Northern Ireland

Health minister urged to bring 'voice of frontline to table' as part of plan to rebuild health service

Health Minister Robin Swann has outlined a blueprint plan to rebuild the health service following the first peak of the coronavirus outbreak
Health Minister Robin Swann has outlined a blueprint plan to rebuild the health service following the first peak of the coronavirus outbreak Health Minister Robin Swann has outlined a blueprint plan to rebuild the health service following the first peak of the coronavirus outbreak

A nursing chief last night called on Robin Swann to have "full engagement" with frontline staff as part of his plan to rebuild the health service as it emerges from the Covid-19 pandemic.

Pat Cullen, director of the Royal College of Nursing (RCN), said while they welcomed yesterday's blueprint document, she was disappointed that there was no consultation with trade unions prior to publication.

"There cannot be meaningful rebuilding and transformation without full engagement with health care staff and openness and transparency during every step taken. This includes robust scrutiny and accountability in relation to decisions that are made," she said.

"We will now be considering the detail of the document... but there needs to be the voice of the frontline at the table. The minister needs to transform services with nurses and other healthcare workers at his side."

The north's six health trusts yesterday unveiled 'first phase' plans up until June 30 about reshaping the hospital and social care system post-Covid as part of an overarching strategy led by the Department of Health.

An emphasis is placed on continuing 'virtual' appointments via telephone or video consultation, while there are proposals to re-open some day centres for the "most vulnerable" including those with learning disabilities.

Red-flag patients urgently requiring diagnostic tests and surgery - many of whom have had treatment delayed for months - will be among those seen first.

Cancer services, maternity care, planned operations, day centres, community mental health, learning disability and children's healthcare visits were among those severely impacted by the pandemic - with the vast majority "paused" in March to prepare for the coronavirus surge.

Mr Swann said priorities included the resumption of cancer treatments as well as other urgent conditions - and described the scale of the overall challenge as "daunting".

Radiotherapy treatment for prostate cancer patients will be among services where increased capacity is sought to deal with backlogs caused by Covid-19.

The north's biggest health trust, the Belfast trust, said it will be engaging with their frontline workers to "reflect on many lessons learned" over the past 10 weeks - saying this will be a "crucial" aspect of future planning.

Mr Swann said the north's waiting lists prior to Covid-19 - the worst in Europe - were unacceptable, adding they are even more horrendous now.

"I am deeply concerned about the impact of this activity downturn on long term health outcomes across the population," he said.

"Throughout the pandemic the HSC has continued to provide high priority and urgent services such as emergency care and many cancer treatments.

"Despite the action I took to protect our highest priority services, a terrible consequence of the pandemic is that for some people conditions will have gone undetected or untreated longer than they otherwise would have. I am also deeply concerned about the impact of the pandemic and the lockdown on mental health, especially for our most vulnerable citizens."

Mr Swann said that he didn't want to simply restore the health and social system "to the way it was at the beginning of 2020", adding that would do a "disservice" to "great staff and people of Northern Ireland".

He announced the appointment of a new management board dedicated to rebuilding services - compromising of mainly senior Department of Health officials, health trust chief executives and "leaders".

However, Unison trade union leader Patricia McKeown told the BBC she was disappointed at the appointment of "another bureaucratic tier" in an already "highly bureaucratic system" to deliver transformation, when the "voice of the worker, patient and public" was "equally valid".

Meanwhile, Macmillan Cancer Support welcomed the blueprint but said a dedicated cancer recovery plan should be created.

Roisín Kerr from the charity said there were 82,000 people living with cancer in the north who know they will experience further delays.

"We need to have the right staff in place with the right equipment and testing to deliver safe care," she said.

"But we also need a person-centred care approach to deliver a package of clinical and emotional support to meet their care needs.

"We have noticed over recent months that people are not just dealing with the physical fear about their treatment but there is an emotional anxiety as well."

The main body representing doctors in the north, the British Medical Association (BMA), also said medics need to be "at the centre of decision making" in relation to service rebuilding.

BMA chief Dr Tom Black said: "We cannot go back to running our services in the way we have been doing. It was not a system that worked for patients or for doctors.

"Covid-19 turned our service on its head as we had to make sure we were able to cope with the potential impacts of a pandemic. We have seen that the health service can change and can change quickly when it needs to, and we need to capture that energy and target it towards improving, changing and rebuilding our health service."