’s and no effective prehospital care as was typical of the time.
It is reasonable to state that this concept is outdated and is effectively a historical opinion that has become embedded in the public consciousness. There have been multiple studies carried out across the world which have failed to find any significant survival advantage for trauma patients with shorter pre-hospital rescue times.
Trauma care has changed beyond recognition in the past decade initially across England, Scotland and Wales and more recently across Northern Ireland and ROI. Patients are now preferentially taken to the most appropriate hospital first for trauma care. Of note across GB, no patient with major trauma would be taken to a hospital which did not have Orthopaedic surgeons on site.
The Northern Ireland Trauma Network set up a trauma triage tool which helps paramedics take more patients to the RVH which is the trauma centre and bypasses multiple other hospitals.
Effectively Antrim, Ulster and Craigavon hospitals are bypassed in the majority of cases of significant trauma and the patient is taken to the RVH as the main trauma centre.
Altnagelvin sees approximately one third of the numbers of patients with significant trauma that attend the RVH trauma centre.
The RVH has also initiated a call and send model – this allows for a patient who fulfils major trauma criteria to be rapidly transferred from any ED to the RVH for ongoing management.
Due to all of the above changes deaths have decreased and lives have been saved.
All of this also ties in with the HEMS service which provides medical input at scene by both helicopter and land based vehicles. There is no application historically or otherwise for any other healthcare problems where the term “Golden Hour” can be used.
Specifically there is no relationship of any kind for Emergency General Surgery.
In respect of the question about stroke treatment: There is a necessity for a patient to attend hospital as early as possible to allow a CT scan of the brain to be carried out and treatment decided within 3 hours.
All patients who have heart attacks are now transported to either Altnagelvin or the RVH for emergency angioplasty. This is the case everywhere across Northern Ireland. Again there is good evidence that deaths have decreased in Cardiology and patients have much better outcomes.
29/03/2023: Update on Services at South West Acute Hospital, including Obstetrics and Gynaecology (including Maternity) and Diagnostic Radiology
The Western Trust, and the Department of Health, are fully committed to the sustainability and the future of Obstetric and Gynaecology Services, including all Maternity services, at the South West Acute Hospital, Enniskillen.
South West Acute Hospital (SWAH) is funded for 6 whole-time equivalent Consultant Obstetricians. Six Consultants are currently on the rota and the rota remains stable. This includes four Substantive Consultants and two locum consultants. It currently includes locum consultant cover due to sickness absence and cover for a Consultant who left to take up a post elsewhere. This would be a standard process for any service.
Recruitment has been ongoing and this includes recruitment for two substantive Consultant posts in addition to Specialty Doctors in Obstetrics and Gynaecology. The two Consultant Posts were last advertised with a closing date of 13 January 23 (no applicants) and have now been re-advertised. This now includes advertising in International medical journals.
In addition to these normal recruitment procedures, including the international medical recruitment programme, the Trust is also promoting via all our Social Media channels as part of an overall campaign.
It is also important to provide some context again that the Health Service as a whole, throughout the UK and ROI, continues to experience ongoing challenges and pressures which has been seen in all Acute Hospitals in Northern Ireland. As a smaller rural Hospital, South West Acute Hospital has been and will continue to face workforce challenges.
Regarding Diagnostic Radiology, two posts were advertised in November 2022 with a closing date 23 December (no applicants). This is also being re-advertised. The Trust have also appointed two Radiology Consultants through International Recruitment. One commences contract at end of March 2023 with the second appointment commencing at end of June 2023. Another Radiologist has now also been appointed on 14 February 2023.
29/03/2023: Update on Rheumatology Service at SWAH
Rheumatology Service at SWAH
The rheumatology Service has been temporarily moved to Omagh Hospital and Primary Care Complex as the Locum Consultant who had previously been in post in South West Acute Hospital left the Trust in October 2022. The Trust attempted to fill the locum vacancy but were unsuccessful in same. We are now actively embarking on the recruitment of a permanent Western Trust Consultant Rheumatologist.
The Trust would like to emphasise, this decision is in NO way related to the temporary removal of emergency general surgery at SWAH.
Why have Rheumatology patients not been informed of this move?
Each patient has not been advised of this temporary change to service provision as this was a temporary change dependent on availability of consultant cover, Rheumatology service provision to SWAH patients continued through an interim outreach model, however located on the Omagh Hospital Site.
It is ongoing Trust practice to align service demand to consultant capacity to equalise and manage the length of time waiting for a first Outpatient appointment across the WHSCT area – however we continue to promote the principles of care “closer to home” so it is not uncommon for patients to be asked to travel for an Outpatient appointment which is deemed reasonable in accordance with the Integrated Elective Access protocols.
How many patients does the Rheumatology Clinic at SWAH currently have?
In February 2023 there were 402 patients from SWAH awaiting a new Outpatient appointment. Staff in the Northern Sector of the Trust have been facilitating outreach clinics on the Omagh Hospital site to mitigate the impact on patients in the Southern Sector of the Trust.
29/03/2023: Update Briefing on Supported Living Review and Stepdown of Avoca Lodge
Western Health and Social Care Trust Engagement on the future model of supported living provision, Stepdown of Avoca Lodge, Gransha Park Site
As part of the reform and modernisation of Adult Mental Health Supported Living services, the Western Trust implemented a staff engagement exercise as part of the review of supported living. This included providing information and questions and answers in respect of the repurposing of Avoca Lodge. Following these staff engagements, the Trust approved to proceed with further engagement exercises with staff, service users and families to determine if a wider public consultation is required.
The initial planned meeting in November 2022 with the Trust Consultation Group was stood down due to ongoing industrial Action. A meeting with Trade Unions was then convened on 12 January 2023 and the engagement commenced for 4 weeks, which closed on 9 February 2023.
Following this period of engagement, and taking on board all feedback from staff, service users and families, the Western Trust have now approved to proceed with the stepping down of Avoca Lodge as the change is not deemed to be major or controversial. This will now involve relocating the service users to other suitable facilities nearby and deploying staff to other Supported Living facilities in the Trust.
Our service user’s health and well-being is our priority and we will continue to support and engage with them and our staff throughout the transition.
The Trust senior team have been communicating with the Trade Unions and meeting with staff, all service users (together with Service User Consultant) and families on Thursday 23 February 2023 to discuss the outcome of this proposal to stepdown Avoca Lodge.
As part of the reform and modernisation of supported living, it is anticipated the future service model will present opportunities to further develop and upskill our current workforce.
The review of supported living is ongoing and information and the final report will be provided when available. Planning in respect of the Avoca Lodge premises, as part of this review of supported living, is also ongoing.
Background
Adult Mental Health (AMH) in the Western Health and Social Care Trust (Western Trust) in collaboration with contracted housing providers and NIHE Supporting People operates a supported living service. The service was developed to facilitate the closure of the long stay psychiatric inpatient wards in the 1980’s and 1990’s. The service enables individuals with significant mental illness to maintain a home address outside of the hospital environment and to live independently in the community. Each individual has a personalised support plan to help them maintain their tenancy and their mental and physical well-being. The individual lives as a tenant within a supported environment with access to 24/7 support.
Given the limited development in the service model since its inception and changes and challenges across wider mental health service delivery, Adult Mental Health (AMH) services in the Trust area are undertaking a review of supported living provision.
What our review has found to date:
- There is an increased level of complexity amongst service users being referred to Supported Living;
- Increased vacancies in contracted Supported Living and an increase in high cost placements;
- Higher numbers of medically fit patients who are having their discharge delayed from mental health inpatient facilities;
- Increased staffing challenges and use of bank/agency staff to help service users with complex needs.
AMH services are working to develop a future model of supported living provision that addresses the highlighted challenges and ensures that thresholds for accessing supported living are more inclusive and address not only low intensity needs but also clients that require more intensive support, rectifying the current gap in service provision.
Avoca Lodge
Avoca Lodge opened in 1996 and is an Adult Mental Health Supported Living facility based on the Gransha site. It is a house of multiple occupancy (HMO) and has the capacity for ten tenants comprising of ten bedrooms. The tenants share bathrooms, toilets, kitchen/dining and social/living space. It is currently home for seven tenants all of whom, secondary to enduring mental illness are assessed as requiring a high level of support to maintain community living and have an individual care and support plans to meet their assessed need. Whilst offering an excellent level of support and care to its current tenant group, the building design and amenities fall short of modern standards. Over the past four years a further 8 tenancies have been offered to individuals with varying levels of need, however for multiple reasons, including levels of complexity, these have not been sustained within Avoca Lodge. Avoca’s 10 spaces represents 3.3% of the total capacity of Adult Mental Health Supported Living places available. There are currently 12 long term tenancies within contracted supported living facilities across the Trust, 9 of these are within Derry City within 5km from the Gransha site (Dunvale House, Clondermott and Ballyoan).
Stepping Down of Avoca Lodge
As a result of the findings the Trust commenced an Engagement exercise on 12 January 2023, proposing that Avoca Lodge is stepped down and the tenants, supported by their current key worker, care team and family move to another local facility that will continue to meet their support and care needs. In this proposal Service users would be supported by their care teams to make decisions regarding their future home based on their assessed need and available places. The tenants would remain under the care off their current Community Mental Health Team key worker and Consultant Psychiatrist.
All Supported Living and nursing home facilities are monitored by Regulation and Quality Improvement Authority (RQIA) and as such there would be no deterioration in the level of support and care that each tenant will receive. There would also be no staff posts lost as a result of any proposals.
The current supported living model consists of a high number of low intensity support beds which are not all being utilised and does not meet the needs of those clients who require more intensive support.
The overarching aim of the proposal is to develop a service that can meet the gap in service provision for those individuals with mental illness, who have higher levels of complexity, in their own communities.
As part of the initial engagement, all affected staff, service users and their families, as well as Trade Unions have been briefed on the proposals and participated in feedback exercises.
Following enquiries and discussions with some MLAs, the Trust senior team have also now set up further engagement sessions with all service users and their families at the beginning of April 2023. This will be to talk through the communications process, answer any concerns and questions raised and provide assurances.
The Trust continue to look at the overall planning in respect of the reform and modernisation of Adult Mental Health Supported Living services and will communicate to MLA/MPs in respect of this in the weeks ahead.
29/03/2023: Western Trust statement in respect Maternity Services and Industrial Action planned for Monday 3 April 2023
A Western Health and Social Care Trust (Western Trust) spokesperson said:
“Industrial Action will take place on Monday 3rd April between 8am and 12pm for members of the Royal College of Midwives. The Western Trust is anticipating disruption to both hospital and community maternity services. We are currently working with our trade union colleagues to maintain safe maternity care for all women and babies during this time.”
The spokesperson added:
“All births will be facilitated in the hospital in which they have been booked, as per Trust and regional policy. Inductions will be carried out as medically required. All scheduled caesarean sections and antenatal clinics in our hospitals and community facilities during planned industrial action will be rescheduled.
“We are currently in the process of making direct contact with women who will be impacted by the strike on Monday.
Planned dates for Industrial Action:
Friday 31st March 2023 - UNISON members | Commencing at 00:01 to 23:59hrs (24 hours)
Monday 3rd April 2023 - NIPSA members | Commencing at 00:01 to 23:59hrs (24 hours)
- UNISON members | Commencing at 00:01 to 23:59hrs (24 hours)
- Royal College of Midwives | Commencing at 8am to 12pm (4 hours)
Further updates will follow on the Public Representative’s Online hub.
22/03/2023: Ceasing the use of Agency Nursing/Midwives employed by Off-Framework Recruitment Agencies in Health and Social Care Organisations in Northern Ireland
Dear colleagues,
The former Health Minister, Robin Swann, outlined plans to reduce expenditure on recruitment agency use in a written statement dated 13 October 2022 (see link) doh-131022-wms.pdf (health-ni.gov.uk).
The Chief Nursing Officer, Maria McIlgorm, has also emphasised the importance of reducing agency spend and supporting, developing and retaining a sustainable workforce that is proud to work in the HSCNI.
The Trust recognises and appreciates the contributions of agency Nurses/Midwives and Health Care Workers in delivering safe, effective and compassionate care to our patients and clients. However, the cost of using recruitment agencies and in particular, off-framework agencies is significant and not sustainable.
The primary aim and direction going forward for all HSC Organisations is to increase stability by maximising our own HSC workforce. Where this is not feasible, the use of agency workers will only be permitted if the agency has been placed on the new HSC Agency Workers; Nursing and Healthcare Support Framework. This revised Framework is being finalised and will come into operation shortly. It is recognised that there will be a need for a short phased transitional period to embed the new arrangements. Further details of the new Framework will be circulated when it is finalised by the Business Services Organisation (BSO). In light of the planned changes in the use of agency workers, detailed guidance will be issued in due course.
It is important to note that as part of the revised approach, the Trust will NOT be permitted to use off-Framework agencies.
Further information about how these new arrangements may impact managers, staff working for the Trust through an off-Framework agency and agency workers working for the Trust is being finalised.
Reducing agency spend is the right thing to do, and not just for cost reasons, but we are endeavouring to improve the Health Service. Our staff have told us that excessive agency use is unfair and can impact on morale.
Building up our own workforce is the best way to support better teamworking to ensure safe and effective care and is vital in order to rebuild our health and social care services across Northern Ireland, and so we are committed to working in Partnership to improve and upgrade the use of Bank working, in the first instance in Nursing.
We deeply appreciate the commitment of our substantive workforce and we are determined to fill our vacancies, stabilise our teams and work in partnership with Trade Unions to strengthen and ensure the benefits of working in HSC are promoted and understood by the entire health workforce.
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February 2023
28/02/2023: South West Acute Hospital remains an Acute Hospital with a Type 1 Emergency Department
New All-Party Group for SWAH welcomes new Emergency Medicine Consultant to SWAH ED…
Western Health and Social Care Trust Chief Executive, Neil Guckian, has launched an all-party group for South West Acute Hospital as part of an overall campaign to promote our fantastic hospital as a Great Place To Work. In addition, the group will engage regularly to look at ideas to help develop services as well as recruit, retain and build our workforce.
Trust Senior Leaders on the group include Chief Executive, Neil Guckian; Medical Director, Brendan Lavery; Director of Planned Care, Mark Gillespie and Associate Medical Director, Professor Ronan O’Hare. At the latest meeting in SWAH, along with representatives from the five main political parties, Trust Senior Leaders also welcomed the latest appointment as a Consultant in Emergency Medicine to SWAH Emergency Department, Dr Stephen McKenzie.
Dr McKenzie, a former student at St Michael’s Primary School and then St. Michael’s College, Enniskillen, commented:
“I am delighted to take up my first Consultant post here at South West Acute Hospital, having qualified from Queen’s University and trained throughout Northern Ireland in the foundation programme and then the specialty training programme in Emergency Medicine.
“I have always wanted to work in emergency medicine and it is great to come back to work here in Fermanagh, where I live with my wife and two children, to this wonderful hospital. I worked here before as a foundation trainee, and was very aware that the facilities and high-tech equipment in SWAH is second to none. This is a really great place to work – the Emergency Department team are amazing and there are exceptional medical, nursing, AHP and support staff here.”
Dr Ian Crawford, Consultant in Emergency Medicine and Clinical Lead for Unscheduled Care, joined the group where it was re-iterated that South West Acute Hospital remains an Acute hospital with a Type 1 Emergency Department.
This has been further emphasised in an official statement from the Department of Health, as follows:
“The suspension of emergency general surgery from South West Acute Hospital (SWAH) does not change its Type 1 ED status or the acute status of the hospital.
“The definition of a Type 1 Emergency Department is ‘A consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services 24 hours a day.’
“No hospital in Northern Ireland provide all types of emergency surgical services and the definition does not require this. Even the larger hospitals with very busy EDs do not provide everything.
“In line with the definition, emergency general surgery is not a pre-requisite. What is required is emergency surgical services. The temporary (as currently the case in SWAH) or permanent (as proposed for Daisy Hill Hospital) suspension of emergency general surgery is not a removal of emergency surgery and those changes will therefore not impact on the type of ED which it is.
“This is not a new policy position. It reflects existing policy.”
23/02/2023: CAMHS Support plan
The Western Trust are aware of a very serious incident which occurred at Youth Sport Omagh last night, where a number of members of our community were present. The Trust are working closely with the Education Authority which has been supporting school children affected by this incident. The following links provides helpful advice to parents/carers and adults in the aftermath of such incidents. The link also gives information about additional support on offer if required.
- CLICK HERE for CAMHS Support Plan
- CLICK HERE for NHS Trauma Leaflet
- CLICK HERE for ‘Supporting Children and Young People after major trauma’
23/02/2023: Update on Supported Living Review and Stepdown of Avoca Lodge
As part of the reform and modernisation of Adult Mental Health Supported Living services, following a four week period of engagement with staff, service users and families, the Western Trust is proceeding with the stepping down of Avoca Lodge. This will involve relocating service users to other facilities which meet their needs and deploying staff to other Supported Living facilities.
Our service user’s health and well-being is our priority and we will continue to support and engage with them, their families and our staff throughout the transition.
The Trust senior team have been engaging with the Trade Unions and meeting with staff, all service users (together with Service User Consultant/Advocate) and families on Thursday 23 February 2023 to discuss the outcome of this proposal to stepdown Avoca Lodge.
The review of supported living is ongoing and information and the final report will be provided when available. Planning in respect of the Avoca Lodge premises, as part of this review of supported living, is also ongoing.
For further information, please see click here to view PDF.
17/02/2023: Continued significant investment in SWAH Diagnostic Infrastructure
As part of continued significant investment in South West Acute Hospital’s diagnostic infrastructure, a new MRI scanner will be installed in the Radiology Department at the hospital in the coming weeks. The replacement of the MRI Scanner is the next stage of equipment upgrade for South West Acute Hospital totalling over £1.7M in investment. This includes the recent instalment of a new CT scanner and Digital Radiography Rooms. A new Mobile Image Intensifier for SWAH Theatres is also due to be delivered in the coming months.
In order to provide continuity of service for patients during the replacement of the MRI scanner, rental of a mobile MRI unit has been secured. Works to install the mobile MRI will commence in the coming days, with delivery of the mobile MRI Scanner confirmed for mid-February.
Tracey McIvor, Radiology Services Manager for the Western Health and Social Care Trust (Western Trust) said:
“We are delighted that essential diagnostic radiology equipment at the SWAH is being updated which includes a new MRI Scanner installation over the next few weeks.
“The South West Acute Hospital provides a local MRI service for patients from Fermanagh and Tyrone, and also delivers the Trust wide Cardiac MRI scanning service. Replacement of the MRI Scanner in SWAH is essential to continue to provide a high quality, safe and efficient diagnostic service for Western Trust patients.
“All recently replaced equipment was installed 10 years ago. Thanks to advances in technology, new equipment for CT and MRI scanning will reduce scanning times and enhance diagnostic capabilities.
“We look forward to continuing to provide the very best quality of care to the Fermanagh and Tyrone communities we serve.”
17/02/2023: Update information in respect of ‘The Golden Hour’
Dr Brendan Lavery, Medical Director
The term Golden Hour was first used by Dr Adams Crowley a surgeon in Baltimore in 1975 in respect to trauma care.
He stated that “the first hour after injury will largely determine a critically injured person’s chance of survival”.
This was in the context of no organised trauma care, medicine in the 1970’s and no effective prehospital care as was typical of the time.
It is reasonable to state that this concept is outdated and is effectively a historical opinion that has become embedded in the public consciousness.
There have been multiple studies carried out across the world which have failed to find any significant survival advantage for trauma patients with shorter pre-hospital rescue times.
Trauma care has changed beyond recognition in the past decade initially across England, Scotland and Wales and more recently across Northern Ireland and ROI.
Patients are now preferentially taken to the most appropriate hospital first for trauma care.
Of note across GB, no patient with major trauma would be taken to a hospital which did not have Orthopaedic surgeons on site.
The Northern Ireland Trauma Network set up a trauma triage tool which helps paramedics take more patients to the RVH which is the trauma centre and bypasses multiple other hospitals.
Effectively Antrim, Ulster and Craigavon hospitals are bypassed in the majority of cases of significant trauma and the patient is taken to the RVH as the main trauma centre.
Altnagelvin sees approximately one third of the numbers of patients with significant trauma that attend the RVH trauma centre.
The RVH has also initiated a call and send model – this allows for a patient who fulfils major trauma criteria to be rapidly transferred from any ED to the RVH for ongoing management.
Due to all of the above changes deaths have decreased and lives have been saved.
All of this also ties in with the HEMS service which provides medical input at scene by both helicopter and land based vehicles.
There is no application historically or otherwise for any other healthcare problems where the term “Golden Hour” can be used.
Specifically there is no relationship of any kind for Emergency General Surgery.
In respect of the question about stroke treatment: There is a necessity for a patient to attend hospital as early as possible to allow a CT scan of the brain to be carried out and treatment decided within 3 hours.
All patients who have heart attacks are now transported to either Altnagelvin or the RVH for emergency angioplasty. This is the case everywhere across Northern Ireland.
Again there is good evidence that deaths have decreased in Cardiology and patients have much better outcomes.
17/02/2023: Response from the Department of Health in respect of ED Type 1 status.
Definitions and a list of all EDs in Northern Ireland is available in Annex 2 (page 29-30) of the DoH published Emergency Waiting Time Statistics:
https://www.health-ni.gov.uk/sites/default/files/publications/health/hs-niwts-ecwt-q3-22-23.pdf
Type 1 Department: A consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services 24 hours a day.
Type 2 Department: A consultant-led service with designated accommodation for the reception of emergency care patients, but which does not provide both emergency medicine and emergency surgical services and/or has time-limited opening hours.
Type 3 Department: A minor injury unit with designated accommodation for the reception of patients with a minor injury and/or illness. It may be a doctor or nurse-led. A defining characteristic of this service is that it treats at least minor injuries and/or illnesses and can be routinely accessed without an appointment.
Removal of general emergency surgery from SWAH does not change its Type 1 ED status.
17/02/2023: Update on services in South West Acute Hospital including Obstetrics & Gynaecology and Diagnostic Radiology
The Western Trust, and the Department of Health, are fully committed to the sustainability and the future of Obstetric and Gynaecology Services, including all Maternity services, at the South West Acute Hospital, Enniskillen.
South West Acute Hospital (SWAH) is funded for 6 whole-time equivalent Consultant Obstetricians. Six Consultants are currently on the rota and the rota remains stable. This currently includes locum consultant cover due to sickness absence and cover for a Consultant who left to take up a post elsewhere. This would be a standard process for any service.
Recruitment has been ongoing and this includes recruitment for two substantive Consultant posts in addition to Specialty Doctors in Obstetrics and Gynaecology. The two Consultant Posts were last advertised with a closing date of 13 January 23 (no applicants) and have now been re-advertised. This now includes advertising in International medical journals. Through International Medical Recruitment, interviews are scheduled for Obstetrics and Gynaecology in SWAH at end of February 2023.
In addition to these normal recruitment procedures, including the international medical recruitment programme, the Trust is also promoting via all our Social Media channels as part of an overall campaign.
It is also important to provide some context again that the Health Service as a whole, throughout the UK and ROI, continues to experience ongoing challenges and pressures which has been seen in all Acute Hospitals in Northern Ireland. As a smaller rural Hospital, South West Acute Hospital has been and will continue to face workforce challenges.
As stated, there is an ongoing recruitment process in place for Obstetrics and Gynaecology, in addition to other services, and the Western Trust will continue to focus on highlighting a very positive message regarding our wonderful staff and our state-of-the-art facilities.
Pre the Covid pandemic, we have featured our healthcare heroes in the West with our #WTHeroes campaign and this now resumes and will again be given special attention at our Western Trust Staff Awards on 9 March 2023.
However, we must point out that it has also already been emphasised in recent months how the very obvious negative public narrative, regardless of where it is emanating from, is impacting this fantastic Hospital.
The Trust are therefore asking our partners and the public to work with us in helping to promote SWAH as a great place to work and this area as a great place to live.
In respect of the point raised regarding Diagnostic Radiology, two posts were advertised in November 2022 with a closing date 23 December (no applicants). This is also being re-advertised. The Trust have also appointed two Radiology Consultants through International Recruitment. One commences contract at end of March 2023 with the second appointment commencing at end of June 2023. Another Radiologist has now also been appointed on 14 February 2023.
15/02/2023: Continued significant investment in SWAH Diagnostic Infrastructure
As part of continued significant investment in South West Acute Hospital’s diagnostic infrastructure, a new MRI scanner will be installed in the Radiology Department at the hospital in the coming weeks. The replacement of the MRI Scanner is the next stage of equipment upgrade for South West Acute Hospital totalling over £1.7M in investment. This includes the recent instalment of a new CT scanner and Digital Radiography Rooms. A new Mobile Image Intensifier for SWAH Theatres is also due to be delivered in the coming months.
In order to provide continuity of service for patients during the replacement of the MRI scanner, rental of a mobile MRI unit has been secured. Works to install the mobile MRI will commence in the coming days, with delivery of the mobile MRI Scanner confirmed for mid-February.
Tracey McIvor, Radiology Services Manager for the Western Trust said:
“We are delighted that essential diagnostic radiology equipment at the SWAH is being updated which includes a new MRI Scanner installation over the next few weeks.
“The South West Acute Hospital provides a local MRI service for patients from Fermanagh and Tyrone, and also delivers the Trust wide Cardiac MRI scanning service. Replacement of the MRI Scanner in SWAH is essential to continue to provide a high quality, safe and efficient diagnostic service for Western Trust patients.
“All recently replaced equipment was installed 10 years ago. Thanks to advances in technology, new equipment for CT and MRI scanning will reduce scanning times and enhance diagnostic capabilities.
“We look forward to continuing to provide the very best quality of care to the Fermanagh and Tyrone communities we serve.”
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January 2023
31/01/2023: Department of Health – Department calls for respectful debate
Department calls for respectful debate
The Department of Health would ask for respectful public debate on the future of health and social care services.
Communities rightly value local services very highly and are fully entitled to strongly advocate for their retention.
However, vigorous debate should not spill over into personal abuse and vilification. Likewise, questioning the honesty or motivations of public officials is not acceptable.
It is a reality of modern medicine that every hospital in Northern Ireland cannot provide every hospital service.
This has been set out in detail in relation to general surgery by the Northern Ireland wide review published by the Department last June – www.health-ni.gov.uk/news/review-offers-new-future-general-surgery-services
Some medical specialties require larger catchment areas and a certain level of patient numbers. This facilitates greater specialisation by clinicians, better recruitment and retention of staff, and more durable and safer care.
Securing the optimum distribution of hospital services – the right care, in the right place, at the right time – is an extremely difficult and challenging task.
24/01/2023: Ticket access to Public Consultation Events on Temporary Suspension of Emergency General Surgery Services at SWAH
We have a limited number of seats available at our public consultation events for those who are unable to access tickets online via Eventbrite. You can reserve a seat by ringing the booking line on: 07775226923 and stating your Name, Telephone number and which event you would like to attend.
The booking line will be open during the following times:
- Wednesday 25th January, 9am -5pm
- Thursday 26th January, 9am – 5pm
- Friday 27th January, 9am – 4.30pm
For full details and information on all Consultation Events: South West Acute Hospital – Emergency General Surgery Consultation
23/01/2023: Update on Public Consultation for Temporary suspension of Emergency General Surgery Services at South West Acute Hospital
The Western Trust has announced a significant consultation process with nine events planned in the weeks ahead. With seven public facing engagements spread across the geography of Fermanagh and West Tyrone and an additional two online consultation events, this should help cater for anyone in our population who may use any of our services at South West Acute Hospital and who wishes to contribute in person to this consultation process.
The Trust has worked with Fermanagh and Omagh District Council colleagues in the planning for these events and to ensure everyone in the area gets the opportunity to have their voices heard, the Trust are offering a public event in each of the seven FODC ‘District Electoral Areas’. In addition, we will also be hosting 2 online sessions for anyone who is unable to attend the 7 face to face events, providing the opportunity to attend either a daytime or evening online engagement. This significant series of consultation engagements can cater for a potential attendance of over 4000 people.
It has been very important to note that access to public facing events must be by ticket only to ensure public safety and the online registration at Eventbrite has been now been simplified for ease of use. The Western Trust has worked with colleagues in FODC to review venue capacity and ensure that we manage attendance at each event according to that capacity. For those who may find it difficult to register online, the Trust will hold some manual tickets for residents and further information will be provided on this in the coming days on how to access these.
In addition to the list of Consultation events there is also an online questionnaire which is available for the public to complete and inform the Trust of their views and to feedback on the consultation documents.
We will continue to keep the matter under review as the Consultation events progress.
Again, here is a reminder of the list of Consultation events and how to register. All information is advertised in the media and will feature on the Trust’s social media channels. Any further updates to information will be available on the Trust’s official Consultation page at: South West Acute Hospital – Emergency General Surgery Consultation
Register for each specific event at the following link or in the table below: www.westerntrust.hscni.net/SWAH-EGSConsultation
South West Acute Hospital Emergency General Surgery Public Session Events
Ticket only Public Session EventsDistrict Electoral Area Venue Date and Time Eventbrite Link (Registration) Enniskillen Fermanagh Lakeland Forum 30/01/23
6:30pm - 8:30pmRegister Here Erne East Castle Park Leisure Centre 31/01/23
6:30pm - 8:30pmRegister Here West Tyrone Ecclesville Centre 01/02/23
6:30pm - 8:30pmRegister Here Erne North Bawnacre Centre 02/02/23
6:30pm - 8:30pmRegister Here Erne West Belcoo Community Centre 07/02/23
6:30pm - 8:30pmRegister Here Mid Tyrone Owenkillew Centre 08/02/23
6:30pm - 8:30pmRegister Here Omagh Omagh Leisure Complex 09/02/23
6:30pm - 8:30pmRegister Here Online Event 1 Online 08/03/2023
1:00pm - 3:00pmRegister Here Online Event 2 Online 13/03/2023
7:00pm - 9:00pmRegister Here
23/01/2023: Update on Old Derg Valley hospital site/building in Castlederg
The outcome of the recently commissioned independent estates survey on the current condition of the Old Derg Valley hospital site/building facility, to help inform decision making, has confirmed that demolition of the former Castlederg Hospital building is essential to manage the site risks, including protecting current services i.e. NI Ambulance Service and Education. This has been discussed with the Department of Health as site owner, and I can now confirm that the Trust has secured approval to proceed to demolish this building. Our Estates Team have erected hoarding around this building and a further intrusive assessment of the roof structure is underway. The Trust is working with the Department of Health on a funding solution for the demolition works but anticipate proceeding with works in the coming weeks.
Neil Guckian
Chief Executive
17/01/2023: Public Consultation on the Temporary Change to Emergency General Surgery at South West Acute Hospital
The Western Health and Social Care Trust (Western Trust) is launching a 12 week public consultation on the temporary change to Emergency General Surgery at South West Acute Hospital, Enniskillen from week commencing 16 January 2023.
The Trust is seeking staff and the public’s views on the temporary suspension of Emergency General Surgery at SWAH and will be facilitating seven face-to-face public engagements across the Fermanagh and Omagh Council area. Two virtual meetings will also be facilitated, as well as engagement sessions for staff.
The consultation will close in April 2023 and the outcome of the consultation will be considered at a Trust Board meeting in the Summer 2023.
It is important to note engagement events will be ticket only. One ticket will be allocated per person and ticket duplication must be avoided to comply with health and safety regulations. To register to attend any of the events please log onto the Western Trust website at: www.westerntrust.hscni.net/SWAH-EGSConsultation
Speaking about the consultation, Western Trust Chief Executive Neil Guckian said: “I accept this will be a concerning time for the local population. I want to reassure people that our priority is to provide a safe, sustainable and effective Emergency General Surgery service for patients in the Western Trust area, ensuring safe services and the best outcomes for all patients.
“The main objective of this consultation is to see if an alternative viable means of delivering Emergency General Surgery at SWAH can be identified. We would encourage the public and our staff to respond to our consultation which is available on the Trust’s website www.westerntrust.hscni.net or by contacting our Health Improvement Equality and Involvement office on T: (028) 71 865127.
Mr Guckian continued: “A hybrid approach of both online and face to face engagement will be taken to enable an inclusive and well-managed approach to consultation events where there is likely to be a high level of public interest.”
Details of engagement events will be advertised locally in the press and via the Trust website and social media sites.
Ticket only Public Session Events:
Register for each specific event here: www.westerntrust.hscni.net/SWAH-EGSConsultation
District Electoral Area Venue Date and Times Enniskillen Fermanagh Lakeland Forum 30 January 6.30 – 8.30pm Erne East Castle Park Leisure Centre 31 January 6.30 – 8.30pm West Tyrone Ecclesville Centre 01 February 6.30 – 8.30pm Erne North Bawnacre Centre 02 February 6.30 – 8.30pm Erne West Belcoo Community Centre 07 February 6.30 – 8.30pm Mid Tyrone Owenkillew Centre 08 February 6.30 – 8.30pm Omagh Omagh Leisure Complex 09 February 6.30 – 8.30pm -
December 2022
19/12/2022: Important Information regarding local health and care services – Tuesday 20 December
Strike Action will take place on Tuesday 20 December by RCN trade union members. Given the reduction in staffing levels anticipated, the Western Trust has regrettably taken the decision to cancel some non-emergency services.
Impact is as follows:
- 515 outpatients new, review and urgent outpatient appointments have been postponed across Altnagelvin Hospital, Omagh Primary Care and Treatment Centre and South West Acute Hospital. Where possible new appointments have already been allocated or will be allocated shortly via letter.
- 37 planned inpatient and day case procedures have been cancelled across Altnagelvin Hospital, Omagh Primary Care and Treatment Centre and South West Acute Hospital.
- 11 Trust managed GP Practice treatment rooms will be closed.
- 27 Women and Children’s services hospital and community based appointments postponded.
- 96 Mental Health and Disability services community based appointments postponed.
The Trust has made contact with patients and service users that are directly affected by tomorrow’s industrial action. If you have not been contacted please assume your care will proceed as planned. We sincerely apologise for any inconvenience caused.
The Trust continues to work with Trades Unions and will provide further information updates on our website or social media channels for more information.
15/12/2022: Western Trust Statement: Industrial Action – Thursday 15th December
Important Information regarding local health and care services – Thursday 15 December.
Strike Action will take place on Thursday 15 December by RCN trade union members. Given the reduction in staffing levels anticipated, the Western Trust has regrettably taken the decision to cancel some non-emergency services.
Impact is as follows:
- 587 outpatients new, review and urgent outpatient appointments have been postponed across Altnagelvin Hospital, Omagh Primary Care and Treatment Centre and South West Acute Hospital. Where possible new appointments have already been allocated or will be allocated shortly via letter.
- 8 planned inpatient and day case procedures have been cancelled across Altnagelvin Hospital, Omagh Primary Care and Treatment Centre and South West Acute Hospital.
- 11 Trust managed GP Practice treatment rooms will be closed.
- A reduced service is anticipated for Community nursing services including rapid response nursing, district nursing, community respiratory nursing and continence services.
The Trust is currently in the process of making contact with patients and service users that are directly affected by tomorrow’s industrial action. If you have not been contacted please assume your care will proceed as planned. We sincerely apologise for any inconvenience caused.
The Trust continues to work with Trades Unions and will provide a further information updates on our website www.westerntrust.hscni.net or social media channels for more information.
12/12/2022: Engagement and Pre-Consultation on the future model of supported living provision
Engagement and Pre-Consultation on the future model of supported living provision
Background: Adult Mental Health (AMH) in the Western Health and Social Care Trust (Western Trust) in collaboration with contracted housing providers and NIHE Supporting People operates a supported living service. The service was developed to facilitate the closure of the long stay psychiatric inpatient wards in the 1980’s and 1990’s. The service enables individuals with significant mental illness to maintain a home address outside of the hospital environment and to live independently in the community. Each individual has a personalised support plan to help them maintain their tenancy and their mental and physical well-being. The individual lives as a tenant within a supported environment with access to 24/7 support.
Given the limited development in the service model since its inception and changes and challenges across wider mental health service delivery, Adult Mental Health (AMH) services in the Trust area are undertaking a review of supported living provision.
What our review has found to date:
- There is an increased level of complexity amongst service users being referred to Supported Living;
- Increased vacancies in contracted Supported Living and an increase in high cost placements;
- Higher numbers of medically fit patients who are having their discharge delayed from mental health inpatient facilities;
- Increased staffing challenges and use of bank/agency staff to help service users with complex needs.
AMH services are keen to develop a future model of supported living provision that addresses the highlighted challenges and ensures that thresholds for accessing supported living are more inclusive and address not only low intensity needs but also clients that require more intensive support, rectifying the current gap in service provision.
All Supported Living facilities are monitored by Regulation and Quality Improvement Authority (RQIA) and NIHE Supporting People and as such there would be no deterioration in the level of support and care that each tenant will receive. There would also be no staff posts lost as a result of any proposals.
The current supported living model consists of a high number of low intensity support beds which are not all being utilised. There is a need to rationalise current provision to adapt the model to meet the needs of clients with higher levels of complexity and to develop a Community Support & Rehabilitation Team in line with the recommendations of the Mental Health Strategy. The overarching aim of the proposal is to develop a service that can
support individuals with mental illness, who have higher levels of complexity in their own communities, and deliver this support and rehabilitation within a continuum of supported housing provision.As part of the initial pre-engagement and staff consultation, all affected staff, service users and their families, as well as Trade Unions will be briefed on the proposals and are encouraged to participate in the consultation.
This initial plan of a four week consultation period with Staff is paused due to the current Industrial action process. Any service change proposal that effect staff must be signed off for consultation by Staff side representatives. This is a Trust requirement and an internal Trust process. As part of this process staff will meet with HR, Staff side representatives and AMH management. The staff side meetings have been stood down secondary to industrial action. The paper cannot be shared with staff until after it is signed off.
As part of the initial pre-engagement, the project lead will have meetings with the relatives and tenants of the Avoca tenants to discuss the potential impact of the proposals. All relatives have been contacted by letter with discussions also having taken place with a number of relatives. The project lead has also advised family and tenants that he is happy to meet with them at any time. Communication with staff via the facility manager has also taken place and staff have been informed that the initial pre-engagement/staff consultation has been stood down until the conclusion of the industrial action.
Following the pre-engagement and staff consultation the project team will give consideration to wider public consultation on any proposed changes.
12/12/2022: Joint statement from the Chief Executives of Northern Ireland’s Health Trusts
Our Health and Social Care System is facing a prolonged period of industrial action.
Inevitably there will be an impact on services. However, we have contingency plans in place and are working closely with the Trade Unions to protect our critical services and to mitigate disruption, as far as possible.
Our staff are not just the back bone of health and care services, they are our colleagues and friends. Working in the Health and Social and Care System is a way of life. The HSC is a family because of the incredible work that takes place on a daily basis, often including additional service over and above normal duties. We obviously want to see all staff properly rewarded for their work. They have been impacted heavily by cost of living increases and escalating pressures on Health and Social Care services. We must also never forget what they did for us all during the pandemic.
HSC leaders issued a joint statement three years ago, when health and social care workers in Northern Ireland were taking industrial action.
Its central plea remains just as relevant today and we repeat it now:
‘We are all aware that the Health and Social Care System in Northern Ireland requires a long-term funding settlement that addresses service, workforce and pay pressures in a sustainable manner. We have been struggling with a system where funding has been made available on a yearly basis, which makes it impossible to plan for the long term. Demand is increasing and will continue to do so, meaning that the current system is simply unsustainable.’
10/12/2022: Statement by Trust Chief Executives
As members of this community as well as health and social care service leaders, we are deeply distressed at the ongoing situation in our hospitals.
Although strenuous efforts are being made to alleviate the pressures, we have a serious capacity deficit which means too many people are waiting too long for care. Much of the impact of this is falling on frail and ill older people and on the staff caring for them.
Pressures on services are expected to intensify further after Christmas and into the early months of 2023.
The case for long-term investment and reform to effectively build capacity has been well made. Right now, however, we have to use whatever levers are available to us to reduce delays and prioritise patient safety.
HSC Trusts have been working intensively with Departmental colleagues on our ongoing response. It has been agreed that the following initiatives will be introduced across the system:
* Patients will leave hospital no later than 48 hours after confirmation they are medically fit for discharge and where a suitable placement which can meet their needs is available. There will be no cost to the patient or their family for this alternative interim placement and it will not impact on their place on any waiting list for their longer term option. Trusts and Care Homes will work closely together to make best use of any and all available capacity. This will include new shared arrangements for pre-admission assessment for care homes seven days a week.
* A maximum limit of three hours for ambulance handover will apply at all EDs. There is agreement in principle to further reduce this limit over the coming months, subject to review. In the interim, for ambulances waiting up to three hours for handover, it is agreed to maintain the focus on immediate release of ambulance crews to respond to immediately life threatening Category 1 calls.
* Maximum use will be made of available space in wards and throughout hospitals, to improve patient flow out of overcrowded Emergency Departments. This will also include, where appropriate, use of chairs rather than beds for patients medically fit to leave hospitals.
These are not steps that we ever wanted or indeed imagined having to introduce. They are not designed as a long-term solution, but as actions to reduce the risk to patients waiting in unacceptable circumstances in ambulances and EDs.
What we absolutely require is a long-term funding settlement and a health and care system which properly reflects demographic trends and is capable of meeting rising levels of demand.
In the meantime, we cannot passively accept the status quo, with all that it means for patient care and safety.
09/12/2022: Western Trust Statement: Industrial Action – Monday 12th December
Industrial Action will take place on Monday 12 December for NIPSA, UNISON and GMB trade union members. This will have impact on the provision of some hospital and community health and social care services across the Western Trust area.
Impact is as follows:
- 625 new, routine and review outpatient appointments have been postponed across Altnagelvin Hospital, Omagh Primary Care and Treatment Centre and South West Acute Hospital. Where possible new appointments have already been allocated or will be allocated shortly via letter.
- 47 inpatient and daycase procedures postponded across our hospitals.
- The following Older People’s Day Centres will be closed:
- Dromore Day Centre(outreach service)
- Foyleville Day Centre.
- The following Learning Disability Day Centres will be closed:
- Omagh Centre
- Glenside Day Centre
- Oaktree Day Centre
- Valley Day Centre.
- The following adult mental health day centres will be affected:
- Melrose Day Centre (closed between 8 am and 12 noon)
- Arden Day Centre (closed between 8 am and 12 noon)
- Creggan Day Centre (closed all day).
- Drumcoo Physical and Sensory Disability Day Centre will be closed.
- We are aware that some service users in receipt of homecare may not receive their scheduled morning call, between the hours of 8am and 12 noon, if it is delivered by the Western Trust. We are asking for the help of family members and carers to assist us during these times by checking in with their relatives / neighbours that receive homecare services. Should an issue arise please call the local Home Care office on the following numbers: Northern Sector (Derry, Limavady, Dungiven) – (028) 7186 4385; Fermanagh (028) 6634 2414 or Strabane Castlederg and Omagh (028) 8283 5911. Homecare delivered by our contracted providers are not expected to be affected.
- There will be limited catering facilities. Patient and client meals will be prioritised but this may include lighter options. Coffee shops in our hospitals will be closed. It is planned that restaurants will remain open but with a reduced service.
- There may be delays in answering calls by our hospital and health centre switchboards. It is advised to only call if your query or request is essential. Our hospital helpdesks may also operate a reduced service.
We are currently in the process of making direct contact with our patients and service users, who will be impacted by the strike action. If you have not been contacted please assume that your care will proceed as planned. We sincerely regret this disruption and would ask for cooperation and patience at this challenging time.
The Trust continues to work with Trades Unions and will provide a further information updates on our website www.westerntrust.hscni.net or social media channels for more information.
08/12/2022: Update Industrial Action
Strike Action will take place on Monday 12th December for NIPSA, UNISON and GMB trade union members and Thursday 15th and Tuesday 20th December for RCN trade union members. We expect that there will be significant disruption to our hospital and community services across the Western Trust area on these days.
As ever our main priority is to ensure and maintain patient safety. Given the reduction in staffing levels expected across most disciplines on the strike action dates, our efforts will be focused on providing emergency services for patients in our hospitals and those at highest risk within our communities.
The Trust is currently developing its contingency plans and we will make direct contact with our patients and service users impacted by the strike action.
The Trust also continues to work with Trades Unions.
06/12/2022: Public Information Guide re: Temporary Change to Emergency General Surgery at South West Acute Hospital
Please find below a PDF of the Western Trust Public Information Guide in respect of the Temporary Change to Emergency General Surgery at South West Acute Hospital which is being issued publicly this week and which will also be advertised in the local newspapers for Fermanagh and West Tyrone.
Copies are also being printed for distribution.
The central online page for Public Information is available on our Website here:
02/12/2022: Fact Check on Temporary Change to Emergency General Surgery at South West Acute Hospital
- Fact Check with updated information in respect of temporary change to Emergency General Surgery at South West Acute Hospital
- Click Here for Fact Check PDF
- Online link (on Western Trust Website) to updated information regarding Emergency General Surgery at South West Acute Hospital for the Public. This will be updated and shared in the weeks ahead as part of the Trust’s public information communications campaign
01/12/2022: Industrial Action Statement
The Western Trust has been informed about the planned industrial action dates for December 2022. The Trust is currently developing its contingency plans for these dates in order to minimise disruption.
We will keep the public informed via our website and social media channels.
Unison – Monday 5 December (Action Short of Strike) and Monday 12 December (Strike Action Day )
NIPSA – From Monday 5 December (Indefinite Action Short of Strike)
RCN – Thursday 15 December and Tuesday 20 December (Strike Action Days)
Update will follow at the MLA/MP Briefing on 16 December 2022
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November 2022
17/11/2022: Presentation – Emergency General Surgery at South West Acute Hospital
The Western Trust updated Presentation to Public Representatives regarding the Temporary suspension of Emergency General Surgery at South West Acute Hospital, Enniskillen.
17/11/2022: Western Trust Statement – Temporary Suspension of Emergency General Surgery at South West Acute Hospital, Enniskillen
Temporary Suspension of Emergency General Surgery at South West Acute Hospital, Enniskillen
The Western Trust today (Thursday 17 November 2022), at a special Trust Board meeting, addressed the challenging position regarding Emergency (unplanned) general surgery at South West Acute Hospital, Enniskillen in light of a further resignation within the general surgery team.
In addition, Trust Board also discussed plans being developed with the Department of Health to expand non-emergency planned surgery at the hospital.
Speaking after the meeting, Geraldine McKay, Director of Acute Services at the Western Trust, said:
“I spoke publicly last month on the fragility of Emergency general surgery at SWAH. At our Trust Board meeting today, we updated Trust Board members on the current position and in particular a further resignation received from another consultant in the general surgery team. This now means that we will not be in a position to provide an emergency (unplanned) general surgical rota from 18 December 2022.
“Despite our previous and ongoing efforts to recruit, we have not been successful to date in securing the necessary consultant workforce. The Trust is therefore now unable to maintain the required workforce to sustain and deliver a safe emergency (unplanned) general surgical service to our population from SWAH.
“Put simply, we cannot provide an emergency general surgery service without a consultant surgical team in place to provide the required 24/7 cover.
“We can confirm that our Trust Board approved today to a recommendation for an unplanned temporary suspension of Emergency General Surgery at the SWAH, Enniskillen. This is necessary to protect public health/safety.
“The current rota for emergency general surgery will be maintained up until 4 December 2022. Planned elective surgery at the hospital will continue.
“There will be no change to the Emergency Department (Type 1) at South West Acute Hospital which will continue to operate as usual on a 24/7 basis. There will be minimal to no impact on the other existing services at SWAH.
“We have developed and will implement alternative clinical patient pathways to mitigate risk and protect the safety of people needing to avail of emergency general surgery services after the current rota ends and are focused on minimising the impact of this temporary arrangement on the hospital’s acute services. We will communicate the clinical patient pathways in the coming days.
“We are liaising with our colleagues in the Northern Ireland Ambulance Service and the Southern Health and Social Care Trust on the new arrangements.”
Commenting on longer term plans, Western Trust Chief Executive Neil Guckian said:
“We need to fully utilise all of our theatre capacity across South West Acute Hospital to undertake more elective procedures, and we are delighted to work with the Department to develop SWAH as an overnight elective surgery centre to benefit the growing numbers of patients on our waiting lists.
“I would like to pay tribute to our surgical teams for their continued commitment despite these mounting pressures and thank staff at South West Acute Hospital for their flexibility in supporting these temporary arrangements.”
“I want to reassure the local community that the Trust is fully committed to developing and enhancing South West Acute Hospital as an essential part of the Western Trust and regional hospital network. SWAH has a very busy Emergency Department, fantastic facilities and a wide range of very vibrant specialities.
“We ask for public support and understanding as we continue to work through the challenges to develop a solution that meets the future needs of our population. We will be carrying out a full public consultation on this temporary change including seeking views on how emergency general surgery might be restored, and will outline the details of consultation process in the coming weeks.
“Extensive work will be undertaken to inform patients of the change to general surgery services, including public advertising, posters and social media messaging.”
17/11/2022: DoH Statement – South West Acute Hospital Update
South West Acute Hospital update
The Department fully recognises the importance of South West Acute Hospital (SWAH) to the people of Fermanagh and Tyrone and to Northern Ireland’s hospital network.
The first duty of any health system is to provide safe care and the Department is satisfied that the Western Trust’s decision to temporarily suspend the service has been taken on public safety grounds, due to a lack of consultant general surgeons.
The mitigations put in place by the Trust will be closely monitored by the Department, including the transport arrangements for patients requiring treatment in other hospitals.
The future for emergency general surgery at South West Acute Hospital will now be the subject of a public consultation. Any permanent decision to cease emergency general surgery will require approval from the Department and Health Minister.
The Department can reassure the local population on SWAH’s future. It is a vital part of our hospital network and will very much remain so.
We can confirm that the Department is working with the Trust to make the hospital Northern Ireland’s third Elective Overnight Stay Centre, following earlier announcements on the Mater Hospital in Belfast and Daisy Hill Hospital in Newry.
This will help the local population to receive better and quicker planned surgical care, and also help the whole region. It is expected to increase the number of operations and patients at SWAH.
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October 2022
17/10/2022: Special Trust Board Meeting to Consider General Surgery at South West Acute Hospital, (SWAH) Enniskillen
Embargoed until 5PM – 17/10/2022
The Western Health and Social Care Trust (Western Trust) held a special Trust Board meeting today (Monday 17 October 2022) during which the challenging position regarding Emergency General Surgery at SWAH was considered.
The meeting also discussed plans being developed with the Department of Health to expand non-emergency planned surgery at the hospital.
Speaking after the meeting, Geraldine McKay, Director of Acute Services at the Western Trust said:
“We have become increasingly concerned at the fragility of Emergency General Surgery at the SWAH. At our meeting today we updated Trust Board members of the current position and discussed a number of future planning options. The Department of Health and the Service Commissioner the SPPG are fully aware of the position and are being kept appraised of developments.”
“Despite our efforts to recruit, we have not been successful to date in securing the necessary consultant workforce. In recent months the Trust has highlighted the challenges of recruiting and retaining experienced consultant surgeons to provide the service.
“This is not a question of funding but maintaining the required workforce. The Trust is funded for six consultant surgeons to provide the service and we currently are working with three surgeons supported by locums. In recent days, we have been notified of forthcoming changes in the staff team which unless restored will leave it impossible to sustain a safe emergency general surgery service at the hospital.
“It is very important to note that no decision was made at today’s meeting and no recommendation from Trust Board has gone to the Department and Minister.
“While intensive recruitment efforts will continue, we also have to prepare for a future in which these do not prove successful. This planning will involve working very closely with our surgical team, our HSC colleagues and the Department to consider and develop clinical pathways for patients served by SWAH who require this service.
“No matter the outcome, however, it is important to stress that elective surgery at the hospital will continue and there would be minimal to no impact on the other existing services at SWAH.”
Trust chief executive Neil Guckian said:
“The province wide Review of General Surgery, which was published by Department of Health In June, highlighted the difficulties of maintaining the workforce for emergency general surgery at sites with a lower patient turnover in terms of rotas, succession planning, skill mix, supporting services and disciplines, best practice and maintaining quality care. It also stressed the potential for expanding elective (planned) surgery on these smaller sites. This would result in more patients being served than ever before. The SWAH would make an excellent regional elective centre. The Trust is determined to make that vision a reality and has been working with the Department on plans for an elective overnight stay centre at SWAH.
“I am very aware that the situation with emergency surgery will be deeply concerning to patients and staff. It’s not a position we want to be in but we have to plan ahead and be up front with the public about what that planning involves. I ask everyone to work with us constructively.”
03/10/2022: Update to Visiting Guidance to Western Trust Hospitals
Update to Visiting Guidance to Western Trust Hospitals
The Western Trust visiting guidance to hospital sites will continue to allow two visitors to visit at the same time, for one hour per day, per patient from FOUR nominated visitors. This will be reviewed again on Monday 10 October 2022.
There has been an easing of restrictions to maternity services which will now allow three nominated visitors, an increase from two previously. Partners can now attend twice daily, however the other two nominated visitors can only visit once per day.
Elective Wards (Wards 3, 21 and 43) at Altnagelvin Hospital and Elective Ward 9 at South West Acute Hospital will now allow one visitor from two nominated visitors to visit for one hour, once per day for post operation patients only. A time slot will need be arranged directly with the Ward.
The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and we are therefore emphasising the social responsibility our visitors have by ensuring they please continue with adherence to infection prevention and control measures in our efforts to reduce the risk of transmission of COVID-19 into high risk and vulnerable settings.
We would also ask that visitors please wear a face mask (covering their nose and mouth) when inside our healthcare facilities, even when in the presence of a patient.
It is extremely important that any individual displaying symptoms of COVID-19 should self-isolate and take a LFD in line with current advice for the general population – they should not visit a hospital.
Visitors should note that despite the latest government guidance that you no longer need to self-isolate from Day 5, as a precautionary measure, you should avoid contact with people you know to be at higher risk from COVID-19 for 10 days, especially those with a weakened immune system and/or in hospital, to make sure you are no longer infectious.
Important information on visiting any Western Trust hospital:
- Two visitors (from FOUR nominees) are permitted to visit for one hour, once per day at the same time.
- Maternity Services – There has been an easing of restrictions to maternity services which will now allow 3 nominated visitors, an increase from two previously. Partners can now also attend twice daily, however the other two nominated visitors can only visit one daily.
- Neonatal Units – both parents or two nominated visitors to spend as much time with their baby as they wish.
- Children’s Ward – Any child admitted to the Children’s Ward can be accompanied by two people (either/both parents or two nominated caregivers from up to two households), at all times for the duration of the stay. We would however ask that parents or other nominated visitors swap places (one person at a time at the bedside) to enable us to maintain effective social distancing.
- Cancer Services – Ward 50 (North West Cancer Centre) at Altnagelvin will now allow for two nominated persons to visit for one hour, once a week. To keep our patients and staff safe from infection risks, virtual visiting remains the preferred option, in order to reduce the risk of COVID-19 spread.
- Elective Wards (Wards 3, 21 and 43) at Altnagelvin Hospital and Elective Ward 9 at South West Acute Hospital will now allow one visitor from two nominated visitors to visit for one hour, once per day for post operation patients only. A time slot will need be arranged directly with the Ward.
Based on high risk of COVID-19 transmission it is important to note that some wards are unable to allow visiting at this time and you will be informed of this when you ring to book your visit.
Depending on the continued level of COVID-19 transmission in the community, all temporary measures are subject to review.
There will also continue to be exceptional circumstances in respect of visiting guidance to the cancer services attending outpatient appointments, maternity scans, neonatal and visiting patients in end of life care. For further information, please refer to the Trust website.We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
Please respect our Staff
For anyone attending any Western Trust hospital or facility, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a Zero Tolerance policy towards abuse across our Trust.
We would like to thank you for your cooperation in relation to all essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here: https://westerntrust.hscni.net/western-trust-covid-19-information-updates/western-trust-covid19-visiting-guidance/
The Trust will meet to review the visiting arrangements again on Monday 10 October 2022.
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September 2022
20/09/2022: Belfast Telegraph Article: PFI Contract at SWAH & Altnagelvin Hospital; Lisnaskea Health and Care Centre – Proposal of Planning Notice (PAN); Update on Neonatal Services at South West Acute Hospital
1. RE: Belfast telegraph Article: PFI Contract at SWAH & Altnagelvin Hospital (19 September 2022)
You may be aware of a recent article in the Belfast Telegraph regarding the PFI Contract for the South West Acute Hospital, Enniskillen. We would like to provide you with some additional clarity to avoid any further misunderstanding.
Overall cost of the contract.
The article does not make clear that the costs of the PFI contract covers both the construction costs of building of the South West Acute Hospital and the additional costs associated with PFI contract. These include payment for Services, whole life costs (such as capital, lifecycle replacement for plant and equipment including specialist medical equipment, maintenance and operating service costs). Services included within the Unitary Charge are Estates Services, Energy & Utilities, Grounds & Gardens and Helpdesk.
Northern Ireland Health Group (NIHG) are contracted to provide these services at the South West Acute Hospital. Therefore it is important to emphasise that the total cost stated in the article covers both the building of the hospital and associated services provided by NIHG over the 30 year contract period. The article headline is very misleading as is states: “Western Trust owes firm £580m for a hospital that cost £224m to build.” The £580m (figure provided by Belfast Telegraph) also covers the costs associated with the provision of the services provided by the contractor, NIHG over the 30 year period.
The Western Trust pays the PFI contractor from funding that was secured centrally from Department of Health. For clarity, the PFI financing allocated to the Trust was specific for this purpose and is in addition to the existing operational budget. The PFI contract for the South West Acute Hospital does not impact on the Trust’s ability to fund other services. Following a detailed and robust business case process that was approved by the Department of Health and the then Health & Social Care Board (HSCB), this funding has been made available to the Trust for the delivery of this acute hospital facility. As stated above, the financing was secured specifically for this purpose and was in addition to the Trust’s existing operational budget.
Penalty Charges
Another important clarification which is not made clear in the article relates to penalties incurred. The Western Trust does not pay financial penalties. The penalties are paid by the contracted PFI provider, NIHG where agreed Service Level Agreements/Performance Standards that were built into the PFI contract are not met. For example, if a piece of equipment such as an endoscopy washer is broken and the Trust is unable to use it, then the Trust would issue a penalty to the contractor.
Like all PFI contracts, the South West Acute Hospital PFI Contract has an extensive performance specification and a penalties regime which was agreed at the outset. This means that the PFI provider NIHG pays penalties if underperformance occurs, under strict circumstances as set out in the contract terms. The contract terms are commercially sensitive and therefore we cannot comment further on them.
2. Lisnaskea Health and Care Centre – Proposal of Planning Notice (PAN)
A spokesperson for the Western Health and Social Care Trust (Western Trust) confirmed:
“A Proposal of Planning Notice (PAN) will shortly be submitted to Fermanagh and Omagh District Council for Lisnaskea Health & Care Centre as part of the design process. As Lisnaskea is designated as a major development, the PAN process has a requirement for a public engagement event, which is provisionally scheduled for the end of October 2022.
“The event will be led and facilitated by the design team and will take the form of a call-in/drop-in type review, with afternoon and evening sessions available. Public notices will be placed in the Fermanagh Herald and the Impartial Reporter detailing the date and time of the public engagement event once confirmed. The event will help identify and address potential planning objection areas prior to the submission of the formal planning application.
“Further public consultant events will be organised as part of the wider project development, to support the design and implementation process.”
3. RE: Update on Neonatal Services at South West Acute Hospital
We wish to provide you with an update/changes to Neonatal Services at the South West Acute Hospital.
As you will be aware, due to chronic workforce challenges the unit moved from six special cots to two providing emergency and stabilisation care only since November 2021.
Extensive recruitment efforts have been ongoing over many months to secure Band 5, 6 and 7 posts. We wish to advise that we have been successful in the recruitment of a Band 7 post and a number of Band 5 posts.
Advertising for the Band 6 posts continue and more widespread radio ads have been developed to try and attract staff from ROI/ NIreland.
It has therefore been approved to move the threshold of delivery in SWAH from 36 weeks to 35 weeks with recommencement of neonatal special care provision for babies from 35 week gestation. Alongside this we will recommence repatriation of some babies from this locality, who are currently receiving special care in other hospitals.
This change is with immediate effect.
We are also pleased to announce that Tinylife have recruited to a Family Support officer to support families with preterm infants in the Tyrone and Fermanagh area. We will be promoting this new role on our social media channels and through local media in due course.
We will continue to keep you updated on the progress of the service.
If you require a further discussion on this, please contact myself on the contact details below.
09/09/2022: MLA MP Briefing – Surgical Services
Click here to Download and Print the Briefing Paper regarding Surgical Services – 09 September 2022
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May 2022
25/05/2022: Omagh Hospital and Primary Care Complex to become Northern Ireland’s second day procedure unit
The Western Trust has welcomed today’s announcement by Minister Swann that Omagh Hospital and Primary Care Complex will become Northern Ireland’s second regional Day Procedure Centre.
The initiative represents a significant step forward in the transformation of health care to tackle waiting lists for urology, general surgery and endoscopy, which will benefit patients throughout the region.
Commenting on the Minister Swann’s announcement, Geraldine McKay, Director of Acute Services said:
“This is great news for the Western Trust and in particular Omagh Hospital and Primary Care Complex. We look forward to working with the Department of Health and our clinical and nursing staff to implement this.”
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April 2022
05/04/2022: Visiting Guidance update for Western Trust Hospitals
The Western Trust will continue with visiting to hospital sites allowing for one visit, for one hour per day per patient. Exceptions will also continue to apply in some areas. All temporary visiting restrictions will be reviewed again on Monday 11 April 2022 and an update will follow then as the Trust plan to implement a phased return to full visiting arrangements across all health care facilities in the months ahead.
COVID-19 transmission rates remain high in the community and the Western Trust continues to deal with challenges and pressures on our Hospitals. Staff absences due to Covid-19 and other sickness together with a sustained number of Covid-19 patients and Covid-19 outbreaks in our hospitals must continue to be managed.
The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly recommends that anyone attending any of our facilities to visit a loved one, to take a lateral flow test immediately prior to attending. This will help to reduce the risk for all patients. All infection and prevention control measures MUST be adhered to when visiting and this includes wearing a facemask properly which covers your nose and mouth at all times, in addition to proper hand washing and adhering to social distancing guidelines.
Important information on visiting any Western Trust hospital:
- One Visitor (from two nominees) is permitted to visit for one hour, once per day.
- The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly advise that anyone attending any of our facilities to visit a loved one, to take a lateral flow test prior to attending.
- DO NOT ATTEND any Western Trust hospital or facility IF you have any symptoms of COVID-19 or are a close contact of someone who is confirmed COVID-19 positive.
- All infection and prevention control measures MUST be adhered to when attending any Western Trust hospital or facility and this includes wearing a facemask properly which covers your nose and mouth at all times. In addition you must adhere to proper hand washing and social distancing guidelines at all times when visiting.
- Based on high risk of COVID-19 transmission it is important to note that some wards are unable to allow visiting at this time and you will be informed of this when you ring to book your visit.
- Depending on the continued high level of COVID-19 transmission in the community, all temporary measures are subject to review.
- A further review of the Visiting Guidance will take place again on Monday 11 April 2022.
There will also continue to be exceptional circumstances in respect of visiting guidance to the North West Cancer Centre, attending outpatient appointments, maternity scans, neonatal and visiting patients in end of life care. Further information.
We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
Please respect our Staff
For anyone attending any Western Trust hospital or facility, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a zero tolerance policy towards abuse across our Trust.
We would like to thank you for your cooperation in relation to all essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
- Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here
The Trust will meet to review the visiting arrangements again on Monday 11 April 2022.
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March 2022
27/03/2022: Sarah’s Story: Appeal to expectant mothers to get their COVID-19 vaccination as soon as possible
Brenda McCabe, Midwifery Lead for South West Acute Hospital and Omagh Hospital and Primary Care Complex along with mum Sarah Marechaux are appealing for expectant mothers to get their COVID-19 vaccination to protect themselves and their babies as she celebrates her first Mother’s Day with her daughter Olivia on Sunday 27 March 2022
Brenda and her colleagues have seen the serious consequences of getting COVID-19, particularly for pregnant women and their unborn baby and taking the opportunity of Mother’s Day to highlight the benefit of getting vaccinated.
Brenda said: “We are very grateful to Sarah Marechaux from Fintona, Co Tyrone for allowing us to share her remarkable story. Sarah had received her first COVID-19 jab prior to giving birth to her daughter via emergency C-section on 23 October 2021 at the South West Acute Hospital, Enniskillen.
“Unfortunately Sarah was seriously ill during her pregnancy having contracted COVID-19 and after giving birth and was treated in the COVID Ward 8 and Intensive Care Unit (ICU) at South West Acute Hospital for 11 weeks. Her condition deteriorated on a number of occasions throughout this time and she was given the last rites twice. It is a miracle that Sarah has survived and this is testament to the dedication and care of the nursing and medical teams and of course to Sarah and her partner Josh that she was finally discharged home in January 2022.
Brenda added: “It is safe to get your COVID-19 vaccination during any stage of your pregnancy and I would encourage expectant mothers to speak to their consultant, midwife, GP or any healthcare professional for more advice if they have any questions or concerns.”
Sister Valerie Topping, COVID-19 Ward 8 at South West Acute Hospital said: “Sarah’s experience of COVID-19 is a remarkable and emotional journey and she will never be forgotten by the nursing staff on the COVID Ward who cared for her, or by the ICU nursing staff, who all took her into their hearts. As a consequence of COVID, Sarah’s condition deteriorated rapidly in hospital on three occasions following the birth of her baby, each time requiring a rapid emergency response by staff, followed by admission to Intensive Care, where she was critically ill on each of these occasions. This had a heart-wrenching effect on all staff caring for her, knowing Sarah was a new mother, separated from her new born daughter and not knowing what the outcome for her and her husband Josh would be.Valerie continued: “However, despite this very traumatic experience, Sarah and Josh, supported by Sarah’s mother, Lorraine, have shown exceptional resilience and determination. Sarah showed great courage throughout her remarkable recovery, fuelled by her desire to be reunited with her baby, Olivia and her older children. We did manage to arrange for Sarah to go home on Christmas morning and with the support of nursing staff she was able to enjoy Christmas with her beautiful family, which was incredibly important for Sarah’s overall health and well-being. Whilst she continues in her recovery, my staff gained immense satisfaction, delight and hope during this challenging time in supporting Sarah until she was finally able to be discharged home, in early January 2022.
“We are delighted to welcome Sarah, Josh and Olivia to a special celebration today to mark Sarah and her families incredible journey last year and to acknowledge the help and support Sarah’s mum Lorraine has provided to her daughter and granddaughter. We would like to wish Sarah well in her on-going recovery and she will always have a special place in all our hearts. Unfortunately Lorraine could not be with us today but we wish to extend a very Happy Mother’s Day to Sarah and Lorraine and we hope you both have a very special day on Sunday.”Sarah Marechaux said: “I like many other pregnant women was anxious about getting the vaccine and had many concerns. I know there is a lot of mix messages and scaremongering stories about the vaccine but I want to appeal to expectant mothers to please speak to their consultant or midwife who will be happy to answer any questions. I owe my life and that of my daughter, Olivia to Dr Andrew Craven, Speciality Doctor who was able to allay my fears and encouraged me to get jabbed.”
Sarah added: “Myself and my partner are extremely grateful for the compassion and care provided to me by all the staff at the South West Acute Hospital and in particular Dr Craven, Sr Valerie Topping and ICU Staff. We have been through a rollercoaster of emotions and no words can express our gratitude to the wonderful staff in the hospital.
“A massive thank you to my Doctors, ICU nurses, Ward 8 staff, Physios, OTs, porters and cleaners – they were all part of my journey in the South West Acute Hospital. There wasn’t a day where someone from any of those departments came to my room and wished me well or where praying for me. Josh and I appreciate everything you have all done for us.
Sarah continued: “When I was seriously ill I was unaware of what was going on around me, however, the staff created a memory book and each of them wrote messages of what was happening that day, who was with me, who held my hand, washed me, brushed my hair etc. The midwives also wrote about how my daughter was getting on – as they knew I was missing out on important milestones. I will treasure this book for ever and read this to Olivia when she is old enough to understand.”Brenda concluded: “Thank you again to Sarah for allowing us to share your amazing story of recovery from COVID-19. This has certainly given a much needed morale boost for our health care staff at this difficult time and we wish you, your partner and your beautiful daughter every happiness in the future. Take care.”
To find the most up to date information on the Western Trust vaccination programme, visit the Western Trust Vaccination web page link: Western Trust Vaccination Webpage
25/03/2022: Western Trust under Severe Pressure due to High COVID inpatients
The Western Trust is facing unprecedented pressures due to the high level of COVID-19 infection in our local community and the subsequent increasing numbers of COVID-19 positive patients in our Hospitals.
As of yesterday 24 March 2022 we had 52 COVID-19 patients in Altnagelvin and 51 COVID patients in South West Acute Hospital, Enniskillen. This is the highest number of COVID patients we have treated for many months.
Our hospitals are currently operating at 100% bed capacity and there remains high numbers of Emergency Department attendances, and many patients facing lengthy waits for admission to wards.
Speaking about the current hospital pressures, Western Trust Chief Executive Neil Guckian said: “The number of COVID-19 inpatients is again increasing at both Altnagelvin Hospital and the South West Acute Hospital. This is putting extreme pressure on the hospital system, including our workforce and is causing us great concern.
“This is not a simple matter of putting up more beds. Beds require staff to care for patients and pre-existing staffing pressures and staff absences due to COVID continue to be challenge.
“It is very regrettable that we find ourselves in such a difficult position again and we are currently considering if we need to step down some services and redirect staff for a period of time, to ensure that we can manage the increasing pressures in a safe manner.”
Neil continued: “As the Chief Medical Officer emphasised yesterday, the threat from COVID-19 has certainly not ended. Although our admissions to Intensive Care are low, we continue to have very significant numbers of very unwell COVID patients needing care in our hospitals.
“We are therefore asking once again for the public to please support us by adopting COVID safe behaviours whilst visiting our facilities. The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly recommends that anyone attending any of our facilities to visit a loved one, to take a lateral flow test immediately prior to attending. This will help to reduce the risk for all patients. All infection and prevention control measures MUST be adhered to when visiting and this includes wearing a facemask properly which covers your nose and mouth at all times, in addition to proper hand washing and adhering to social distancing guidelines. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
“Patients and families should also be aware that due to the ongoing pressure for hospital beds patients may be discharged without their full package of care being in place, or discharged to another care facility until the place of their choice is available.”
Neil concluded: “Every single member of our staff across our hospital and community settings are yet again rising to the extreme challenges we are facing and we again thank them for their tremendous efforts.
“For anyone attending any of our hospitals or facilities, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a zero tolerance policy towards abuse across our Trust.”
07/03/2022: Actor and Mencap NI Ambassador James Martin officially opens Sensory Room at Altnagelvin Hospital’s Emergency Department
The Western Trust Chief Executive Neil Guckian warmly welcomed actor and Mencap NI Ambassador James Martin and guests to officially open the Adult Learning Disability Sensory Room at Altnagelvin Hospital’s Emergency Department today (Monday 07 March 2022).
James Martin said:
“Thank you for inviting me to open the sensory room at Altnagelvin Hospital. It will help many people with a learning disability and their families when they have to go to hospital in an emergency. It can be scary to go to hospital, so this will help keep people calm and happy so they can get better treatment. This new sensory room will be fantastic and really help people.”
James continued:
“It is important that people with a learning disability get help and support when they visit hospital and that staff understand how to help them. Simple changes make a big difference, more time, better communication and clearer information can all help to make sure someone with a learning disability is treated well in hospital.”
Neil Guckian, Chief Executive at the Western Trust expressed his delight to be part of the official opening of the first Sensory Room installed in a Northern Ireland Emergency Department. Neil said:
“I wish to warmly welcome you all to Altnagelvin Hospital’s ED today to celebrate the opening of this wonderful sensory room. This facility has been extremely well received by staff, clients and families since opening on 01 December 2021.”
Neil continued:
“Thank you to our Acute Liaison Nurse Clionagh McElhinney for her vision and commitment to improving the lives of patients with a Learning Disability and to our Emergency Department staff for their dedication and support as they continue to deliver safe and effective care for our population in the North West. This initiative was undertaken in response to feedback and discussion with carers and service users who have attended ED in the past and is a reflection of working in partnership with different professionals with the support of the Trust’s Adult Learning Disability Involvement Team. Given the successful feedback to date of our first sensory room, we are hopeful that we can replicate such areas in other parts of the Trust. Well done everyone on this outstanding achievement we are extremely proud of you all!”
Clionagh McElhinney, Acute Liaison Nurse based at Altnagelvin Hospital explained:
“To help improve the experience of people with a Learning Disability and their carers when attending the Emergency Department, we worked in partnership with our ED colleagues to create a new sensory room. This room provides a quiet, relaxing environment to minimise stress and anxiety so that their clinical procedures can be carried out and avoids unnecessary interaction with other patients in ED Waiting Area.
“I would like to thank the local supplier of sensory equipment Creative Activity and in particular Kieran McMullan Sales Manager who helped to design the room and provided a very efficient and professional service. The room was fitted inside 4 hours with limited disruption to services within ED. Thank you Kieran and your team.”
Clionagh added:“The feedback that has been received since this room opened from both staff and patients has been phenomenal and is testament to the care and dedication of the staff in ED. Comments received:
“The difference it made to the person’s care was unbelievable, he was so settled and calm once taken into the room. We were able to get his clinical observation once in the room.” (ED staff member)
“Fantastic Facility” (carer)
“Usually this would have been the most stressful things in our life but with the new sensory room it was brilliant, he loved it. This has to be the one of the best ideas Altnagelvin has ever done- well done everyone!! (parent)
Colleen Hamilton, Assistant Services Manager for Unscheduled Care at Altnagelvin Hospital’s Emergency Department said
“We are delighted to have this dedicated space in our Emergency Department to support patients with a learning disability and their carers. Once the room door is closed you would not imagine you are in the midst of an extremely busy and noisy environment – it really is a calm oasis and has been very well received by the staff here in the department. It allows us to carry out tests and procedures much more easily and in less time which is beneficial to the patient and staff. We are very proud that we are the first ED in Northern Ireland to have this sensory room and look forward to continuing to provide the best care to our patients in the future.”
07/03/2022: Visiting Guidance update for Western Trust Hospitals
The Western Trust will continue with visiting to hospital sites allowing for one visit, for one hour per day per patient. Exceptions will also continue to apply in some areas. All temporary visiting restrictions will be reviewed again on Monday 21 March 2022 and an update will follow then as the Trust plan to implement a phased return to full visiting arrangements across all health care facilities in the months ahead.
COVID-19 transmission rates remain high in the community and the Western Trust continues to deal with challenges and pressures on our Hospitals. Staff absences due to Covid-19 and other sickness together with a sustained number of Covid-19 patients and Covid-19 outbreaks in our hospitals must continue to be managed.
The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly recommends that anyone attending any of our facilities to visit a loved one, to take a lateral flow test immediately prior to attending. This will help to reduce the risk for all patients. All infection and prevention control measures MUST be adhered to when visiting and this includes wearing a facemask properly which covers your nose and mouth at all times, in addition to proper hand washing and adhering to social distancing guidelines.
Important information on visiting any Western Trust hospital (from Monday 7 March 2022):
- One Visitor (from two nominees) is permitted to visit for one hour, once per day.
- The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly advise that anyone attending any of our facilities to visit a loved one, to take a lateral flow test prior to attending.
- DO NOT ATTEND any Western Trust hospital or facility IF you have any symptoms of COVID-19 or are a close contact of someone who is confirmed COVID-19 positive.
- All infection and prevention control measures MUST be adhered to when attending any Western Trust hospital or facility and this includes wearing a facemask properly which covers your nose and mouth at all times. In addition you must adhere to proper hand washing and social distancing guidelines at all times when visiting.
- Based on high risk of COVID-19 transmission it is important to note that some wards are unable to allow visiting at this time and you will be informed of this when you ring to book your visit.
- Depending on the continued high level of COVID-19 transmission in the community, all temporary measures are subject to review.
- A further review of the Visiting Guidance will take place again on Monday 21 March 2022.
There will also continue to be exceptional circumstances in respect of visiting guidance to the North West Cancer Centre, attending outpatient appointments, maternity scans, neonatal and visiting patients in end of life care. For further information, please refer to the Trust website – link here.
We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
Please respect our Staff
For anyone attending any Western Trust hospital or facility, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a zero tolerance policy towards abuse across our Trust.
We would like to thank you for your cooperation in relation to all essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
- Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here
The Trust will meet to review the visiting arrangements again on Monday 21 March 2022.
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February 2022
22/02/2022: Altnagelvin Hospital Emergency Department Message
Our Emergency Department at Altnagelvin Hospital is under extreme pressures this evening, as is the entire Emergency Care network across Northern Ireland. We will be asking patients and the public to work with us around facilitating early discharge from the hospital where possible and seeking other alternatives if they need to attend the Emergency Department.
See below video link which will be posted on our social media channels this evening.
22/02/2022: Visiting Guidance update for Western Trust Hospitals
The Western Trust will continue with visiting to hospital sites allowing for one visit, for one hour per day per patient. Exceptions will also continue to apply in some areas. All temporary visiting restrictions will be reviewed again on Monday 7 March 2022 and an update will follow then as the Trust plan to implement a phased return to full visiting arrangements across all health care facilities in the months ahead.
COVID-19 transmission rates remain very high in the community and the Western Trust continues to deal with challenges and pressures on our Hospitals. Staff absences due to Covid-19 and other sickness together with a sustained number of Covid-19 patients and Covid-19 outbreaks in our hospitals must continue to be managed.
Medical Director, Dr Catherine McDonnell said:
“It is really important to continue to be cautious in our health and social care settings. There is still over 400 patients in hospitals across the region suffering from COVID-19, a number of which have contracted the virus within the healthcare facility. We need to be diligent and vigilant in regards to continuing with Infection, Prevention and Control practices to keep staff safe, patients safe and to protect our services. We will also continue to wear masks and socially distance in our facilities. I look forward to more hopeful times. I ask for your patience and caution in the weeks and months ahead to ensure that we keep you safe, your colleagues safe and our patients safe.”
The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly recommends that anyone attending any of our facilities to visit a loved one, to take a lateral flow test immediately prior to attending. This will help to reduce the risk for all patients. All infection and prevention control measures MUST be adhered to when visiting and this includes wearing a facemask properly which covers your nose and mouth at all times, in addition to proper hand washing and adhering to social distancing guidelines.
Important information on visiting any Western Trust hospital (from Monday 21 February 2022):
- One Visitor (from 2 nominees) is permitted to visit for one hour, once per day.
- The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly advise that anyone attending any of our facilities to visit a loved one, to take a lateral flow test prior to attending.
- DO NOT ATTEND any Western Trust hospital or facility IF you have any symptoms of COVID-19 or are a close contact of someone who is confirmed COVID-19 positive.
- All infection and prevention control measures MUST be adhered to when attending any Western Trust hospital or facility and this includes wearing a facemask properly which covers your nose and mouth at all times. In addition you must adhere to proper hand washing and social distancing guidelines at all times when visiting.
- Based on high risk of COVID-19 transmission it is important to note that some wards are unable to allow visiting at this time and you will be informed of this when you ring to book your visit.
- Depending on the continued high level of COVID-19 transmission in the community, all temporary measures are subject to review.
- A further review of the Visiting Guidance will take place again on Monday 7 March 2022.
There will also continue to be exceptional circumstances in respect of visiting guidance to the North West Cancer Centre, attending outpatient appointments, maternity scans, neonatal and visiting patients in end of life care. For further information, please refer to the our Visiting Guidance Page.
We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
Please respect our Staff
For anyone attending any Western Trust hospital or facility, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a zero tolerance policy towards abuse across our Trust.
We would like to thank you for your cooperation in relation to all essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
- Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here
The Trust will meet to review the visiting arrangements again on Monday 7 March 2022
15/02/2022: Temporary Visiting Restrictions remain in place in Western Trust hospitals
Following Health Minister, Robin Swann’s announcement regarding COVID-19 Restrictions, the temporary visiting restrictions in Western Trust hospitals will continue and will be kept under constant review by the Trust Visiting Group. Current guidelines permit 1 person to visit for 1 hour once a day in the previously agreed areas with two nominated visitors.
Within the Western Trust Health and Social Care settings, social distancing and other COVID safe measures must continue.
The public is being asked to continue to wear face coverings while attending HSC enclosed settings to help protect our staff and vulnerable patients.
The Trust will meet to review the current visiting arrangements again on Monday 21 February 2022 and an updated will be provided following that review meeting.
Visiting guidance specific to each area can be found here.
Staff Urged to be ‘Diligent and Vigilant’ Following Easing of COVID-19 Restrictions
Medical Director, Dr Catherine McDonnell gives staff an update following Health Minister, Robin Swann’s announcement yesterday (14.02.22), she said:
“The health minister’s announcement yesterday on the easing of COVID-19 restrictions is a welcome development for us all. You will note that the lifting of restrictions applies to the various public settings.
(For your convenience, please click HERE for the Minister’s full announcement and associate statements).
“It is really important to continue to be cautious in our health and social care settings. There is over 400 patients in hospitals across the region suffering from COVID-19, a number of which have contracted the virus within the healthcare facility.
“We need to be diligent and vigilant in regards to continuing with Infection, Prevention and Control practices to keep staff safe, patients safe and to protect our services. We should continue to wear masks, socially distance (particularly at break time) and to participate in the Asymptomatic Staff Testing programme”
Catherine finishes by saying thank you to staff for all the work done over the past two years.
She added:
“I look forward to more hopeful times. I ask for your patience and caution as we move into the weeks and months ahead to ensure that we keep you safe, your colleagues safe and our patients safe.”
Visiting restrictions continue and will be kept under constant review by the Trust Visiting Group. Current guidelines permit 1 person to visit for 1 hour once a day in the previously agreed areas with two nominated visitors. Staff should remind the general public and patients on admission that these restrictions remain in place.
10/02/2022: Neonatology Ward South West Acute Hospital
Western Trust committed to working through staffing challenges at SWAH Neonatal Unit
Deirdre Mahon, Director of Women and Children’s Services at the Western Health and Social Care Trust said:
“I want to acknowledge the public’s concern surrounding the current position of our neonatal unit in South West Acute Hospital. Many will have seen the negative narrative online and in press in recent days. Contrary to some incorrect information quoted, I would like to reassure expectant parents and the wider public that the Trust is committed to working through the staffing challenges faced in the Neonatal unit at South West Acute Hospital and indeed support Neonatal services and maternity services across the Trust as a whole.
“It is important that the public and key stakeholders are aware of the background of the unit, its current position, the work we have completed to date and work that is currently ongoing.” Deirdre explains: “The unit is commissioned for six special care cots. Over recent years/months many senior experienced neonatal nurses have left due to retirement, to pursue a different career pathway or to accommodate a better family life balance. This has left a huge depletion of experienced neonatal nurses with a result that the unit is having great difficulty providing adequate nursing cover for many shifts.
“Contrary to some of the recent headlines, this is not about cutting neonatal or maternity services. We are doing everything in our power to actively try to recruit and address gaps in our workforce to ensure a safe and sustainable neonatal service. However, we have to date been unsuccessful in attracting and employing trained/ experienced neonatal nurses to work in Enniskillen. We recognise that there is a regional and a national shortage of neonatal trained nurses and the situation in SWAH has been escalated to the Neonatal Network NI, PHA and HSCB.
“The staffing crisis has been further exacerbated by the Covid-19 pandemic and short-term sick leave and staff isolation within the Western Trust.”
“Neonatal Units across the Region have all endured significant staffing shortages and because of the specialist knowledge and skills required to care for preterm and sick babies, there has been no opportunities to seek cross-cover across hospital sites. The Trust do accept nurses (Adult/Children) and Midwives (some midwives are working there temporarily at present but are not Qualified in Specialty) to work in our neonatal units but they require a further period of training and support. They must complete a recognised course (3 neonatal modules) through QUB to get the QIS qualification.
“Whilst we recognise that the shortage of neonatal nurses in South West Acute Hospital has been an ongoing concern, the Unit have implemented contingency plans to ensure that all babies born in the hospital are safely cared for. This has included reducing cot capacity in order to provide emergency and stabilisation of sick and preterm babies to another regional unit for ongoing specialist care if required. It is also important to note that all of the babies transferred during this period would have met the criteria for transfer regardless of the aforementioned challenges. It is also important to note that all of the babies transferred during this period would have met the criteria for transfer regardless of the aforementioned challenges and that, to date, no babies have been moved to any unit outside of the region.
“As well as the Trust continued and active recruitment, a Project Board is now been established to look at all the different aspects of neonatal service delivery at South West Acute Hospital, to ensure the safe care for all babies born in our hospital and within that, project teams will be implemented to look at key areas within the overall structure. The Health and Social Care Board and the Public Health Agency have members on this Project Board who are working closely with senior management and clinical leads who are responsible for overseeing how this work will move forward.
“South West Acute Hospital senior clinical management team and Human Resources are also currently engaging with an external advertising agency and working with our communication team to plan how we can try to address this nursing shortage locally and as a wider recruitment exercise.
“Initially, as part of this process, there will be a PR campaign launched, highlighting the Trust Neonatal service and the opportunities available there and featuring this as a ‘Great place to work and live’.
“Finally, we acknowledge that the negative headlines and narrative which has been prominent online and in the media recently is unhelpful in attracting staff to take up important roles in South West Acute Hospital. Moving forward, as we strive to promote and highlight Fermanagh as a ‘Great Place to Work and Live’ it will be very important for all key stakeholders and our local communities to work with us in helping promote the campaign and sharing positive messages publicly on this to attract staff to come and work in SWAH.”
10/02/2022: Update Briefing: Adult Mental health Services
Adult Mental Health Services
The Adult Mental Health Service provides a range of inpatient and community based services for adults. The Adult Mental Health Service is structured along key functional lines and is a biopsychosocial model and therefore delivered by a range of multidisciplinary professionals i.e., Nurses, Social Workers, Psychiatrists, Psychologists and Occupational Therapists and Pharmacists. To ensure service user and carer involvement in the development and provision of services, we work closely with a service user consultant as well as carers groups.
The functionalised teams are as follows: Primary Care Liaison (PCL) Crisis Response Home Treatment (CRHT), Recovery Service, Adult Psychological Therapy, Alcohol and Drug Service, Forensics, Personality Disorder and Eating Disorder.
The Crisis Service
The Crisis Service provides a 24 hour, 7 day a week response to those people experiencing a significant mental health crisis. The service will offer a range of responses to manage short term crisis including, inpatient services, home treatment and acute day care.
In the Northern Sector which covers Derry City, Limavady and Strabane Council areas, Crisis Response Home Treatment (CRHT) is provided through a 30 bed inpatient unit including 6 higher intensity inpatient beds. The team performs a number of functions i.e. 24/7 gate-keeping to inpatient beds, crisis assessments, community home treatment based interventions as alternatives to hospital admission and acute day care provision.
In the Southern Sector, which covers Omagh and Fermanagh Council areas, CRHT is provided through 26 inpatient beds (with 5 higher intensity beds) in the Tyrone and Fermanagh Hospital. It performs similar functions including 24/7 gate-keeping to inpatient beds, crisis assessments, step up and step down to Rathview Home Treatment House and community home treatment based interventions as alternative hospital admission.
Primary Care Liaison
PCL – a single point of access to Tier 3 Mental Health services. Due to the geography of the Western Trust there are three entry points; one in the Northern Sector, one Omagh and one in Enniskillen in the Southern Sector. These teams address all urgent mental health referrals and elective referrals within a 9 week standard as per the Mental Health Access Protocol. Co-located with PCL teams in both sectors there will be a well-being hub which will manage all tier 2 referrals from GPs. These hubs will liaise and link with the Community Sector and Voluntary Sector to ensure a ‘no wrong door approach’ for clients requiring Tier 2 mental health services.
Recovery Service
Mental Health Recovery Services in the Western Trust exist to support people with serious and enduring mental health problems in their personal journey towards recovery. Services are underpinned by the principles of a person centred, strengths based approach, recognising the unique skills, creativity and expertise both of the service user and the helper. The guiding principles of autonomy, fairness, protection, dignity and respect are integral to the therapeutic alliance.
There are 6 locality based multi-disciplinary Recovery teams across the Trust.
Recovery Services include 10 supported living facilities which provide accommodation and support for those with complex needs in line with the established criteria. There are also 5 centres providing day opportunities across the Trust. The Recovery Service also encompasses provision for short breaks and carers support. There are a number of contracts with Community and Voluntary Sector providers managed through the Recovery Services. The Recovery Service includes the Condition Management Programme, a DEL funded service to support unemployed service users to manage their health condition and gain employment. The development of the Recovery College hub and spoke model and a range of service user initiatives are managed through the Recovery Service.
A specialist aspect of the Recovery Service is the Forensic Mental Health Team which is a Trust Wide Service that works predominately with recovery clients with co-morbid forensic issues and mental health conditions.
Adult Psychological Therapy Services
There are two Adult Psychological Therapy Teams, one north and one south. These teams primarily treat service users at Steps 4 & 5 (more complex cases). The Teams incorporate modalities such as CBT, Psychology and Psychotherapy. We aim to manage referrals to this team within a 13 week standard as per the Mental Health Access Protocol.
Other Specialist Services
There are a number of Trust wide specialist services such as Addictions, Eating Disorders, the Regional Trauma Network and Personality Disorders. Service users within the Specialist services can be managed within a single team depending on need or in partnership with any of the above services.
With Addiction Services there are 2 managed multi-disciplinary community addiction teams and an Tier 4 Regional Inpatient Detoxification Unit. There is a substance misuse liaison provision to acute and mental health hospitals also.
Eating Disorders is a managed multi-disciplinary team which has Trust wide responsibility.
Personality Disorder Team is psychology led with a Trust wide remit currently providing support and partnership working with the above teams. They continue to developing services for therapeutic groups across Trust and supporting practitioners to sustain these groups.
The Regional Trauma Network are a specialist multi-disciplinary team providing intervention for service users that have been assessed as having experienced significant Trauma, including Troubles related issues.
Perinatal Mental Health Team
Recruitment has commenced for this team, with the Team Lead and Consultant Psychiatrists posts currently live. The final configuration of the team, within the available budget, will be confirmed shortly.
Transformation Projects
Mental Health Liaison Service
The Western Trust commenced the development of an Enhanced Mental Health Liaison service (MHLS) to its acute general hospitals in 2019 with a view to improving the care and treatment of people with mental health or addictions presentations in Emergency Departments and acute general hospital wards and to support discharge and appropriate follow-up. This will be mainstreamed with confirmation of recurrent funding and has progressed in recent months with recruitment of nursing staff and a trustwide Clinical co-ordinator.
Towards Zero Suicide
The Towards Zero Suicide (TZS) collaborative aims to research and adopt best practice in suicide prevention. We are fully engaged in the relevant regional workstreams and initiatives, with the wider implementation of our co-produced safety-planning tool a regional priority. This Service Improvement post is also confirmed for mainstreaming in Adult Mental Health Services.
Stepped Care Model – How services are organised
From Regional Mental Health Care Pathway, 2014
Five Ways to Wellbeing – What we can all do
10/02/2022: COVID19 Vaccine Programme Update
- Our Mass Vaccination Centres at Foyle Arena, Omagh Leisure Centre and Lakeland Forum are now closed. We once again express our thanks to the councils for their ongoing support for our vaccination programme.
- Our vaccination teams will now work out of three smaller ‘hubs’ for the next stage of the programme: Anderson House (Altnagelvin), Key Worker Accommodation (SWAH) and Old School Canteen (T&F) will be our bases through February starting from this Wednesday 2/2/22.
- Clinics will run on a variety of days, including evenings and weekends. We advise checking our website for weekly updates as the timetable may be subject to change depending on public demand.
- Children aged 5 to 11 years in a clinical risk group, or children who are a household contact of someone who is immunosuppressed, are now being offered a first dose COVID-19 vaccine, with an interval of eight weeks between the first and second doses.
- GPs will be writing out to these children to advise them to book on to a Trust site to receive their vaccinations.
- If you have received a letter, then please log on to the booking system and make an appointment to attend one of the Western Trust’s clinics for 5-11 year-olds at our three ‘hub’ locations.
- Vaccination teams will also be visiting special schools from Monday 31/1/22 to help support this element of the programme.
- Many of those who received their first dose COVID vaccination through their school are now due their second dose. The school vaccination programme is now complete, so these young adults should attend a public vaccination clinic at one of our hub locations, both booked slots and a limited capacity for walk-ins are available.
- It is vitally important that they receive this second dose in order to maintain optimum levels of immunity.
- All those eligible for a second dose should have received a text message advising them to make arrangements for their second dose, a minimum of 12 weeks after their first dose, or 12 weeks after being COVID positive if they have subsequently tested positive or have shown COVID symptoms.
- The Western Trust will re-introduce their COVID Vaccination Telephone Booking & Support Line from this week. Opening hours will be 9am to 5pm Monday to Thursday and 9am to 4:30pm on Fridays. The number to ring is 028 7161 0753
Mobile Clinics:
Date Area Venue / Address Tues 22nd Feb Strand House of Value, Longs Supermarket, Strand Road. Thurs 24th Feb Strathroy Strathroy Community Centre Tues 1st Mar Shantallow Community Centre Wed 2nd Mar Greysteel Vale Centre, Greysteel Thurs 3rd Mar Castlecoole St. Michaels Scouts Hall, Erne Rd, Enniskillen Tues 8th Mar Creggan Central Old Library Trust, Creggan Thurs 10th Mar Killyclogher Cappagh Parish Hall, Killyclogher - Bookings are now open for both general public and the 5-11 at clinical risk to book slots for vaccination at all three of our hubs here
- For the latest on the Western Trust’s vaccination programme, including opening hours and schedule of opening for each of the hub location and mobile clinics, click here
- Full details on vaccine eligibility, including dose intervals and guidance for different age brackets, click here
10/02/2022: COVID-19 Update
At February 2 2022
Workforce Absence
09/02/2022; Once per day Visiting continues for Western Trust Hospitals
With continued high transmission rates of COVID-19 in the community, the Western Trust will continue with the temporary visiting restrictions across our hospital sites allowing for one visit, for one hour per day per patient. There will be exceptions which will apply in some areas.
The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly recommends that anyone attending any of our facilities to visit a loved one, to take a lateral flow test immediately prior to attending. This will help to reduce the risk for all patients. All infection and prevention control measures MUST be adhered to when visiting and this includes wearing a facemask properly which covers your nose and mouth at all times, in addition to proper hand washing and adhering to social distancing guidelines.
Important information on visiting any Western Trust hospital:
- One Visitor (from 2 nominees) is permitted to visit for one hour, once per day.
- The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly advise that anyone attending any of our facilities to visit a loved one, to take a lateral flow test prior to attending.
- DO NOT ATTEND any Western Trust hospital or facility IF you have any symptoms of COVID-19 or are a close contact of someone who is confirmed COVID-19 positive.
- All infection and prevention control measures MUST be adhered to when attending any Western Trust hospital or facility and this includes wearing a facemask properly which covers your nose and mouth at all times. In addition you must adhere to proper hand washing and social distancing guidelines at all times when visiting.
- Based on high risk of COVID-19 transmission it is important to note that some wards are unable to allow visiting at this time and you will be informed of this when you ring to book your visit.
- Depending on the continued high level of COVID-19 transmission in the community, all temporary measures are subject to review.
- A further review of the Visiting Guidance will take place again on Monday 21 February 2022.
There will also continue to be exceptional circumstances in respect of visiting guidance to the North West Cancer Centre, attending outpatient appointments, maternity scans, neonatal and visiting patients in end of life care. For further information, click here.
We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
For anyone attending any Western Trust hospital or facility, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a zero tolerance policy towards abuse across our Trust.
We would like to thank you for your cooperation in relation to all essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
- Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here.
The Trust will meet to review the visiting arrangements again on Monday 21 February 2022.
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January 2022
24/01/2022: Once per day Visiting re-introduced for Western Trust Hospitals and Facilities
While there remains continued high transmission rates of COVID-19 in the community, the Western Trust are further easing restrictions on visiting to hospitals and facilities from after midnight on Monday 24 January.
From 00:01am on Tuesday 25 January 2022, the temporary visiting restrictions across our hospital sites and facilities will be eased further to allow for one visit, for one hour per day per patient. There will be some exceptions which will apply in some areas.
The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly recommends that anyone attending any of our facilities to visit a loved one, to take a lateral flow test immediately prior to attending. This will help to reduce the risk for all patients. All infection and prevention control measures MUST be adhered to when visiting and this includes wearing a facemask properly which covers your nose and mouth at all times, in addition to proper hand washing and adhering to social distancing guidelines.
Important information on Visiting any Western Trust hospital or facility from 00:01am on Tuesday 25 January 2022:
- One Visitor (from 2 nominees) is permitted to visit for one hour, once per day.
- The new visiting guidance will be applicable from 00:01am on Tuesday 25 January 2022.
- The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly advise that anyone attending any of our facilities to visit a loved one, to take a lateral flow test immediately prior to attending.
- DO NOT ATTEND any Western Trust hospital or facility IF you have any symptoms of COVID-19 or are a close contact of someone who is confirmed COVID-19 positive.
- All infection and prevention control measures MUST be adhered to when attending any Western Trust hospital or facility and this includes wearing a facemask properly which covers your nose and mouth at all times. In addition you must adhere to proper hand washing and social distancing guidelines at all times when visiting.
- Based on high risk of COVID-19 transmission it is important to note that some wards are unable to allow visiting at this time and you will be informed of this when you ring to book your visit.
- Depending on the continued high level of COVID-19 transmission in the community, all temporary measures are subject to review.
- A further review of the Visiting Guidance will take place again on Monday 7 February 2022.
There will also continue to be exceptional circumstances in respect of visiting guidance to the North West Cancer Centre, attending outpatient appointments, maternity scans, neonatal and visiting patients in end of life care. For further information, please refer to the Trust website.
We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
For anyone attending any Western Trust hospital or facility, we ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a zero tolerance policy towards abuse across our Trust.
We would like to thank you for your cooperation in relation to all essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
- Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here
The Trust will meet to review the visiting arrangements again on Monday 7 February 2022.
20/01/2022: Northern Ireland Hospital Based Termination of Pregnancy Statistics, 2020/21
Department of Health
The Department of Health (DoH) today published statistics relating to medical abortions and terminations of pregnancy in Northern Ireland HSC Hospitals during 2020/21.
The statistical bulletin presents information on the number of medical abortions and terminations of pregnancy carried out in HSC Hospitals in Northern Ireland during 2020/21.
The information release is published here
19/01/2022: RQIA to publish Report on Lakeview Hospital
RQIA inspected Lakeview Hospital on 16 – 18 August 2021 and highlighted areas for improvement. As part of the normal RQIA inspection processes, families of patients in Lakeview Hospital at that time were involved.
The Trust took immediate action and developed an Improvement Plan with identified timeframes for the required improvements. As part of normal Trust processes, a number of staff information sessions have taken place. Within these sessions, staff were informed of the highlighted areas for improvement and the improvement plan was developed in conjunction with staff. The Plan was shared and agreed with RQIA.
The Trust is committed to providing the highest quality services for all the patients and service users in its care. The Trust takes very seriously the areas identified as requiring improvement in Lakeview Hospital and has demonstrated its willingness to take whatever actions are necessary to ensure the service is compliant with the relevant standards and practices.
As part of this process, all families involved have now been contacted and meetings have taken place with all but one family (who advised they were content and did not require a meeting) to fully update on the current position and the ongoing planning process as stated above. All families have also since been communicated with and provided with a copy of the RQIA Report.
Work identified in the Improvement Plan remains ongoing and is managed through a Project Team and Project Board as well as being overseen by the Trust Corporate Management Team.
RQIA will publish their report on Wednesday 19 January 2022.
18/01/2022: DOH Release – Orthopaedic Surgery Initiative Launches at South West Acute Hospital
Orthopaedic surgery initiative launches at South West Acute Hospital
Twenty one patients received hip replacements last week through a new orthopaedic surgery initiative for Northern Ireland.
It is only one of a range of initiatives taking place to utilise additional in-house and independent sector capacity to tackle hospital waiting times. The Western Health and Social Care Trust in partnership with Musgrave House has planned a programme of hip replacements using surplus theatre capacity in the South West Acute Hospital between now and March 31.
Health Minister Robin Swann said:
“Last year when I published a new Elective Care Framework to tackle the waiting lists, I gave a clear commitment that I wanted to see all HSC capacity utilised whenever and wherever possible.
“That included a specific focus on making better use of theatre capacity that was not in active operation and where HSC activity isn’t being delivered, for example, at evenings and weekends or where services have not been commissioned. I would much rather see our hospital theatres leased to independent providers to treat HSC patients than see them lying empty and patients forced to dwell on a waiting list for even longer.
“The South West Acute Hospital is a brilliant facility and a major asset for the region within the HSC estate. It would be a major disservice to the unacceptable numbers of people on a hospital list, but especially those experiencing daily pain and discomfort whilst waiting on a hip replacement, if we were not to seek to utilise the empty theatre and ward space there.
“I was delighted therefore that in only its first week the partnership saw 21 new hips delivered, with more full theatre lists planned for the days and weeks ahead. Whilst this is only one of many initiatives, these are genuinely life-changing procedures for the patients that benefit from them.
“These are operations for health service patients funded by the health service. Every procedure matters and it’s a small step in the right direction every single time we get a person off a waiting list.
“Tackling our waiting lists is a major priority for me, and in sourcing additional capacity whilst still demonstrating value for public money in association with a major focus on increasing HSC capacity, will realistically be a part of that.”
The Chief Executive of the Western Trust, Mr Neil Guckian stated:
“The Western Trust’s South West Acute Hospital has state-of-the-art theatre facilities and is well equipped to support such important regional initiatives. We are delighted to be supporting the work through uncommissioned ward and theatre facilities at the hospital which will see a significant number of procedures completed. This is a fantastic partnership which helps to tackle lengthy waiting lists and we are looking forward to working closely with the Health and Social Care Board and the various providers over the coming weeks.”
If successful, this initiative will be carried into the next year to help alleviate long waiting times.
17/01/2022: Temporary Visiting Restrictions for Western Trust Hospitals and Facilities eased to once per week
There remains a continued high level of COVID-19 transmission in the community and, while pressures including staff absences also continue to be a challenge, the Western Trust understand the significant importance that visiting patients in our hospitals provides.
Therefore, from 6pm on Monday 17 January, there will be an initial easing of temporary visiting restrictions, across our hospital sites and facilities, which will now allow for one visit per week per patient. In order to ensure the continued safety of our patients, staff and families attending there is further important information to be considered by anyone visiting our hospitals or facilities – see details below.
Temporary Visiting Restrictions from Monday 17 January 2022
- One Visitor (from 2 nominees) is permitted to visit for one hour, once per week.
- The visiting week referred to will run from Monday 17 January (after 6pm) to Sunday 23 January 2022.
- The Trust treats the safety of our patients, staff and everyone attending our facilities with the utmost importance and therefore strongly encourage and strongly advise that anyone attending any of our facilities for visiting a loved one, to take a lateral flow test prior to attending.
- All infection and prevention control measures MUST be adhered to when attending any Western Trust hospital or facility and this includes wearing a facemask at all times.
- Based on Covid-19 risk assessments, it is important to note that some areas in our hospitals or facilities may be temporarily subject to not allowing any visits to occur, eg. where there is presently a Covid-19 outbreak. Therefore, prior to attending the hospital or facility it is recommended that you check with the Ward Manager for where you hope to visit.
- Depending on the continued high level of COVID-19 transmission in the community, all temporary measures are subject to review.
- A review of the temporary Visiting Guidance Restrictions will take place again on Monday 24 January 2022.
In addition, there will also continue to be exceptional circumstances where visiting on a more regular basis is permitted. For further information, please refer to the Trust website – click here.
Furthermore, these temporary visiting restrictions do not apply to birthing partners attending appointments to maternity services and full details of maternity arrangements are on the Trust Website – click here.
We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
The Trust acknowledges that this is a very difficult time for everyone but we continue to act in your best interest and the best interest of your relative/friend in hospital. We ask that you continue to work with us and please respect our staff and the guidance they give you at all times. There have been incidents where our staff have received verbal abuse and harassment and we would ask everyone to please refrain from such behaviour and remind everyone that we operate a zero tolerance policy towards abuse across our Trust.
We would like to thank the public for their cooperation in relation to these essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
- Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here
REVIEW in one week: The Trust will meet to review the visiting arrangements again on Monday 24 January 2022 and a further update will be provided following that review.
11/01/2022: Visiting Restrictions to continue temporarily for Western Trust Hospitals and Facilities
Due to the unprecedented high level of COVID-19 transmission in the community and the continued pressures on our hospitals, with significant staff absences due to COVID-19, the temporary visiting restrictions implemented across our hospital sites and facilities in December will continue until further notice.
There will continue to be exceptional circumstances where visiting will be permitted and you can click here to find out more in respect of this.
It again should be noted that the new visiting restrictions does not apply to birthing partners attending appointments to maternity services and full details of maternity arrangements can again be found here on the Trust Website.
We would encourage you to keep in contact with your loved ones via Virtual Visiting arrangements. You can continue to arrange a ‘virtual visit’ with your relative or friend on a smartphone or tablet. Our hospitals have access to free Wi-Fi and our staff can help set this up. Please be patient as there continues to be significant staffing pressures at present and our staff will have to prioritise clinical work and patient care at this very busy time.
The Trust acknowledges that this is a very difficult time for everyone. However we continue to act in your best interest and the best interest of your relative/friend in hospital. We ask that you continue to work with us and please respect our staff and the guidance they give you at all times.
We would like to thank the public for their cooperation in relation to these essential recent changes to our visiting arrangements. Your support helps us to provide safer care for your relatives and friends who are currently in hospital.
- Updated Visiting Guidance and specific information is provided on the Western Trust Website specific page here
The Trust will meet to review the visiting arrangements again on Monday 17 January 2022 and a further update will be provided following that review.
10/01/2022: Update on Vaccination Programme
It should be noted that the numbers attending the Trust’s Mass Vaccination Centres has reduced considerably and there has been a similar pattern across the region. Your support in helping to share/promote the Trust’s messaging would be greatly appreciated in helping to get the hugely important message out to the public.
The full schedule for the Mass Vaccination Centres is publicised until 17 January 2021.
Please note – Foyle Arena is closed this Saturday 8 January 2022 and the Lakeland Forum, Enniskillen, will be closed from after 5pm on Saturday 8 January as the Fermanagh & Omagh Council area site moves back to Omagh Leisure Centre (opening from Monday 10 January from 12pm)
Mass Vaccination Centres
Foyle Arena Omagh Leisure Complex Lakeland Forum Tues 4/1/22 12.00pm – 8.00pm CLOSED CLOSED Wed 5/1/22 9.00am – 5.00pm CLOSED 9.00am – 5.00pm Thurs 6/1/22 9.00am – 5.00pm CLOSED 9.00am – 5.00pm Fri 7/1/22 9.00am – 8.00pm CLOSED 9.00am – 8.00pm Sat 8/1/22 CLOSED CLOSED 9.00am – 5.00pm Sun 9/1/22 9.00am – 5.00pm CLOSED CLOSED Mon 10/1/22 9.00am – 5.00pm 12.00pm – 8.00pm CLOSED Tues 11/1/22 CLOSED 9.00am – 5.00pm CLOSED Wed 12/1/22 12.00pm – 8.00pm 9.00am – 5.00pm CLOSED Thurs 13/1/22 9.00am – 5.00pm CLOSED CLOSED Fri 14/1/22 9.00am – 5.00pm 9.00am – 5.00pm CLOSED Sat 15/1/22 9.00am – 5.00pm CLOSED CLOSED Sun 16/1/22 CLOSED 9.00am – 5.00pm CLOSED Other key points:
- The level of staffing at our Mass Vaccination Centres has had to be scaled back where possible to help address staff shortages in other essential services. It is important to note this has not had any negative impact on ability to facilitate members of the public seeking vaccination.
- Over the next few weeks the Western Trust will also be running a model where both the Mass Vaccination Centres AND Mobile Vaccine Clinics will be in operation (See mobile clinic timetable below). The initial planning is for Mobile Clinics to be placed in areas which worked well previously and are part of low uptake areas and these will also continue to be reviewed.
- There does remain a concern in particular with the level of Covid Booster uptake amongst those aged 50+
- In the week ahead, we will be highlighting targeted communications to Age 12-15 year olds encouraging them to book their next vaccine dose as it is anticipated that the return to school will lead to high levels of transmission amongst this group.
- The next cohort to be vaccinated will be the aged 5-11 year olds who are considered “at risk” – further plans on this to be released in the coming weeks. This will be facilitated by Trusts with letters being issued from GPs to eligible children.
Below is the next schedule of Mobile Vaccine Clinics planned. Due to limited availability for the Mobile Vaccine Clinics we would continue to encourage anyone, where possible, to book and attend the Mass Vaccination Centres listed above to receive your relevant Vaccine – 1st, 2nd or Booster.
Upcoming Mobile Vaccine Clinics Date Times Venue Dosage Wednesday 5th 4pm to 8pm Limavady Leisure Centre 1st, 2nd, Booster Tuesday 11th 4pm to 8pm Shantallow Community Centre 1st, 2nd, Booster Thursday 13th 4pm to 8pm Castlederg Healthy Living Centre 1st, 2nd, Booster Tuesday 18th 4pm to 8pm Alley Theatre, Strabane 1st, 2nd, Booster Wednesday 19th 4pm to 8pm Derrygonnelly Community Centre 1st, 2nd, Booster Thursday 20th 4pm to 8pm Long Tower Youth Club 1st, 2nd, Booster Tuesday 25th 4pm to 8pm Patrician Hall, Carrickmore TBC 1st, 2nd, Booster Thursday 27th 4pm to 8pm Dromore 1st, 2nd, Booster Tuesday 1st Feb 4pm to 8pm Diamond centre, Claudy 1st, 2nd, Booster
07/01/2022: Chief Executives Report to Trust Board
Click Here for latest Report to Trust Board (6 January 2021) from Chief Executive, Neil Guckian.
06/01/2022: Update on Neonatal Services in South West Acute Hospital
Following the Trust’s briefing to MLAs and MPs (information provided to Public Representatives on Friday 3 December 2021) please note the following updated information in respect of the continued pressures on Neonatal Services at SWAH.
- The Neonatal Unit at South West Acute Hospital (SWAH) is commissioned for 6 special care cots. Due to our current staffing crisis, we can only provide emergency care to babies born in SWAH and provide stabilisation and transfer to another Neonatal unit for ongoing specialist care if required. Subsequently we are maintaining 2 cots to permit this.
- The Neonatal Unit currently provides emergency care to babies, stabilisation for those that need transfer to another unit for ongoing care and babies who require a short period of special care are cared for at SWAH between the neonatal unit and maternity.
- Any baby that requires ongoing neonatal care will be assessed and those that require short term care can remain on the unit. However those that require a higher level of care will be transferred to another unit. A total of 6 babies were transferred to other neonatal units during the period 1/10/21 – 31/12/21. It should be pointed out that all of these babies required a higher level of care and would always have been transferred accordingly, regardless of the current situation.
- As advised previously the staffing situation within Neonatal at South West Acute Hospital has been and remains a concern. Whilst the management team (with senior HR input) continue to actively try to recruit, we have to date been unsuccessful in attracting and employing trained/ experienced neonatal nurses to work in Enniskillen. We recognise that this is a regional and a national issue and this has been escalated to the Neonatal Network NI, PHA and HSCB.
- The staffing crisis has been further exacerbated by the Covid-19 pandemic and short term sick leave, with the Western Trust currently enduring significant staffing pressures across all services.
- We recognise that parents/families may have to travel long distances if a women or baby is admitted to another unit in N. Ireland. Staff in neonatal and maternity will communicate to families who are affected and keep them informed.
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