‘The Trust should utilise the Downe to help meet the needs of the local community’

‘The Trust should utilise the Downe to help meet the needs of the local community’

17 April 2024

LAST week week I was delighted to visit the Downe Hospital to meet with staff and discuss a variety of pressing issues with South Eastern Trust chief executive Roisin Coulter. 

As MP for South Down, the performance of both the Daisy Hill Hospital in Newry and the Downe in Downpatrick regularly fills my in-tray, with correspondence from patients, staff, and the wider public, increasingly concerned with the growing crisis in our local healthcare system. 

In East Down area, this concern largely focuses on the health trust’s failure to recognise the community’s growing sense of frustration and anger at the reconfiguration of emergency services and the impact that this has had on our ability to access vital, lifesaving care. 

It is obvious that the reconfiguration of emergency services in the area is giving rise to persistent delays at the Ulster Hospital.

Waiting times for patients inside the emergency department and those stranded outside in an ambulance in Dundonald are amongst the worst anywhere in Britain or Ireland. 

This is unacceptable. 

Locally, the Downe is off-limits to all but a small minority of cases, with doors closed and patients redirected instead to the Ulster.

Given the worsening situation with ambulances in South Down, the emergency operators are now increasingly directing patients to make their own way to hospital —putting the patient and the public at increased risk. 

This often results in patients self-presenting to the Downe foyer, attempting in their anguish to seek emergency care and ultimately putting themselves at increased risk by reducing their ambulance response time further as they are turned away. 

However, not everybody can jump in a car and travel up to the Ulster in Dundonald. Indeed one member of staff from the Downe was in tears lately when they recalled how they had no choice but to give an elderly lady £20 for diesel as she couldn’t afford the journey. 

This is unacceptable. 

Quite frankly, this means our local community does not enjoy equal access to health services that other citizens across the north of Ireland take for granted.

In the absence of a ‘rights based entitlement framework’ the ongoing transformation of the health and social care system is not meeting the healthcare needs of rural citizens, especially in places like South Down.

Given the mounting evidence now available to the public, this dangerous reality is undeniable, unjustifiable and unacceptable.

So what can be done about it? 

In short, the South Eastern Trust should utilise the Downe to help meet the needs of the local community and simultaneously alleviate the growing pressure on the Ulster. 

With this in mind I have now asked the organisation to implement the following initiatives – immediately extend the Downe’s Urgent Care Centre to seven days per week between 8am and 8pm and commit publicly to work towards reopening the hospital’s emergency department through a genuine process of codesign and consultation with staff. 

It is also time to look again at the configuration of emergency services in the trust area and harness the untapped potential of the Downe, including its modern facilities, and dedicated staff who are telling us they want to do more.

This would significantly reduce ambulance presentations at the Ulster, shorten handover times and greatly improve the patient experience as they would be seen and treated much quicker. 

A proposal to open a 10-bed inpatient unit at the Downe should be actioned without further delay. 

It is my understanding that a proposal has previously been considered to open an inpatient unit that would not only keep more patients in the local area, but offer long overdue opportunities for local nurses who were redeployed to the Ulster and Lagan Valley hospitals during Covid-19 to return home to the Downe. 

And the Ambulance Service must agree a working directive that ensures there is at least one Category 1 emergency response vehicle available at all times in the local area. 

Ambulances that are sitting waiting outside the Ulster Hospital and then redeployed into the greater Belfast area puts local lives at risk.

Consequently, local ambulance response times are amongst the worst of anywhere in Britain or Ireland. A new protocol must be urgently agreed to ensure equal access to life-saving emergency services for our local community.  

There is no doubting that the transformation of our healthcare system is the greatest challenge facing the public service here in generations and the decision-makers face unenviable choices and excruciating dilemmas. 

But transformation – if it’s to be successful – must deliver for all, not a few. 

At its very core it must delivering fair and equal access to life-saving services for the people of Down as well as Belfast.

Otherwise are we wrong to ask, transformation for who?