No plans for any more A&E cuts

No plans for any more A&E cuts

12 February 2014

DOWN District’s most senior health chief has given an assurance that there are no plans to withdraw all A&E services from the Downe Hospital.

South Eastern Trust chief executive, Mr. Hugh McCaughey, said while he understands the concern and frustration about the recent decision to close the hospital’s emergency department at weekends, there are no plans to axe the emergency service at the hospital.

He said securing weekend cover had become increasingly difficult in the last few months of 2013 with fears growing that there would be an “unplanned closure” at the Downe due to the unavailability of locum cover.

Mr. McCaughey said such a scenario would not have provided an opportunity to put in place additional ambulance cover and staff at other hospitals. He said such a situation would not have been good for the hospital or patients.

The chief executive has also refuted suggestions that plans to provide a minor injuries service at the Downe at weekends is a forerunner for such a service replacing the hospital’s emergency department.

Mr. McCaughey said the Trust is “committed” to the Downe and explained that despite exhaustive efforts, the organisation could not recruit the doctors it needed.

However, he made it clear that if the doctors needed to work in Downpatrick on Saturdays and Sundays become available, “the emergency department will reopen.”

He continued: “I’m clear if we get sufficient doctors tomorrow the emergency department will reopen at weekends,” declared Mr. McCaughey, explaining the plans for a minor injuries unit are not viewed as a permanent replacement for weekend emergency services.

Mr. McCaughey said the new service is in line with a directive from Health Minister Edwin Poots to mitigate the loss of Saturday and Sunday A&E provision and is one which staff at the Downe are also keen to provide.

Explaining he understands local concern about the weekend closure, the Trust chief made it clear the organisation is committed to the Downe and the reopening of the A&E department at weekends.

“The issue is that I do not believe there is an easy short term fix to the problem we have. I don’t want to give any sense of false hope that we can press some magic button to produce the doctors we need.

“There seems to be an emerging view that some politicians do not want the minor injuries unit in conjunction with the GP out-of-hours service at the Downe at weekends. I think there is probably a fear that if they accept this then that’s it. I want to make it clear that we do not see things that way. This unit is a stop gap.

“One of the first things the Health Minister told us to do was mitigate the impact of our decision to close the A&E service at weekends and that is what we are doing,” he said.

The chief executive said he understands the disquiet around the A&E closure and how the decision has impacted on the Trust’s relationship with local politicians in particular. It’s an issue he wants to address.

“While there has been criticism of the suddenness of the closure, the Trust had looked at all possible options to keep the emergency department open. In the end, it just wasn’t possible,” he continued.

“Everyone was shocked and the Health Minister is on record as saying he was not happy with the situation either, but there were no other options. We simply did not have the staff we needed to cover weekend shifts. We issued a statement a week before the closure warning the public about what could happen and things really accelerated from there.”

Politicians have been scathingly critical of the Trust’s inability to recruit the staff they need to work at the Downe and Mr. McCaughey expressed regret at the comments from some accusing the organisation of “bad management.”

But he admitted the way the Trust handled news of the closure was not its normal practice, explaining it was the speed with which things happened that it made it difficult for the organisation to tick all the boxes in the way it normally would have and in a manner which was to everyone’s satisfaction.

“Two of our doctors announced they were going and we were making efforts to fill their shifts right through November, but we were finding it more difficult to get locums. With more vacancies across the piece it was making the job of recruiting them even more difficult. We realised through November that the situation was not going to get any easier and was actually worse than it was six months earlier,” said McCaughey.

Asked if the weekend A&E closure at the Downe was solely due to a shortage of doctors or a reluctance to work in Downpatrick, the Trust chief admitted it was a “little bit of both.”

He continued: “There are big units in England closing because they cannot get doctors and there are fewer staff grade doctors about. The bigger picture is that there’s a national shortage of middle grades and those who have applied to some of our adverts have been quite categoric that they would only work at the Ulster Hospital.”

Mr. McCaughey conceded that the change to emergency services at the Downe has affected the Trust’s relationship with others.

He added: “We have always had a very good working relationship with elected representatives and want to get back working with them. We are keen to work with the hospital taskforce established by Down Council and are committed to rebuilding trust between ourselves and local politicians. “If we are all saying different things the public becomes confused and I don’t think that serves anyone. With divided voices we are less likely to get the things we want for the hospital.”