HEALTH chiefs have insisted that they intend to restore services to pre-coronavirus levels at the Downe Hospital in Downpatrick — as soon as it is safe to do so.
But the South Eastern Trust maintains that it is not possible to put a timetable in place at this stage due to a number of factors, including the potential for a second surge of the virus, staff availability, medication supply and the need to provide support within the care sector.
A series of changes were made to services at the Downe last month as part of a Northern Ireland-wide response to the deadly virus which at one stage was suggested could claim up to 30,000 lives.
The health trust says the Downe continues to provide a vital part in its response to Covid-19, including the successful rehabilitation of many patients who have had the virus.
Last month, the hospital’s emergency department, minor injuries and day procedure units, along with the outpatients department, were all closed and all available staff and equipment from these units was then requisitioned for use in other parts of the health trust area.
And while a number of services have been restored at the Ulster and Lagan Valley hospitals — which the health trust also manages — South Down MP Chris Hazzard is concerned that no services have been reinstated at the Downe.
Writing for the Recorder last week, he said health chiefs asked the local community to be open minded and understand that a “temporary” overhaul of services at the Downpatrick hospital was absolutely necessary as the organisation prepared for the biggest challenge it had ever faced.
Mr Hazzard said the community and all shades of political opinion accepted the “unprecedented nature” of the situation and wholeheartedly supported the health trust in its endeavour to reorganise local services to help those in need of intensive medical support, with health chiefs insisting that they would ‘fully restore services to normal as soon as possible.
The MP also expressed concern about the maintenance of the endoscopy service at the Downe Hospital and that a promise staff temporarily moved to the Ulster Hospital would be paid for their travel time was not honoured. He also raised concern that a commitment to pay staff for the days they went on strike last December has not been delivered.
In a detailed response — issued after last week’s production deadline had passed – the South Eastern Trust said while the Covid-19 outbreak appeared to have reached a plateau within its hospitals, “the incidents and challenges within the care sector continue to increase” and the organisation is currently some distance from being able to return to business as usual.
The statement continues: “We are now considering a recovery plan for our elective, cancer and all other key services. This will include the services we can safely restore and by when.
“There is also a global supply issue regarding anaesthetic, opioid and other medications.The shortage of these medications, amongst others, will have an impact on what services we can restore and how quickly.
“Royal College guidelines for surgical specialities and endoscopy currently advise risk assessment and only performing very urgent procedures. This is due to the risk to the staff and also the patient attending hospital.
“This is significantly limiting the level of endoscopy we can carry out at this time. There are no plans to cease the reprocessing and maintenance of the endoscopy equipment in the Downe day procedure unit.”
The health trust insists that it is required to agree any recovery plan regionally to ensure equitable provision, explaining the bowel screening programme Mr Hazzard refers to has been suspended across Northern Ireland.
“Our priority will continue to be the safety of our patients and staff whilst we do this,” said the health trust.
“There is an ongoing requirement for additional staffing from across the organisation within the emergency departments at the Ulster and Lagan Valley hospitals which continue to have significant and rising numbers of patients attending.
“Both EDs have been separated into Covid-19 and non-Covid-19 spaces. The safe separation of patients requires the support of more staff, helping to reduce the likelihood of cross infection and facilitates the requirement for social distancing.”
The health trust says there is also a requirement to separate inpatient wards into Covid-19 and non-Covid-19 spaces at the Ulster, Lagan Valley and Downe hospitals which requires the support of more staff.
“Unfortunately, the Trust is also experiencing significant numbers of staff absences at present. The reasons include self-isolation due to symptoms and shielding of vulnerable persons. This includes a high number of staff who work in the day procedure unit in the Downe Hospital,” the statement continues.
“In addition, we continue to work with colleagues in primary care, including the independent sector where there is an ongoing high level of pressure as a result of the virus.
“In some cases, our staff have been providing care and support to the nursing and residential homes in the locality where the need is most acute. Supporting our colleagues within the care sector and the most vulnerable in our society is an absolute priority.”
The health trust insists that a commitment to pay staff travel time between the Downe and Ulster hospitals has not been rescinded and that eligible staff will receive a payment in lieu of travel time.
In relation to strike pay, the Trust said Stormont health minister Robin Swann gave a commitment that pay deducted as a result of industrial action would be reinstated, with payments from the Business Services Organisation delayed as a result of Covid-19. Trust officials say the deferred payment has been agreed by regional trade unions.