HEALTH campaigners have welcomed as "long overdue" proposals for a radical shake-up of stroke treatment services in Northern Ireland.
Stormont chiefs have suggested six models for consolidating services into between three and five larger 'hyperacute' units, compared to the current spread of services across 11 hospital sites.
They insist the proposals, which have gone out for a 12-week public consultation, will lead to better outcomes for patients.
But some politicians have expressed alarm that it would see the closure of stroke units in more rural areas.
Five of the north's eight acute care stroke units could close under the plans.
Emergency stroke care could be lost at Causeway Hospital in Coleraine, South West Acute Hospital in Enniskillen, Daisy Hill in Newry, Ulster Hospital in Dundonald and Antrim Area Hospital.
In all scenarios, the hyperacute units will be sited at Royal Victoria Hospital in Belfast, Altnagelvin in Derry and Craigavon Area Hospital.
In the five-unit model, acute services would also be offered in Enniskillen and Antrim.
As well as offering acute care at eight hospitals, the existing stroke care network provides supporting treatments at three others – Lagan Valley in Lisburn, Downe Hospital in Downpatrick, and the Mater Hospital in Belfast.
The new plans would be supported by an extension of the air ambulance service, with the provision of a second helicopter helping to transport stroke patients in rural areas.
Stormont ministers had committed to review stroke services prior to the collapse of power-sharing in early 2017.
It followed the findings of a Stormont-commissioned examination of healthcare in 2016 by Professor Rafael Bengoa.
Department of Health permanent secretary Richard Pengelly said the proposals were an "exciting opportunity to change services for the better".
"Our hospital stroke services are currently too thinly spread. Too many units are struggling to maintain sustainable quality care and staffing levels," he said.
"The principle of consolidating care is backed by stroke charities, expert research and the proven success of reforms introduced in London and Manchester."
Brenda Maguire, of the Stroke Association, welcomed the launch of the consultation.
"Reform is urgently needed and will save lives, reduce disabilities and help everyone affected by stroke to access the ongoing support they need to rebuild their lives," she said.
"There is clear evidence that reshaping stroke services works – creating larger hyperacute stroke units with the equipment and experts to treat stroke patients, all day, every day as well as creating more sustainable services."
Dr Tom Black, the British Medical Association in Northern Ireland's council chair, said the announcement was part of a "long-overdue process of transforming healthcare in Northern Ireland".
"We know that for patients it may be worrying that services seem to be reducing, and that changing a service will mean it is not as good. In reality by reorganising services in this way it improves access to treatment and ultimately means better outcomes for those who have had a stroke," he said.
However, UUP MLA Roy Beggs hit out at Stormont officials for announcing the proposals during a week when Brexit is dominating headlines.
He claimed they were the "equivalent to using a sledgehammer to crack a nut", saying he does not believe centralising services would produce better clinical outcomes.
Sinn Féin MLA Pat Sheehan said reconfiguring services "must be carried out in a regionally balanced way, in partnership with those who use and deliver services".
SDLP MLA Justin McNulty said the proposals wer "deeply disappointing" and a "continuation of the policy of side-lining Daisy Hill Hospital".
