Western Trust publishes rebuilding health services plan while acknowledging we will continue to live with COVID-19

The Western Health and Social Care Trust Rebuild Plan April – June 2021 has been published as the Health Minister Robin Swann detailed his ambitions for the re-building of the north's health service, while stressing the need for sustained investment to deliver the plans.

Speaking in the Assembly this morning Mr. Swann said the pandemic has had a 'significant impact' on 'our already appalling waiting lists'. It had also 'highlighted serious long established fragilities in our health and social care system, especially in terms of staffing capacity'.

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The five regional Trusts and the Northern Ireland Ambulance Service all published their latest rebuild plans to help address these problems.

Mr. Swann said the Trust rebuilding plans include elective (planned) care being prioritised regionally. Mr. Swann told MLAs elective surgery will be prioritised in line with greatest clinical need, and will not be dependent on a patient’s postcode.

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The Western Trust plan acknowledges the onerous burden the coronavirus surges have placed on staff.

"We are cognisant of the significant demands that have been placed on staff both physically and emotionally and we remain committed to working in partnership with staff and Trades Unions to support our staff recovery from the pandemic.

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"The Trust is committed to taking a carefully considered and balanced approach to rebuilding services taking into account lessons learned over the past year whilst also acknowledging that we will continue to live with COVID-19 for some time and this will continue to impact on how we can deliver our services, including social distancing and infection prevention control measures," it states.

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The rebuild plan is candid about how much can be achieved in the short term.

"We are committed to delivering safe and effective care for all our clients and patients but initially our focus will be on treating the most urgent cases first. As a result, some patients may continue to wait longer than we would like," it declares.

A regional Rebuilding Management Board, led by the Department of Health has developed a number of principles that will guide the reopening of services. They are as follows:

 Principle 1: We de-escalate ICU as a region, informed by demand modelling and staffing availability;

 Principle 2: Staff are afforded an opportunity to take annual leave before assuming ‘normal’ duties;

 Principle 3: Elective Care rebuild must reflect regional prioritisation to ensure that those most in clinical need, regardless of place of residence, are prioritised (short notice cancellations may result in the scheduling of routine patients to avoid the loss of theatre capacity);

 Principle 4: All Trusts should seek to develop green pathways and schedule theatre lists 2-3 weeks in advance. The aim will be, for any given staffing availability, to maximise theatre throughput;

 Principle 5: The Nightingale facilities should be prioritised for de-escalation to increase regional complex surgery capacity as quickly as possible.

"The Trust will also continue to work together with our partners locally and across Northern Ireland to implement the recovery of non–COVID-19 health and social care services," the Trust states.

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Key priorities remain ensuring equity of access for the treatment of patients across the north, the minimisation of transmission of COVID-19, and the protection of access to the most urgent services.

Speaking in the Assembly this morning Mr. Swann said: “Our health service prides itself on being available to all, free at the point of access. I will today contend that we are in grave danger of undermining this essential feature of our health service. With ever growing waiting lists – I would question whether all of our citizens have adequate access to the health services they need?

“To address this burning issue, I will in the near future be publishing for consultation a cancer recovery plan, an elective care framework and the urgent and emergency care review. Our great staff want us to be ambitious about the future of health and social care.

“They want us to build back better, to learn the lessons of the pandemic in terms of capacity, resilience and investment. I share that ambition 100 per cent. I believe the people of Northern Ireland do too.

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“However, without a significant and recurrent funding commitment from the Executive, I fear that we will be severely restricted in our ability to deliver. We will be fighting the scourge of waiting lists with at least one hand tied behind our backs.

“We must start putting this right. It is a long-term task and it needs long-term, recurrent funding.”

Describing the current single year budgetary position as “extremely disappointing”, Mr Swann stated: “The present funding model which we operate within is not fit for purpose. What is really needed is a multi-year budget and unfortunately the Executive hasn’t received this from Westminster.”

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He continued: “To properly put waiting lists right, we will clearly need more staff in our health service. But how can you recruit additional people to the workforce if there’s no certainty you’ll have the money to keep paying them next year?

“How do you sign up more young people for the required years of training on the basis of single year funding?

“I recognise there are many pressing rival demands on the public purse in Northern Ireland. Huge issues face every Department. I fully accept that the Executive has limited room for manoeuvre in budget terms. Decisions are taken in London and we have to play the cards we are dealt.

“However, I cannot think of a more pressing issue facing us than waiting times. It cries out for action. It is a daily rebuke to the standing of this House and to the reputation of politics.

“It leaves thousands and thousands of our people in avoidable pain – our fellow citizens, our neighbours. We owe it to them to do much, much better.”