Written Ministerial Statement

The content of this written ministerial statement is as received at the time from the Minister. It has not been subject to the official reporting (Hansard) process.

Department of Health - Announcement on Elective Overnight Stay Centre

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Published on Wednesday 19 October 2022.

Mr Swann (The Minister of Health): There is a significant shortfall in the capacity of the Health and Social Care Service (HSC) in Northern Ireland to meet the current demand for elective care services and this is reflected in our unacceptably long waiting times. Addressing the gap between current capacity in our hospitals to deliver the required levels of demand for services is one of the most pressing challenges facing the HSC now and for the foreseeable future.

The Review of General Surgery published in June 2022 is a positive building block, not just for general surgery, but for the wider transformation of our HSC system. Implementation of the Review of General Surgery will ensure that people across Northern Ireland who require general surgery receive the high quality, sustainable and equitable care and treatment they need, when they need it.

Implementation of Review of General Surgery will also shape how elective surgery is delivered in Northern Ireland – with better patient outcomes across the surgery spectrum.

I have always been clear that the Review of General Surgery is not about closing any hospitals instead it is about ensuring that optimum and sustainable care can be provided to our patients. Given the huge and growing demand for health and social care, we will need to maximise every inch of our hospital estate.

In the Review, I announced the next phase of the Elective Care Centre model that will play a vital role in tackling our lengthy waiting lists. Elective Care Centres are designed to provide a dedicated resource for less complex planned surgery/procedures and are a means to increase productivity, efficiency and reliability of the service.

There is robust evidence to show that concentrating certain procedures on a smaller number of dedicated centres, protected from the impact of emergency care, and dealing with a higher volume of patients, improves productivity and overall patient experience.

These centres also aim to reduce the significant variation in access to services and to standardise patient pathways to ensure consistency and equity of service provision. This approach is already working locally in our Regional Day Procedure Centres, in other parts of the UK and internationally.

The Regional Day Procedure Centre (DPC) at Lagan Valley Hospital (LVH) has been operational since Autumn 2020 and supports a range of surgical specialties. Approximately 4,600 patients from across Northern Ireland have been treated at the DPC at LVH, and a further approximately 9,000 patients have received endoscopy or biopsy procedures at the centre. This is additional regional capacity to help reduce long waiting times.

Omagh Hospital has also been established as a Regional Day Procedure Centre. When fully operational it will see seven regional theatre lists per week across urology and general surgery – two specialities with some of the longest waits across the HSC. Going forward, this means an extra 1,750 patients across these specialities will be treated per year. In addition, 10 regional endoscopy sessions at Omagh Hospital will see an extra 3,000 patients per year.

However, not all patients and not all types of surgical procedures are suitable for a Day Procedure Centre - the nature of the surgery or the patient’s clinical circumstances may mean that an overnight stay in hospital is required. There are huge numbers of patients on our waiting lists to whom this applies.

Therefore, in line with the Review of General Surgery and the strategic direction articulated in the Elective Care Framework, the Mater Hospital is becoming an Elective Overnight Stay Centre. This will be a centre for intermediate complexity surgery requiring an overnight stay and will include a range of surgical specialties.

The implementation of the Mater as an Elective Overnight Stay Centre is taking place on a phased basis, initially with day procedures in the first instance and then a move to procedures requiring an overnight stay. The first day procedure patients have been seen, and overnight stay patients are expected in November 2022.

In the Review of General Surgery, I also committed to announcing the next Elective Overnight Stay Centre in the Autumn.

I am therefore delighted to announce that Daisy Hill Hospital in Southern Trust will, become an Elective Overnight Stay Centre for patients requiring intermediate complexity surgery with an overnight stay.

In addition to the wide range of services already provided at DHH it will become a vibrant and dynamic Elective Overnight Stay Centre that provides elective care, not just for its local population but also for the region. Surgeons and patients alike will travel to DHH from across Northern Ireland. It will not be just for patients requiring general surgery but will include other specialties.

DHH has already proven the viability of this approach for elective work. It is currently providing elective overnight stay surgery for breast, ENT, urology and general surgery for patients in the Southern Trust. Going forward this will expand and include patients from across Northern Ireland.

The implementation of these plans remain subject to Trust decision making processes, engagement and recruitment.

Along with our regional Day Procedures Centres at Lagan Valley and Omagh, and the Elective Overnight Stay Centre at the Mater Hospital, Daisy Hill will join the Elective Care Centre model and will play an important role in tackling our lengthy waiting lists and improving outcomes for our patients.

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