Hospital at Home: New service aims to ease winter strain on Northern Trust hospitals

Antrim Area Hospital Emergency Department

The Northern Health and Social Care Trust has warned that it may be “difficult to provide all services whilst managing the expected increase in demand for unscheduled or critical care” as it launches its 2025/26 Winter Plan.

Outlining the plan to board members during a meeting at Antrim Hospital on Thursday, Gillian Traub, Director of Operations, acknowledged that staff are “very anxious” about the coming months.

She said planning began in August in anticipation of heightened pressure across the Trust’s hospital and community services.

Gillian Traub, Director of Operations, Northern Health and Social Care Trust

Ms Traub highlighted the need to improve ambulance handover times, one of the Trust’s key areas of focus, saying:

“The longer they are waiting at our door, they are not on the road for the next patient.”

Improvements are expected through enhanced senior nursing within Antrim and Causeway emergency departments, alongside “anticipatory care planning” for East Antrim care home residents, among other measures.

She stressed that hospital emergency departments are “there for anybody who needs it” but reminded the public that there is a “range of other services available”, including minor injuries units, GPs, and pharmacies.

“We are managing a very challenging situation with very unwell patients both inside and outside in ambulances,” she added.

Ms Traub also emphasised the importance of timely hospital discharge for patients who are medically fit.

The Trust will have the additional support of 35 beds in the independent sector, which have been “block-booked” to assist with patient discharges.

A Trust spokesperson said:

“We will work with our independent sector providers to maximise care home bed availability, including beds offering an enhanced level of care for those with complex needs.

“We will optimise the use of intermediate care beds to support patient discharge, recovery, and independence.

“Our site co-ordination hubs at Antrim and Causeway Hospitals will continue to focus on expediting discharges and reducing delays.”

Ms Traub noted that the Trust needs “support, flexibility and understanding” around discharge arrangements, acknowledging that patients may not always be offered their first preference for onward care — a situation that can be “challenging” for both families and staff.

The Trust is also establishing a ‘Hospital at Home’ service to provide an alternative to hospital admission.

The initiative will allow older, frail patients to receive hospital-level care in their own homes for certain conditions that would normally require admission.

GPs will identify patients who could benefit from this service, supported by a multi-disciplinary team delivering a “wrap-around” care plan to enable them to remain at home.

The Trust said it anticipates that “dedicated consultant input will prevent unnecessary emergency department and acute hospital admissions and avoid premature admission to long-term care.”