WE WARNED HAYES WE WARNED THE DEPARTMENT WE WARNED THEM TIME AND TIME AGAIN EVEN ROD HALLS WARNED THE PEOPLE OF FERMANAGH YOU DO NOT HAVE THE POPULATION FOR AN ACUTE HOSPITAL AND NOW LOOK ================================================================= 2. MIDWIFERY SERVICES IN THE OMAGH DISTRICT WELCOME: was extended by the Committee Chair, Councillor McAnespy to Mr Kieran Downey, Director of Women and Children’s Services and Dr Michael Parker, Clinical Lead for Obstetrics and Gynaecology who were then invited to address members on midwifery services in the Omagh district. ADVISED: by Dr Parker, that a Strategy for Maternity Care in Northern Ireland had been introduced two years ago and was to be implemented in full by 2018. He added that the strategy sought to provide high quality, safe and sustainable maternity services. OUTLINED by Dr Parker the current problems being encountered within the Western Health and Social Care Trust (WHSCT) in meeting the doctors ratio required to meet the requirements of the Maternity Strategy. He referred to the difficulties in recruiting F1s/F2s and ST3s within the consultant led maternity unit at the South West Acute Hospital (SWAH). Dr Parker made reference to the lack of cover in place especially after 5.00 pm and over weekends within the consultant led maternity unit and to the fact that there were only two permanent ST3 doctors in place. Dr Parker added that there was a need for a further five doctors to be recruited and spoke of the stipulation by the Public Health Authority (PHA) to have these in place from August and to the similar staffing problems being encountered in paediatrics. He further added that the Northern Ireland Medical and Dental Training Agency (NIMDTA) did not supply ST3s to the SWAH so there was already an issue in relation to fulfilling the criteria stipulated by the PHA. Dr Parker also advised that neo-natal services in the SWAH had also been affected with criteria changing from 30 weeks to 34 weeks gestation which meant that even an expectant mother at 33 weeks in labour would be transferred to Altnagelvin and those with a BMI of 40 and patients with diabetes would also have to be referred to one of the larger hospitals. He also referred to a report which was currently being undertaken by Commissioners with regard to this matter. WITH REGARD: to the WHSCT perspective Mr Downey pointed out that Dr Parker had alluded to the issue of medical locums. He referred to the struggle being experienced by the WHSCT to get doctors to come to the SWAH with younger doctors gravitating towards Belfast thus resulting in a medical locum bill in excess of approximately £6m and made reference to the falling birth rate, the complexities around obesity and diabetes and the increasing standards around safety as detailed in the Strategy for Maternity Care. He advised that to put the ratio of ST3s in place as required by the Strategy would cost in the region of £1.2m. He added that the Trust was therefore trying to ‘out’ high risk patients to the larger hospitals. He further added that deliveries at the SWAH were currently fluctuating at around 1,100-1,200 births and Dr Parker highlighted that 1,000 was the normal cut-off to retain maternity services and that if births dropped to 800-900 it would be very difficult to get approval from the Royal Colleges as there was a need for the critical mass to keep the skills levels within the unit. Dr Parker further advised that NIMDTA interview and approve junior doctors with an allocation of 6 for SWAH, however, currently only 3 junior doctors had been allocated and it now appears that only two would take up their positions, resulting in the SWAH being 4 doctors down at this stage . He advised that adverts had been placed in the local and national press and medical journals to recruit to the middle tier with a closing date of 31 July and a start date of 1 August and currently there is only 1 possible applicant. In the absence of achieving the required quota the WHSCT would have to go back to recruiting locums which will cost in the region of £1.5m. Comments were then invited from members. DISCUSSION: ensued, during which the Committee Chair, Councillor McAnespy referred to her role on the Western Local Commissioning Group and of the apparent need to attract doctors to work and reside in this area of the province to counterbalance the staffing issues. Councillor Deehan advised that she wished to record her thanks to the outgoing Committee Chair, Councillor McLaughlin and to congratulate Councillor McAnespy on her appointment to the Chair. She expressed concern at the update provided regarding maternity services and felt that the Council as a corporate body in consultation with Fermanagh District Council needed to ensure that services were protected for the community. She referred to the previous fight to retain maternity services in the Tyrone County hospital (TCH) which was lost because birth rates had fallen below a certain level, leaving it unsustainable and of the Council’s favour for 24 hour midwife care in Omagh. Councillor Deehan made reference to the major impact the changes would have on new mothers with the long journey and the possibility of being faced with the prospect of having to leave their infant baby many miles from home. She also referred to discussion with the Minister for Health, Social Services and Public Safety, Mr Edwin Poots MLA at the official opening of the SWAH regarding the need for continued focus on cross border and cross boundary working and of the importance of workforce planning to address the staffing issues. In response Dr Parker advised that in terms of workforce planning speciality committees had previously met three times a year but these had been stood down and reiterated the difficulties with regard to recruitment and retention of staff which affected any forward planning. He added that the SWAH was perfectly placed with regard to cross border work ie in conjunction with Sligo but that this required early deliberations at a political level, particularly as Cavan, Letterkenny and Sligo were currently examining the potential to amalgamate in order to have one large maternity unit to service their region. IN RESPONSE: to a query from Councillor McLaughlin, Dr Parker outlined the procedure in relation to midwifery provision with every expectant mother allocated a midwife for antenatal care with the expectant mother seen at hospital at 34 and 41 weeks respectively. IN RESPONSE: to a query from Councillor Fitzgerald, Dr Parker advised that it would cost in the region of £2,000 per couple when a baby was transferred for care from the SWAH to one of the larger hospitals. IN RESPONSE: to queries from Councillor Smyth, Dr Parker advised that if an expectant mother had a BMI of over 40 it was safer for her to deliver in a larger hospital. He added that should for instance the maternity unit at the Mater hospital close there would be other hospitals close by but if the SWAH maternity unit closed patients would be isolated. Councillor McLaughlin left the meeting at this juncture. IN RESPONSE: to further queries from members, Mr Downey advised that the SWAH was currently rated in the top 4 of 104 maternity units in the UK, with Altnagelvin being the largest maternity unit outside Belfast and that Craigavon was currently expanding their maternity facilities in order to deal with around 3,500 births. Dr Parker added that a huge amount of promotion work needed to be undertaken by the WHSCT and Councils to encourage patients back to the SWAH. FURTHER DISCUSSION: ensued, during which other members echoed the previous concerns and referred to the road infrastructure and of the difficulties encountered by other bodies such as the PSNI in terms of retaining staff in the South West of the province. Members referred to the state of the art facilities at the SWAH and to the experienced staff who would be more than capable of caring for these mothers and new babies. Concern was also expressed regarding the cost of locums and of the domino effect on other services within the SWAH such as paediatric services etc and of the role of GPs in relation to encouraging expectant mothers to the SWAH rather than other hospitals such as Altnagelvin or Craigavon. Councillor Campbell left the meeting at this juncture.
Posted on: Thu, 07 Aug 2014 21:38:55 +0000
Trending Topics
Recently Viewed Topics
© 2015