- In Type 1 emergency care departments, the percentage of patients attending that were either treated and discharged home or admitted within 4 hours decreased by 5.3 percentage points, from 71.6% to 66.3% ).
- In Type 2 emergency care departments, the percentage of patients attending that were either treated and discharged home or admitted within 4 hours decreased by 4.6 percentage points, from 87.5% to 82.9% .
- In Type 3 emergency care departments, the percentage of patients attending that were either treated and discharged home or admitted within 4 hours remained at 100.0%.
- The number of patients that waited longer than 12 hours to be either treated and discharged home, or admitted, increased slightly (34, 3.4%) from 987 to 1,021. In particular, performance declined notably at the Ulster between January and March, from 223 to 397.
Between March 2012 and March 2013:
Dear Minister, Edwin Poots,
In relation to the current crisis at Antrim Hospital, we at Save The Mid believe that this is a direct result of removing both the A&E and Acute wards at the Mid Ulster Hospital.
In 2006 a risk assessment carried out by Deloitte Touché stated that the highest risk to services at Antrim Hospital would be to downgrade the Mid Ulster Hospital to its current status.
A group of senior consultants in Antrim Area Hospital have described the A&E department as "ineffective and unsafe".
The claim was made in a letter from seven consultants in the department to the hospital's medical director.
Jim Stewart & Edwin Poots
Save The Mid has lobbied the government and Northern Health & Social Care Trust since May 2010 post the removal of A&E at the Mid Ulster Hospital - http://savethemid.weebly.com/
Most recently we responded to Transforming Your Care, the response can be found here http://savethemid.weebly.com/tyc-response-2013.html
In the post consultation report Save the Mid was cited by the Transforming Your Care review report, “There were a number of respondents who referred specifically to the Northern Trust in terms of performance and current services. This includes some of the Councils in that area, and other interest groups (for example ‘Save the Mid’). Some of these responses highlighted current service issues, and did not feel that the proposals address these sufficiently. “http://www.tycconsultation.hscni.net/wp-content/uploads/2013/03/Transforming-Your-Care-Vision-to-Action-Post-Consultation-Report.pdf
Save The Mid strongly contested the view that Antrim Area Hospital would ever be able to meet its targets with the capacity it has since shutting down acute services in Mid Ulster Hospital, it was having serious problems before the Mid Ulster lost its A&E. Even with the new A&E about to open, this will not solve the capacity issue, a view that is shared by Edwin Poots.
I am Hugh McCloy, chair of the group, over the years I have met Jim and Edwin several times along with other government officials. According to the DHSSPS Edwin Poots has the backing of the public, in my position I can state that Edwin does not have the support of the public for what has transpired in Antrim Hospital and the future that is posed, and I share the view that Edwin Poots should step down as Health Minister as he has failed to improve services since removing Jim Stewart.
Meeting targets in A&E is just not about the capacity of the A&E, it is the ability of the hospital to admit patients via A&E. This is what has caused the problems at Antrim Area Hospital since before the closures of A&E services in Mid Ulster Hospital in 2010 and subsequently wards 2 & 3 the following year.
1 year on from the controversial Rutter & Hinds review, where the bullying culture inside Antrim A&E by senior medical managers was covered up, service provision has got worse, and both these reviewers are on the Transforming Your Care review team.
Since Rutter & Hinds, and the removal of Jim Stewart what have we really seen to improve the performance at Antrim Hospital?
· The ambulance entrance to Antrim A&E turned into a clinical area to hold patients in: http://savethemid.weebly.com/1/post/2012/09/antrim-area-hospital-corridor-ae-ward-out-of-sight-out-of-mind.html
· Extra beds called escalation beds that are placed inside bays and in front for fire doors, this practice was on-going when the turnaround team was in the hospital, this was deemed acceptable and now serious questions have to be placed on this current review: http://savethemid.weebly.com/1/post/2013/02/dangerous-antrim-ae-performance-leads-toescalationbeds-placed-infront-of-fire-exits.html
· Targets still not being met : http://savethemid.weebly.com/1/post/2013/04/antrim-ae-patients-waiting-over-12-hours-wait-the-equivalent-of-319-days-for-admission-or-discharge.html
· Unreported yet is the death of a baby which is now subject to a Serious Adverse Incident investigation that originated in Antrim A&E, the baby attended the A&E on the 25th March 2013
· The Trust having to hire out 15 intermediate care beds in a private hospital, Brooklands Antrim. This costing more than it did to provide inpatients at the Mid Ulster (see TYC response).
What the review team failed to remedy is the capacity of Antrim to admit acutely ill patients, when inpatient capacity fills up the hospital goes into escalation mode, when this happens patients begin to spend longer in A&E. Antrim Hospital has been in a state of constant escalation since December 2012, so much so that the use of escalation beds is now monitored at Trust Board level: http://www.northerntrust.hscni.net/pdf/IAG_support_210313v2.pdf last page. Yet since the removal of former chair Edwin Poots has not stepped in to take any action against the CEO Sean Donaghy or Trust Board, surly further action would be required after going as far as to sack Jim Stewart for performance issues.
All the turnaround team appointed by Edwin Poots has done is manipulate patient pathways so that patients are not classed as waiting for treatment in A&E, instead of waiting in A&E they are waiting elsewhere in the hospital, or discharged only to return again within 30 days as emergency patients. 2602 patients have had to return to Antrim A&E since April 2012 as emergencies 30 day after being discharged (reference page 12)
Post Rutter & Hinds admissions to the hospital are mainly vetted by consultants to ensure only those who require admission are admitted, despite this Antrim admits more acutely ill patients now than in its history, yet its internal capacity was never developed to cope with this.
· March 2010 (reference page 54) - 2131 patients were admitted to Northern Trust Hospitals via A&E; Antrim 1,407, Causeway 454, Mid Ulster 123, Whiteabbey 147.
· January 2013 (reference page 63, March 2013 figures are not released yet) - 2672 patients were admitted to Northern Trust Hospitals via A&E; Antrim 2044 & Causeway 628.
The figures simply do not add up, every health minster past and current knew that they were going to have to develop more inpatients yet did not, as more and more cuts came straight form the Assembly the future of the Mid Ulster was sealed despite if it was needed or not and the current state of Antrim Hospital is directly related to both bad management by the Northern Trust, decisions made by Health Ministers backed by the Assembly and the closure of Mid Ulster hospital at a cost of its ability to admit patients. (See other attachment for references to extra beds)
Edwin Poots has done more damage to health care in Northern Ireland in 2 years than the legacy of health ministers before him, instead of correcting mistakes made in the past he set in motion a review that will not fully bite into health services until he leaves his post. Edwin admitted on Hansard in the Assembly that it was a mistake to shut down acute services in the Mid Ulster Hospital, there is no point admitting mistakes that you are not willing to fix, unfortunately for patients from Mid Ulster & Antrim we are still forced into the Antrim Area Hospital based on a mistake of the past and the current mistake that thinking the new A&E will solve the problems Antrim currently faces.
With the future of both the Causeway and Mater hospitals A&E’s in doubt be under no illusion that without any significant increase in inpatient capacity the provision of acute care will collapse in public hospitals, Antrim Area is Northern Irelands Mid Staff scandal the only difference being Antrim is being covered up.
Maybe the Health Minister should make his primary concern maintaining and sustaining hospitals that are under his control rather than celebrate the opening of private health hubs that will only adversely affect our hospital system. Both Newry and Lisburn are to get health hubs, this will impact upon Lagan Valley and Daisy Hill hospitals, the Mid Ulster Hospital is now classed as a health hub, if Edwin takes a closer look he will see this model did not work for Mid Ulster or the Northern Trust and should question why he would roll this model out across Northern Ireland.
Editor's Viewpoint – 11 April 2013
The row between the former chairman of the Northern Trust Jim Stewart and Health Minister Edwin Poots has got very personal.
Mr Stewart was sacked by the minister and now he is demanding that Mr Poots should resign, arguing that statistics on breaches of waiting time targets at Antrim Area Hospital show that demands on the accident and emergency service are neither realistic nor achievable.
And he presents a quite compelling case showing that in March – even with extra resources and additional expertise from Britain – there were 299 breaches of the 12-hour limit patients should wait to receive treatment compared to 94 in the same month last year. Mr Stewart's sacking after a public row with the minister over targets was strange given that heads seldom roll in the health service.
For example, there was no similar action taken against anyone for the deaths of four babies in the pseudomonas outbreaks in Belfast and Londonderry a year ago.
Where the truth, or even the moral high ground, in the current row lies is something to be decided on another day. It would be more fruitful to examine if current A&E provision in the province is adequate to meet demand. The public perception certainly is that it is not.
While targets can be a meaningful way of ensuring efficient use of resources, the results can be massaged to indicate better performance than is actually achieved.
The minister might usefully look again at targets across the NHS to ensure that they set achievable outcomes without prejudicing care, which is, after all, the primary duty of the service. There is no doubt that staff in hospitals are under increasing pressure and no good purpose is served by blaming them when they fall short of arbitrary treatment times. Staff have no control over who, or how many, turn up at hospital doors, particularly during winter months and that should always be borne in mind, even by Mr Poots.
Health Minister, Edwin Poots today gave the go-ahead for two new £40m health centres.
Antrim A&E - Patients Waiting over 12 hours wait The equivalent of 319 days for admission or discharge
Between 4th Jan -15th Mar 639 patients who have attended Antrim A&E have had to wait over 12 hours before they were admitted or discharged.
This is the equivalent of a minimum of 319 days spent waiting in A&E by these patinets.
Still births instances in Northern Ireland have increased since 2011
A stillbirth occurs when a fetus has died in the uterus. A wide variety of definitions exist. Once the fetus has died, the mother may or may not have contractions and undergo childbirth. The term is often used in distinction to live birth or miscarriage and the word miscarriage is oftentimes used incorrectly to describe stillbirths. Most stillbirths occur in full-term pregnancies.
In Northern Ireland the Births and Deaths Registration (Northern Ireland) Order 1976, as amended contains the definition :-
“still-birth” means the complete expulsion or extraction from its mother after the twenty-fourth week of pregnancy of a child which did not at any time after being completely expelled or extracted breathe or show any other evidence of life.
Registration of still-births can be made by a relative or certain other persons involved with the still-birth but it is not compulsory to do so.
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