Daisy Hill ED on verge of collapse

Thursday, 20 April 2017

THE Southern Trust has failed to attract any applicants for consultancy roles solely based at Daisy Hill's Emergency Department since 2015.

At Thursday's (April 13) Trust Board meeting, which was called to discuss Daisy Hill Hospital's Emergency Department crisis, it was revealed that one consultant was appointed but that doctor is shared between Daisy Hill and Craigavon Area Hospital.

In October 2016, an applicant declined the post and since then the Trust has offered a 10% wage increase but that has failed to entice any potential consultants.

The Trust's Clinical Director of Emergency Medicine Gareth Hampton, stated that they have offered to pay consultants more than any other hospital in Northern Ireland, while also confirming that there were 100 Emergency Department shifts not filled in April.

The Board also unanimously agreed to a 1million contingency plan for Craigavon in case the Emergency Department at Daisy Hill is suspended at night.

The plans will provide Craigavon's Emergency Department with additional inpatient accommodation.

Dr Richard Wright, Medical Director of the Southern Trust, told the Board that in order to safely run an Emergency Department there must be 10 consultants, however, Daisy Hill only has two.

This had led to fears that junior doctors will not have the support of senior staff that they need, which could ultimately collapse Daisy Hill's Emergency Department.

“For the last number of years we've been coping with difficulties of staffing at the Trust, in particular the shortage of Emergency Department staff," explained Dr Wright.

“Over the last two years we have tried to put measures in place, be it specialists or short term doctors.

“We have also brought in other measures in Daisy Hill, in particularly. This worked very well over the last two years but this was to try and buy us time.

“Emergency Department activity has risen by 10% from last year.

“The Emergency Department is at particular risk if we don't have senior staff to support junior doctors. That puts patients at risk.

“We may not be able to sustain the service over the coming months. At the moment we have been working very closely with our colleagues in other Trusts around the province to see if they can shore us up. Those Trusts are struggling themselves."

A significant gap in the the overnight rota (8pm to 8am) cannot be filled and is proving to be the most problematic shift for the Trust.

Dr Wright revealed that 80-90% of shifts are being filled by locum doctors but this is "unsafe" as junior staff are not being trained appropriately.

Previously, the Trust has relied upon local doctors to help cover shifts at the Emergency Department but when they are not available, locum staff are brought in.

Failing that, consultants from other areas of the hospital take care of Emergency Department patients but that is "not sustainable".

“We can do that for a night but we could not have the same people working around the clock for 48 hours and expect them to deliver a service the next day," added Dr Wright.

“Part of our plan may result in us closing and the majority would have to be relocated to Craigavon. We will have to plan for that possibility."

The Chair of the Southern Trust, Roberta Brownlee, stated that they need the "commitment" from professionals who want to work in Daisy Hill Hospital and added that they are "taking this very seriously".

Ms Brownlee also stated that the Trust has spent "in excess" of 1 million on Emergency Department staff cover.

“We want to get names for people who want to work at Daisy Hill Hospital," she said. "We need the commitment.

“Covering a shift will not make this any better. We need consultants who want to work there. On many occasions we have no applicants for the Southern Trust.

“I will be looking to see that we get consultants by getting people to go and work there even on the short, medium and long term."

Stephen McNally, Acting Chief Executive of the Trust, added: "The last time the board met it was made clear that we want to keep Daisy Hill open.

“There are concerns with medical doctors in each Trust. We got consultants to put their hands up and volunteer.

“We as a Trust board have a duty of care to our patients."

The Southern Trust Board is due to meet again on Thursday, April 27, to discuss the names of 12 consultants that have been put forward to take over the Emergency Department and gauge their "commitment" in doing so.


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