Northern Ireland

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BMA NI consultation responses and briefing papers

We respond to a wide range of consultations and also publish briefing papers on behalf of members. Most of these relate to proposed changes in public policy and legislation that affect our healthcare system or the medical profession in Northern Ireland. 

Our most recent responses and briefings are available to download below.

 

BMA NI briefing paper on the duty of candour

Key points:

On 18 November 2004, Mr John O’Hara QC was appointed chair and asked to conduct an inquiry into the events surrounding and following the deaths of children due to hyponatremia. The report into hyponatremia related deaths was published on 31 January 2018. As a consequence of the first recommendation to introduce an individual statutory duty of candour with criminal sanctions made in his report, BMA has submitted the below evidence.

BMA Northern Ireland's aspiration is for doctors to provide care in a safe and well-run healthcare system. And while the focus on candour in Justice O’Hara’s report is welcome and will help us achieve this aspiration, criminalising doctors and other healthcare professionals will not help us to get there. Those who are responsible for causing harm to patients due to neglect or wilful misconduct should be held to account and sanctioned. 

Patient safety debates over the last decade have recognised that it is the way that healthcare systems are organised - alongside financial and staffing pressures - that are responsible for breaches in patient safety and rarely the responsibility of individuals. The emphasis is on creating the conditions and culture where reporting becomes the norm and, importantly, lessons are learnt and disseminated across the healthcare system. 

Read the briefing paper

 

BMA NI response to Northern Ireland Ambulance Service Consultation and EQIA on Introduction of a Proposed Clinical Response Model

Key points:

  • BMA NI is supportive to the proposals for when a response is dispatched to a patient. Two of which were “treat and leave” and “treat and refer” and suggests a “referral to GP” option could be added to these.
  • GPs should have the same referral options as NIAS and BMA and NIGPC would welcome the opportunity to work with NIAS on a referral to GPs process and developing a method through which GPs can access the NIAS directory of services.
  • The reduction in the Rural-NI response time gap from 84% in 2013 to 52% in 2017 is welcome but anticipate that this will require imaginative ways of working by NIAS.
  • Public education: The consultation document does touch on the inappropriate use of the ambulance service by the public. A public education campaign on appropriate use of the ambulance service may be something NIAS may wish to consider.

Read the response

 

BMA NI response to Briefing Paper on Northern Ireland Budgetary Outlook 2018-2020

Key points:

  • Welcome the continuing commitment to ‘Health and Wellbeing 2026 - Delivering Together’ throughout the budgetary outlook. We are concerned that the additional funding necessary for implementation cannot be found outside the Conservative Party and Democratic Unionist Party’s confidence and supply agreement.
  • We welcome the protection afforded to the Department of Health’s resource budget.
  • BMA Northern Ireland is against increased health trust carparking charges, the reintroduction of prescription charges or increasing higher education tuition fees as options for raising revenue.

Read the response

 

BMA NI response to Consultation on Strategic Framework for Imaging Services in Health and Social Care (January 2018)

Key points:

  • The BMA believes that the impact Brexit will have on various aspects of imaging services has not been addressed in this framework. Of particular concern regarding Brexit's potential impact include: All-island healthcare arrangements; requirements of the Ionising Radiation (Medical Exposure) Regulations 2000 (IRMER); procurement processes; rights of EEA doctors to work here and freedom of movement.
  • BMA welcomes and agrees with the framework's guiding principles.
  • BMA welcomes that workforce issues are central to the framework. We also welcome that the department are aware of our concerns over the definition of unfilled vacancies and the way data is collected in relation to this. The proposed training numbers for radiologists need to increase and there are concerns over the proposed volume of reporting to be carried out by radiographers.
  • We welcome the intention to develop networks of care across Northern Ireland and would suggest that this includes all island healthcare where appropriate and recognises best practice.
  • We also welcome the commitment to investing in imaging services and urge that this investment must be long-term and sustainable.

Read the response

 

BMA NI response to Review of oxygen supply in primary care in Northern Ireland (November 2017)

Key points:

  • The BMA believes that community pharmacies do not have access to the full range of appropriate technology to deliver an adequate home oxygen service to patients.
  • The BMA feels the provision of home oxygen through community pharmacies did adequately met access requirements during the day but not in the ‘out of hours’ period.
  • The BMA reiterates the need for this service to offer increased access to portable concentrators, or other systems which do not require the use of long lines. This would eliminate a potential trip hazard and ensure that patients are not confined to small areas of their homes.

Read our response

 

BMA NI response to restrict the sale of nicotine inhaling products to under 18s

Key points:

  • The BMA supports restrictions on selling nicotine inhaling products and related products to anyone under 18.
  • We are supportive of the exemptions laid out in the consultation document to allow access to nicotine inhaling product licensed as medicine.
  • We welcome the offences and penalties being linked to existing penalties for tobacco sales offences.
  • We are supportive of restrictions on adults buying nicotine inhaling products on behalf of anyone under 18 years old, bringing nicotine inhaling products in line with other restricted products and in line with the rest of the UK.
  • There is a need for the department to continue to monitor the usage of nicotine inhaling products, including e-cigarettes amongst young people.

Read our response

 

Reshaping stroke services (September 2017)

Summary of the consultation response:

BMA Northern Ireland believes that as well as reviewing how services are delivered, more work needs done on addressing lifestyle factors that lead to stroke as well.

•    Evidence in the report is selective and does not take into account physical geography of Northern Ireland or location of services;
•    There is insufficient consideration given to staffing levels and ensuring the right workforce is in place to deliver stroke services;
•    The impact on primary care re the shifting or reshaping of services needs to be considered, in order that GPs are not placed under additional pressure; and
•    Care needs to be taken to ensure that hospitals are not destabilised, and that any decisions taken are clinically driven and are in the patient’s best interests.

Read our response

 

Smoking in cars (February 2017)

Summary of the consultation response:

BMA Northern Ireland has a goal for a tobacco free society based on:

  • policy and legislative changes;
  • education and information;
  • smoking cessation; and
  • tobacco industry accountability.

We recommend the inclusion of two clauses in the proposed regulations:

1. Prohibit smoking in private vehicles carrying children under the age of 18.
2. Consideration should be given to extending banning smoking in all private motor vehicles regardless of the age of the driver and passengers

Read our response

 

Draft programme for government framework 2016-21 (July 2016)

Summary of consultation response:

  • A robust evidence base for the proposed outcomes based framework needs to be established and critiqued to ensure that it is fit for purpose.
  • The government must tackle the drivers of poor health by making health improvement an objective in all policy areas, in recognition that it is fundamental to a prosperous and sustainable society.
  • Social and economic prosperity for people in Northern Ireland will require much broader thinking and action than is evident in the draft PfG.
  • Public health input must be put onto a statutory footing and consideration given to the introduction of health impact assessments of all Government policies.
  • An additional indicator should be added to capture the structural and systematic factors that enables us to show how this impacts the on health outcomes of the population of Northern Ireland.
  • The draft PfG does not make clear how the outcomes, indicators and measure link to tackle the issues raised.

Read our response

 

Proposed health and social care structural reform (February 2016)

Summary of consultation response:

  • BMA Northern Ireland believes that clinical leadership is fundamental to how health and social care is designed and delivered and we reiterate our call for doctors to be meaningfully involved in service development and leadership.
  • Results from the political summit and the expert panel must also be considered and included in any proposed change to structure and accountability arrangements.
  • BMA Northern Ireland urges our politicians to listen to, and engage with, doctors working on the front line of health and social care. Only then will we secure the health and social care system that is fit for purpose for the 21st Century.

Read our response

 

Helicopter emergency service (HEMS) consultation (January 2016)

Summary of consultation response:

  • BMA Northern Ireland fully supports the establishment of a HEMS linked into the Northern Ireland Trauma Network.
  • HEMS should use existing frameworks such as the Association of Air Ambulances.
  • HEMS in Northern Ireland should be funded directly by the government to ensure sustainability of the service.
  • It should be a doctor-paramedic model, to enable a rapid clinical response.

Read our response