Northern Trust approves £50m savings plan as unions warn staff are ‘broken’

Antrim Area Hospital

The Northern Health and Social Care Trust has approved £50 million worth of savings as it attempts to balance its books by March 2027, amid warnings from trade unions about the potential impact on patients, services and an already stretched workforce.

The savings plan was approved by Trust board members at a meeting at Antrim Area Hospital on Thursday (August 27), with members reminded that the organisation has a statutory duty to break even by the end of the financial year.

However, the scale of the challenge remains significant, with a further £3.8 million gap highlighted during the meeting.

‘It does keep me awake at night’

Interim chief executive Suzanne Pullins acknowledged the difficulty involved in finding the required savings.

“It has been quite challenging trying to identify areas where we can release cash,” she said.

Non-executive member Kathy Mackenzie highlighted the remaining £3.8 million gap.

Interim chief executive Suzanne Pullins

Ms Pullins said:

“This is very challenging. It does keep me awake at night.”

Referring to the Trust’s experience during the previous financial year, she added:

“Last year gives me confidence we have processes and we will be able to deliver.

“We will have to keep a very tight control. We are really under pressure for the rest of the financial year.”

She stressed that maintaining financial stability was “absolutely critical”.

Focus on staffing costs

Jacqui Reid, director of human resources, organisation development and corporate communications, outlined plans to reduce expenditure on locums, agency staff and overtime while seeking to “focus on strengthening the workforce”.

The proposals come against a wider financial challenge across Northern Ireland’s health service, with the Department of Health saying it faces a funding gap of around £800 million and is currently overspending by approximately £2 million per day.

Trade union representatives, however, raised significant concerns about the Trust’s plans and the process surrounding them.

UNISON raises consultation concerns

Stephanie Greenwood, UNISON health convener, told the board:

“We are not satisfied that this financial plan is consulted on properly and has not been shared with staff.

“Staff are in panic mode. They have heard all sorts of rumours. We are not satisfied an equality impact assessment has been done properly.”

Speaking earlier at the meeting, Ms Greenwood said the union was “very concerned” about the proposal being put before board members.

“We are very concerned about the proposal this board is being asked to consider today, being asked to approve a major cut to the Trust budget,” she said.

“This Trust must understand the combined effect such cuts will have on patients and service users.”

Ms Greenwood said the Trust had obligations to consult trade unions and called for full disclosure of relevant information relating to the proposals.

She also stressed that public bodies have obligations around consultation and assessments, including equality impact assessments.

She warned that the proposed cuts could “damage public health and negatively affect the workforce”.

“We are very concerned about the proposal to reduce recruitment,” she added. “Your staff are broken and that is shameful.”

Trust stresses financial duty and patient safety

Board chair Anne O’Reilly emphasised the Trust’s duty to break even financially, saying this had to be a “major driver and consideration” for the board alongside its focus on patient safety.

“As a senior management team, we have been carrying this for months, trying to figure out the best way to go about this with the least impact,” she said.

“It is very sobering where we are. It is not a comfortable decision we have had to make.”

Responding to concerns over engagement with unions, Ms O’Reilly said:

“From the Trust’s point of view, we prioritise strong engagement with trade unions and that will continue.

“These are challenging and difficult times for everyone within health and social care. We know the seriousness of our decision and will exercise our duty to the best of our ability as a board.”

‘Cuts dressed up as efficiencies are still cuts’

Ian Boersma, higher executive officer with NIPSA, told members it was “unrealistic” to suggest a reduction of this scale could be absorbed by “doing more with less”.

He expressed concern that staff would be expected to “absorb additional duties” and warned that any reduction in the use of agency workers must not result in a reduction in overall workforce capacity.

“Our members believe there should be no cuts to the health service. Patients and staff should not be expected to pay the price. Cuts dressed up as efficiencies are still cuts,” he said.

“Staff deserve a pay award and parity. Nobody working in the health service should be struggling to make ends meet. The budget must reflect what is required to provide a safe, effective health service.”

Health service facing £800m gap

The Department of Health says it is facing a funding gap of around £800 million and is currently overspending by approximately £2 million each day.

It said health and social care trusts across Northern Ireland have been developing savings plans since January.

According to the Department, measures will include a “vacancy control process, reducing temporary staffing (including bank, agency and locum staff) and setting the appropriate number of hospital beds as more care is delivered in the community, closer to people’s homes”.

It added:

“Trusts will also standardise care pathways, shorten hospital stays and reorganise services to strengthen and sustain vulnerable services.”