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Northern Ireland health service cuts: Western Trust's £12.5m savings proposal



The new South West Acute Hospital replaced the Erne Hospital in 2012

The new South West Acute Hospital replaced the Erne Hospital in 2012

The new South West Acute Hospital replaced the Erne Hospital in 2012

The Western Trust covers the council areas of Strabane and Derry City, Fermanagh and Omagh District and a portion of the Causeway Coast and Glens Borough Council area.

It is proposing £12.5m in savings.

Major or controversial savings

Cut in locums, nursing and agency social workers - £1.6m

Closure of approximately 30 beds/care spaces across medical and care of the elderly wards. There will be an increase in waiting times for routine care within hospitals. This will impact on throughput across our acute hospitals and requires a remodelling of inpatient beds and care spaces across both sectors. It will also require the Trust to pursue pathways to improve flow and access. Admissions and discharges tightly managed.

Reduction in routine elective surgery - £1.78m

Significant deterioration in access to routine elective care provided by the Trust to the population of the Western Trust area, and to the northern part of the Northern Trust area for some specialties. There will be a reduction of approximately 40 elective inpatient beds across both South Western Acute Hospital (SWAH) and Altnagelvin Hospital.

Cap on locum repayment - £700,000

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Concern locum staff may leave the Trust to secure enhanced locum rates elsewhere.

Domiciliary care and nursing home care packages reduced - £1.16m

Estimated 275 Domiciliary Care Packages will not be put in place, equating to 2,745 care hours per week and 8-10 Nursing Home beds.

Consolidate services onto fewer sites and rationalise existing services - £170,000

Proposal to consolidate the services in the Derry/Londonderry area provided by William Street and Rectory Field Residential Homes onto fewer sites. The Trust will also rationalise and consolidate daycare services in the Southern sector in recognition of previous consultation exercises which will affect Gortin, Dromore and Rosslea.

Impact on residents currently living within the residential homes and availing of daycare services, and on staff delivering these services.

Vacancy control measures - £1m

Delays in recruitment and staff required to use annual leave in one year ie - no carrying leave over into new year. This will lead to increased waiting times for routine assessment in the community.

Cut or reduce service development - £2.49m

Investment in new services delayed or cut leading to reform and modernisation not being taken forward.

Service remodelled on temporary basis - £470,000

Reform of neonatal service provision at SWAH to a transitional care based service. Babies that require special care services will be managed within the Paediatric Ward with a Specialist Neonatal Nurse in attendance, and may impact the paediatric ward's capacity.

The Trust will also reform the Older Persons Assessment and Liaison Service (OPALS) in its hospitals in order to maximise the efficient use of resources. Impact: Potential impact on staff and increased length of stay in acute hospitals.

'Low impact' savings

Constraints to Goods and Services budgets - £740,000

Reduced capacity to support Trust services, and increased impact of equipment failures, along with reduced responsiveness to estates and potential for increased health and safety risks due to delay in repairs. Potential impact on staff morale.

Vacancy controls in administration, corporate and support services - £510,000

Reduced responsiveness and performance of key, support services including cleaning, medical records, clinical coding and estates services including on call.

Accelerate projects which will deliver increased efficiency and reduced costs - £950,000

Increase Trust income - £900,000

Increase hourly rate for paid carparking at the three hospital sites within a new tiered charging scheme and revisit revenue schemes to secure savings where possible. The Trust will also revisit its financial assumptions for recovery of Nursing Home income in-year.

Western Trust Chief Executive, Dr Anne Kilgallen said: “The safety of the patients and clients under our care is our utmost priority and we have borne this in mind in developing our proposals. The trust has sought to protect emergency and unscheduled care, red flag and cancer patients, looked after children (child protection), frail people and people with a disability.

“It is important to note that the draft savings plan is a public consultation and that no decisions have been made regarding the implementation of the proposals contained within the plan.”

She continued: “We would encourage all members of the public to respond to our consultation which is available on the Trust’s website www.westerntrust.hscni.net or by contacting our Equality Office on (028) 82835834. We will be holding a series of staff and public engagements which will be advertised locally in the media and via our website and social media sites.”

The full consultation document is available here.

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