Northern Trust accused of ignoring community in hospital surgery shake-up

The voices of the community have been “totally disregarded” by the Northern Health and Social Care Trust, it has been claimed.

That was the view of SOS Causeway Hospital campaign group vice-chair Adele Tomb following a recommendation on Thursday morning, May 22, at a public meeting of the Trust board, at The Braid, Ballymena, on the future delivery of emergency general surgery at Antrim Hospital and elective surgery at Causeway Hospital, Coleraine.

The Trust will now write to the Department of Health with a final decision to be made by Health Minister Mike Nesbitt before it can be implemented. The recommendation follows a 14-week public consultation process.

Speaking after the meeting, Adele said she believed by removing emergency general surgery from Causeway Hospital, other services could “fall”.

“The feeling is the Trust can’t be trusted. The Trust has brought up more concerns and provided no real assurance at all,” she suggested.

“SOS Causeway will continue in our endeavours to protect the health care services for the people of the Causeway Coast and Glens.”

William Taylor, Farmers for Action, told the Trust board, he believed the recommendation was “a total dereliction of duty”, claiming that members had “paid no attention whatsoever to the consultation”.

Rev Donard Collins, rector of Killowen Parish and chair of an inter-church council in Coleraine, said: “Concerns have not been addressed.”

He highlighted to Trust board members’ concerns over “patient safety, sickness and death” as a potential result of the Trust board decision.

Speaking after the meeting, he noted the distance involved for patients in the Causeway area who will require emergency treatment and experience worsening conditions on the way to Antrim Hospital.

Retired consultant physician Dr Owen Finnegan told the Local Democracy Reporting Service:

“It was the wrong decision. The presentation was very much superficial which did not address the concerns and the responses to the consultation.

“The concern, as a previous consultant, who is well-experienced and is now able to look from the outside, is that this will be detrimental to the service throughout the whole of the Northern Trust, not just Causeway, but Antrim will also suffer.”

He suggested  it could also have an effect on “non-surgical patients” and there are not facilities in Antrim to “accommodate the extra workload”. He also queried future long-term provision for cancer or other age-related illnesses. He also noted the lack of a business case.

Speaking at the meeting, Northern Trust chief executive Jennifer 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.

“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.

“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.

“As a board, we believe the recommendation being made today is the best model for our general surgery service moving forward.”

Gillian Traub, director of operations at the Northern Trust, commented:

“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.

“W 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.”

Consultant surgeon James Patterson said: 

“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.”

The chief executive stressed the recommendation “in no way signals our intent to downgrade Causeway Hospital”.

“I want to reassure our community, Causeway is and will remain a vital part of our acute hospital network. This proposal does not change that. We are fully committed to maintaining a 24/7 emergency department and acute in-patient services at Causeway.

“By reshaping our general surgery service, we believe Causeway Hospital is perfectly positioned to become an elective hub for the entire North West.”

The Trust has also noted new Department of Health standards for emergency and elective surgery contained within the Department’s 2022 Review of General Surgery cannot be fully met without reconfiguration.

Emergency general surgery is the treatment of patients presenting with acute abdominal issues such as appendicitis, bowel obstruction, hernia, soft tissue infections requiring treatment or bleeding.