Health Dept. says Altnagelvin '˜central' to cancer services amid fears over review

Department officials were responding after staff from the Pathology Department at Altnagelvin Hospital spoke of their outrage over proposals which they fear could see local services shut down and centralised.

One staff member warned that the pathology labs, which test patients’ samples to diagnose conditions, was the “spine bone” which enabled local GPs and hospitals to start treating patients.

They also warned that a perceived threat to three of the five pathology divisions in Derry was completely at odds with the recent expansion of cancer services at Altnagelvin and could remove dozens of key professional posts from the city.

The Department of Health however said that the proposals currently being consulted on make no reference to the withdrawal of pathology services from Altnagelvin, nor propose the centralisation of pathology services in Belfast.

The Western Trust’s Pathology Services are part of the local Diagnostics and Cancer Services and involves five sections: clinical chemistry, haematology, microbiology, histopathology and cytopathology.

The latter three could be centralised under proposals to divide pathology across the north into ‘hot’ and ‘cold’ services, as they would fall within the latter category.

The departments currently test biopsy, tissue and other samples from GP and hospital patients at Altnagelvin.

Staff there have said that the tests and results they produce make up 70 per cent of the diagnoses made for individual patients, which then allows for the appropriate treatment to be administered.

The proposals under the Pathology Services Network Review include having one centralised site for microbiology or having one site with satellite hub laboratories.

One employee at the Pathology Department claimed the proposals, if adopted, “would mean moving away from Altnagelvin to some centralised site close to Belfast.”

“To be honest, there is outrage among staff,” the lab worker said. “With the new Cancer Centre for people from Derry, Tyrone, Fermanagh and Donegal, this could mean the tests being done here, will be removed from the very site we are meant to be serving.

“To take them away from the site that is supposed to be expanding is very, very short-sighted.

“This is all being driven by a willingness to consolidate work to one site and save money,” the staff member added.

The ‘Modernising HSC Pathology Services’ proposes the separation of ‘hot’ tests, which need to be processed within a few hours and would not be affected, and ‘cold’ tests, those which are not time critical, and which would be impacted.

It states: “Best practise indicates that by consolidating the high volumes of cold tests onto a smaller number of sites, there is potential to achieve significant economies of scale with improved quality and reduced cost.”

Options include reducing the number of current sites to between one and five hubs, and the use of new technology to store and disseminate information on samples.

One staff member warned that there were widespread concerns over the potential impact of any changes, particularly if there were to be delays the diagnosis and treatment of patients with sepsis.

Staff have warned that similar moves towards centralisation of labs elsewhere had proved extremely problematic.

“My understanding is they are trying to fast-track a single overall IT platform for Northern Ireland but that is in its infancy,” one staff member said, adding: “You would have reasonably well paid, proper graduate jobs, which are already thin on the ground here, taken away.

“There is a lot of concern, and obviously people here are worried about jobs, student loans, mortgages.”

SDLP Foyle Assembly candidate, Mark H Durkan, said that any proposed transfer of services was deeply worrying.

He said: “I am responding to the consultation on behalf of the SDLP and I will be expressing our support for the retention and, indeed, expansion, of the services here at Altnagelvin.

“I would call on local people and indeed other parties to respond to this threat to services for patients and also to the workforce here locally.”

Responding to the issues raised, a Department of Health spokesperson said the proposals and options for the modernisation of pathology services across the north are currently being consulted on and no decisions have been taken about the future service delivery model.

She added: “The proposals for reforming the service are about delivering the best pathology services for people in the north of Ireland.

“They make no reference to the withdrawal of pathology services from Altnagelvin, nor does it propose the centralisation of pathology services in Belfast.

“Altnagelvin is a vital part of the of the acute care infrastructure in the north of Ireland and central to cancer services in the North West.

“It is important that anyone with views as to how we can best deliver a world class pathology services should participate in the consultation.

“All contributions to the consultation are welcome and will be given careful consideration.”

A spokesperson for the Health and Social Care Board said the proposals were part of the Health Minister’s vision to create a world-class, innovative and sustainable pathology service.

She said: “The consultation was developed by the Health and Social Board in partnership with the Pathology Network (PathNet NI), following extensive engagement and pre-consultation with a range of key stakeholders including Health and Social Care Trusts, professional associations and institutes, universities and Royal Colleges.

“Details about the consultation and how to respond can be accessed on the Board’s website at www.hscboard.hscni.net/get-involved/consultations. The public consultation will end on 24 February 2017.”

A Western Trust spokesperson meanwhile said: “All staff have been encouraged to consider the proposals within the consultation document and to respond to them.

“The Western Trust currently provides a comprehensive range of high quality pathology services for patients.

“The opportunities for further development of these services will be highlighted by the Trust within its response to the consultation.”