Debate contribution: Bangor and Newtownards Minor Injury Units: Closure

Debate contribution by Mr Nick Mathison on 30 April 2024.

MLA

Mr Nick Mathison

Party at the time

Alliance Party

Date

30 April 2024

Type

Debate contribution

Business

Adjournment

Heading

Bangor and Newtownards Minor Injury Units: Closure

Assembly identifier

Official Report component 4487802

Read the official Assembly record

Text

Before I begin my remarks, I want to find the one point of agreement that we have had, which is that we should all pay tribute to our Health and Social Care staff, particularly those working in emergency medicine and unscheduled care. They are doing a fantastic job in very difficult circumstances across Northern Ireland, but I think that that may be the only point of agreement that we have reached in the debate. Before I look at my prepared remarks, I will pick up on a few things that were mentioned in the debate. Mr Easton suggested that the minor injury unit at the Ulster was in some way contributing to the delays and the backlogs and the difficulty of moving patients through the emergency department. It is my understanding that, if anything, the minor injury unit is actually reducing the number of patients attending the ED and getting clogged up in that system. I also want to pick up on a comment by Michelle McIlveen that seemed to conflate services at the old minor injury unit and what a GP provides. I suggest that the conditions for which you attend your GP do not require services that you expect to receive at a minor injury unit, which is for broken fingers, dislocated shoulders and those sorts of conditions. I do not imagine that those would require queuing at your GP's surgery, so I am not sure where that comparison was being drawn. I also want to pick up on a comment from Stephen Dunne, who suggested that this was not about saving money but about improving the patient experience. I agree with that, and I know that no change in service is ever perfect from day 1, but, in my view, this minor injury unit is about providing an enhanced service for the least sick patients who do not need to be in an emergency department. Last year, the trust took the decision to change how minor injuries were treated in the Ards and North Down area. We got confirmation that the old Bangor MIU would remain closed and that the Newtownards site would close, moving all minor injuries treatment to the Ulster Hospital. As already referenced, the new service that is available at the Ulster brings an enhanced offering for patients. There are longer opening hours — 70 hours-a-week access rather than the previous 40 — and a service that is seven days a week, 365 days a year. That is a significant improvement on the five-days-a-week service that previously operated on the other sites. As far as I am concerned, this represents a planned change to locate a service in a setting with access to the expertise that can treat minor injuries and to clinicians who can provide care in more serious cases, should it be required. There is also access to scanning and imaging equipment and a consultant-led team, should the condition be serious enough to require it. As I referenced, the new service was designed to reduce attendance at hugely stretched ED services and improve the flow through the system for the least sick patients. I agree that all services need time to be fully evaluated and to bed in, but it appears to me that the new MIU is performing well. We have customer satisfaction rates at around 98%. We have patients accessing more streamlined care. I have heard from clinicians working in the service that many can be discharged home from the MIU to return the next day for a scheduled attendance, with scan or X-ray results provided. Those are patients who would have been waiting in the ED for hours and hours, possibly through the night, to receive those results. I know which service I would prefer. In March, 3,500 patients were seen in the MIU, just over 2,000 of them by nurse practitioners and 1,500 by other medical staff on site. Typically, those were more complex cases that could not have been dealt with in Bangor or Newtownards and would almost certainly have had to be redirected to the Ulster Hospital anyway. I acknowledge that all of this is said in the context of an ED service at the Ulster Hospital and across Northern Ireland that is under huge pressure. None of us doubt that. The patient experience is unacceptable in many emergency departments, but the trust is clear, and I take the same view, that that patient experience in ED is not to do with the closure of MIUs. It is about a hospital system that is not functioning. It is about patients who cannot get discharged because there are no domiciliary care packages, and it is about an Ambulance Service that is struggling to offload patients because of clogging in the system. We need to be brave enough to take the decisions to tackle those problems with our creaking systems. What is not required is the undoing of planned change and the reform of how we deliver what is a fairly small element of treatment in the area. Not small to the people who need it but, as my colleague Andrew Muir said, small in the scale of the health service. These are the kind of planned changes and reform that we need to be encouraging and supporting as elected representatives, not blocking. I urge my colleagues across the House from North Down and Strangford to get behind the transformation agenda. As we do hope to see the urgent care system developing —

— at the Ulster Hospital again, I welcome that and hope that Members will support it.

931 words. Text as published by the Northern Ireland Assembly.

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