Safety and quality of services a priority in financial plans
Health and Social Care in Northern Ireland is still facing significant financial challenges in 2014/15, the Chief Executive of the Health and Social Care Board (HSCB) said today (30th October 2014).
HSCB Chief Executive Valerie Watts was speaking after the Health Minister Jim Wells outlined the scale of the challenge in a written Ministerial statement.
Ms Watts said that the absolute priority was safeguarding the safety and integrity of health and social care services in Northern Ireland.
“Whilst the £80m additional funding for health and social care will help minimise some of the impact on frontline services, currently there remains a shortfall in funding across the system.
“The Trusts were asked to prepare a range of contingency proposals aimed at addressing this difficult financial position, minimising as far as possible, any potential negative impact on patient and client care, and at all times putting the safety of patients and clients as our first priority.
“The HSCB has liaised very closely with the Trusts, and has critically reviewed, analysed and revised the proposals as appropriate to safeguard the safety and integrity of services. The HSCB then provided an assessment to the Department of Health, Social Services and Public Safety (DHSSPS), who after extensive consideration and challenge to the plans, in conjunction with the HSCB and Trusts, approved the implementation of the contingency proposals.
- 2.5% cut to DHSSPS Arm’s Length Bodies, and to Department of Health’s administration costs, and no additional funding made available for a number of planned service developments and pharmacy spend.
- Subject to the necessary approvals, staff will receive either the incremental progression they are entitled to or a 1% non-consolidated pay award if they are at the top of their pay scale.
- Subject to the outcome of necessary consultation processes, higher and lower clinical excellence awards will not be made to senior medical staff for 2012/13 and 2013/14.
- HSCB has also critically reviewed its baseline funding and has ensured that all funds not already committed have been released for the purpose of protecting front line services to patients and clients.
Plans being implemented across Trusts areas
- Trusts will be introducing a range of workforce control measures to reduce overtime and also the number of agency/temporary staff, whilst endeavouring to ensure that the integrity of the service is maintained and there is no compromise to patient or client safety.
- There will be some reduction in planned elective activity with the focus being on ensuring that urgent patients are seen and treated in a timely way.
- There will be some changes in domiciliary care spend based on reassessing current needs and reprioritising services to ensure the highest priority needs are met within the current resources and that any impact on the ability to discharge patients in a timely and effective way is minimised as far as possible.
The Trust contingency plans include a range of specific proposals (See Notes to Editors for further information). This will include:
- Temporary closure of 3 Minor Injury Units (MIUs) – Armagh, Whiteabbey and Bangor. Alternative services are available and patients who normally use these services can visit their Pharmacist, wait to see their own GP, use another MIU or visit their nearest Emergency Department if appropriate. The staff in these units will be redeployed to work in Emergency Departments and in other services, which will also reduce the spend on bank and agency staff.
- Ward/bed closures – there will be a range of temporary bed closures and amalgamation of wards and outpatient clinics on the basis that appropriate alternative arrangements will be put in place to maintain safety and patient flows. This will allow staff to support acute and other critical services.
The HSCB Chief Executive said: “I fully understand the concern that the implementation of the contingency plans may cause. Inevitably, the plans may mean that some people will have to wait longer or travel further for some non-urgent treatment which is hugely regrettable.
“The very nature of providing health and social care always carries a degree of risk. The service changes particularly over the winter period will, no doubt, increase the level of risk. However, the HSCB and Trusts will continue to take all proactive steps to protect critical and urgent frontline services and to closely monitor and review temporary arrangements that are put in place to ensure that unacceptable risks are minimised and avoided.
Ms Watts added: “We are working in a very difficult financial climate; the costs of providing health and social care are rising every year faster than the budgets we are allocated. You have only to look at the financial challenges facing the NHS in England, Scotland and Wales to understand that the increasing demand for, and cost of, health care is not just unique to Northern Ireland. Therefore it is absolutely essential that we continue on the journey of reforming and transforming our services.”
Some of the main changes are listed below (please note this is not a full list of every measure being implemented). Please contact the relevant Trust for further details – http://online.hscni.net/other-hsc-organisations/.
Temporary closure of 3 Minor Injuries Units (MIUs)
- Armagh Minor Injuries Unit in the Southern Trust provides a service from 9am to 5pm Monday to Friday and approximately 32 patients a day use the service. It will temporarily close from 17th November 2014. Staff will be redeployed to work in the Emergency Department at Craigavon Area Hospital.
- Whiteabbey Minor Injuries Unit in the Northern Trust provides a service from 9am to 5pm Monday to Friday and approximately 40 patients a day use the service. It will close temporarily from 1st December with the 4 nursing staff moving to support unscheduled care, including minor injuries, in Antrim Area Hospital.
- Bangor Minor Injuries Unit in the South Eastern Trust provides a service from 9am to 5pm Monday to Friday and approximately 39 patients a day use the service. It will temporarily close from 1st December 2014. This will consolidate nursing staff across a reduced number of beds, reducing spend on bank and agency staff.
- Temporary closure of 27 intermediate care/rehabilitation beds, including 7 beds in Mid Ulster and 20 beds in Dalriada. Staff will be re-allocated to support acute services at Causeway and Antrim Area hospitals and reduce bank and agency usage. The Northern Trust has reduced the length of stay in intermediate care beds with the effect that the remaining beds can adequately absorb this additional activity.
- Temporary closure of a number of respite beds currently provided in Dalriada with the understanding that respite will be re-provided in the Independent sector or through direct payments to service users.
South Eastern Trust
- Temporary closure of 9 medical beds at Downe Hospital and 6 medical beds at Lagan Valley Hospital achieved through reductions in agency nursing workforce.
- Temporary closure of 20 GP beds, Bangor Hospital (staff will be absorbed into current vacancies or roles currently filled by bank /agency staff).
- Belfast Trust will restrict the recruitment of administration and clerical staff until the end of the year and reduce backfill cover in relation to current administration and clerical vacancies. The potential consequences of this include the closure or restriction of opening hours in cash offices, reduction in cover at reception/clinic areas and recruitment delays.
- Western Trust will accelerate planned changes at the Tyrone County Hospital in Omagh in relation to the Cardiac Assessment Unit and the Urgent Care and Treatment Centre. The changes are in line with services planned for the new Omagh Local Enhanced Hospital which is due to open in 2016. The Trust will also temporarily merge the Palliative Care and Rehabilitation Wards at the Tyrone County Hospital.
- Ambulatory Paediatric Service, South Tyrone Hospital (Southern Trust) This service, which is used on average by 35 patients per week, is currently available 5 days a week from 9am to 5pm and provides a possible alternative to hospital admission . Under the contingency plan, the opening hours of the service will be temporarily reduced to 9am to 1pm, Monday to Friday from 17th November. This will ensure a daily service is still available at South Tyrone. The Paediatric Advice Lines will also continue to be accessible at Craigavon Area Hospital and Daisy Hill Hospital.
- Loane House, South Tyrone Hospital (Southern Trust) provides non acute hospital services for older people. Staff from Loane House are being temporarily redeployed to other units to reduce flexible workforce costs in line with reduced bed numbers. The Southern Trust retains the option to increase the number of beds to assist with patient flow issues.