Northern Health Trust approves major surgery service overhaul, pending ministerial approval

In a significant step towards reshaping healthcare delivery in Northern Ireland, the Board of the Northern Health and Social Care Trust has approved a recommendation to centralise emergency general surgery at Antrim Area Hospital, while designating Causeway Hospital in Coleraine as the primary hub for elective (planned) general surgery and procedures.

The decision, made during a public meeting at The Braid in Ballymena, follows a 14-week public consultation held between August and November last year. The proposal now awaits approval from the Health Minister and the Department of Health before implementation.

The move aims to address mounting pressures on the Trust’s surgical services, which Chief Executive Jennifer Welsh described as facing an “inevitable collapse” without action.

Speaking at the meeting, Ms Welsh said:

“When we first began this process, we gave a commitment that proposals for any new model would be based on the evidence and data that is available to us, and that is what we have presented here today. The work done by our teams to get us to this point has been painstaking.”

The decision comes amid concerns from some community members and staff, who voiced apprehensions during the consultation process about the potential impact of service changes.

Ms Welsh acknowledged these concerns, stating, “I know there is tremendous depth of feeling on this issue, including from some of our own staff, and throughout the consultation period we have met with a wide range of stakeholders, and heard concerns from our local community about our proposals to transform how we deliver general surgery services.”

She added, “Put simply: we cannot continue to provide emergency general surgery across both our acute sites. If we do not act now and plan for service change, we are facing an inevitable collapse. I do not say that to scaremonger or cause alarm; I’m saying this because it is the very difficult reality we are faced with.”

Community Engagement and Consultation Feedback

The Trust’s consultation process, which garnered significant community input, was praised for providing “invaluable” insights. Ms Welsh expressed gratitude to those who participated, noting:

“The comments and feedback we received during the consultation period, and indeed throughout this whole process, have been invaluable, and I would like to thank people for taking the time to respond to the consultation.”

She further explained, “It provided us with fresh insights and new perspectives, allowing us to go away and interrogate the data and dig deeper to give ourselves the assurances we need that this is the correct course of action.”

The consultation feedback has been compiled into a detailed Consultation Feedback Report, which outlines the thematic analysis of responses and the Trust’s responses to public concerns.

A Vision for Sustainable Surgical Services

The approved model seeks to create a more sustainable and efficient surgical service by separating emergency and elective procedures.

Antrim Area Hospital will become the centre for emergency general surgery, while Causeway Hospital will focus on elective surgeries, potentially reducing waiting times for planned procedures.

Consultant surgeon James Patterson highlighted the benefits of this approach, stating:

“It’s important to say that, under the recommended proposal, general surgery will not be removed from Causeway Hospital. This is about separating out emergency general surgery from elective procedures so that we can ensure elective theatre time at Causeway is protected.”

Mr Patterson also noted the potential for Causeway Hospital to become a regional hub for elective surgery, which could help address Northern Ireland’s lengthy surgical waiting lists.

“Should service change go ahead, it creates an opportunity for Causeway to become an elective hub, and this could really start to make a difference when it comes to tackling lengthy waiting lists,” he said.

Additionally, the model would enhance training opportunities for surgical trainees by providing access to both emergency and elective surgery environments.

Addressing Community Concerns

Despite the Trust’s confidence in the proposal, some local residents have expressed unease about the centralisation of emergency surgery at Antrim. Gillian Traub, Director of Operations at the Northern Trust, acknowledged these concerns, stating:

“We accept that what we are recommending today as a Board, will not be welcomed by some in our local community who have raised very genuine concerns about any proposed change.”

Ms Traub reassured the public that the Trust is committed to a smooth transition if the plan is approved, adding:

“Should service change go ahead, we will do all we can to build public trust and confidence by ensuring that the transition to a new model will be as smooth as possible, for both our patients and staff.

“As senior leaders, we would not be recommending this if we didn’t believe it is the right thing to do and, importantly, necessary; to ensure we continue to provide safe services for our community, and a stable, sustainable general surgery service for the future.”

Commitment to Causeway Hospital’s Future

The Trust was keen to dispel fears that the changes signal a reduction in services at Causeway Hospital.

Ms Welsh emphasised:

“Our Vision and ambition for Causeway remains. We have an unwavering and continuing commitment to the hospital, our workforce and wider community. Causeway Hospital’s future is secure. It is, and will remain, an important part of our Trust’s acute network, and an important part of the region’s acute hospital network. This proposal does not change that.”

She further confirmed the Trust’s commitment to maintaining a 24/7 Emergency Department and acute inpatient services at Causeway, adding:

“By reshaping our general surgery service, we believe Causeway Hospital is perfectly positioned to become an elective hub for the entire North West. We are keen to see further investment in expanding and enhancing services at the hospital and we hope we will have the support of our local community when it comes to driving that vision forward.”

Next Steps

The Board’s recommendation has been formally submitted to the Department of Health for consideration by the Health Minister. No changes to the current delivery model will take place until a final decision is made.

The Trust has pledged to keep the public informed as the process moves forward.

As Northern Ireland’s healthcare system navigates ongoing challenges, including staffing pressures and growing waiting lists, the proposed changes aim to ensure the long-term sustainability of general surgery services. The Trust hopes that, with community support and ministerial approval, the new model will deliver safer, more efficient care for patients across the region.

For more details on the consultation process and the proposed changes, the public can access the Consultation Feedback Report on the Northern Health and Social Care Trust’s website.