Northern Trust acknowledges higher maternity staff absence rates amid concerns over Antrim pressures

The Northern Health and Social Care Trust has acknowledged “higher than usual absence rates” within its maternity services team over recent months after concerns were raised by campaign group SOS Causeway Hospital.

SOS Causeway Hospital recently met with senior Department of Health officials to highlight what it described as “severe pressures within Antrim maternity services following the centralisation of births”.

All hospital births in the Northern Trust have taken place at Antrim Area Hospital since July 2023, following the end of deliveries at Causeway Hospital in Coleraine.

The campaign group presented Freedom of Information (FOI) data which it said showed “repeated delays in inductions and elective caesarean sections, alongside a sharp rise in red escalation events” following the amalgamation of services.

An FOI response relating to expectant mother “deferrals” at Antrim Area Hospital shows that, between August 2023 and October 2024, the highest number of inductions delayed by more than 12 hours was 23 in October 2024, followed by 22 in May 2024 and 17 in September 2024. During the remaining months in that period, the number of women experiencing delays of more than 12 hours ranged from two to eight.

During the same period, the highest number of inductions delayed by less than 12 hours was 37 in August 2024, followed by 26 in October 2023, 22 in both September 2023 and June 2024, and 16 in October 2024.

There were no delays of less than 12 hours recorded during two months of the reporting period. In the remaining months, the number of women affected ranged from two in March 2024 to 13 in July 2024.

The highest number of planned caesarean sections delayed by more than 12 hours involved nine patients in April, September and October 2024.

Five women experienced delays of more than 12 hours in February and March 2024; four in September 2023 and July 2024; three in June and August 2024; two in December 2023 and January 2024; and one in May 2024.

There were 1,408 planned and emergency caesarean sections carried out at Antrim Area Hospital during 2024, compared with 1,250 in 2023.

The campaign group also highlighted what it described as “significant staffing pressures and high sickness levels”.

A spokesperson for the Northern Health and Social Care Trust said:

“We have been experiencing higher than usual absence rates within our maternity services team over recent months and recognise the impact this is having on other staff members. Our priority is the safety of women and babies in our care and the well-being of our staff.

“We are disappointed to hear that some staff feel they are not being listened to. We have processes in place to address any concerns that are raised by staff and would encourage any member of staff with concerns to come forward.

“The Renfrew Report, published in 2024, reflected an increase in intervention rates and complexity in pregnancies more generally, and this continues to be a trend experienced by Trusts across the region.

“The very nature of maternity services means there will be natural peaks in activity throughout the year. Decisions to delay planned inductions or elective caesarean sections are made on a case-by-case basis and are clinically assessed to prioritise the safe care of all women and babies and ensure one-to-one care for women in labour.

“Since the reconfiguration of our maternity services in 2023, when all hospital births began taking place at Antrim Area Hospital, we introduced a new monitoring tool which provides enhanced intelligence and analysis of clinical activity and acuity on a four-hourly basis. We are the only Trust in Northern Ireland to use this enhanced tool to monitor activity in our maternity department.

“We keep rotas under regular review to ensure that we have sufficient levels of staffing and remain committed to providing the highest standards of safe maternity care.”

SOS Causeway Hospital also raised concerns about the planned new midwifery-led unit, claiming that “high levels of maternal complexity, comorbidities and high BMIs may significantly limit the number of women eligible to use the unit”.

A £5.7 million midwifery-led, three-suite facility within a new two-storey building is currently under construction at the front of Antrim Area Hospital, with the cost being met by the Department of Health.

The unit will provide three additional birthing suites separate from the main maternity ward, while women will continue to have access to on-site obstetric and consultant-led services if required. It will also have its own dedicated entrance.

The facility is intended for women whose pregnancies are classed as low risk and who have no additional medical complications. It is expected to accommodate two to three women each day, along with their birth partners.

Northern Trust interim chief executive Suzanne Pullins previously said:

“Unlike the four other HSC Trusts in the region, the Northern Trust has no midwifery-led unit currently, so this is a really welcome step closer to delivering improved experiences for women in our community.”

The development of the three-suite unit at Antrim Area Hospital was a commitment made to the Northern Trust by Permanent Secretary Peter May when he approved the Trust board’s recommendation to consolidate all hospital births at Antrim.

SOS Causeway Hospital chairperson Gemma Brolly said:

“SOS Causeway Hospital has always acted in good faith and with transparency, with the well-being of this community at the heart of our work.

“We were assured by NHSCT that centralising births to Antrim Area Hospital was the right decision, that capacity was in place and that antenatal services at Causeway would be enhanced.

“As we approach three years since the transfer of births, the evidence now consolidates our case: centralisation was a detrimental mistake, and it must be corrected.”