Patients wait on both sides of hospital care crisis as Ballymena home treatment expansion remains unfunded

Sunday 08 November 2026

A total of 159 patients medically fit for discharge remained in Antrim and Causeway hospital beds on Thursday morning, while 58 people in Antrim’s emergency department were waiting for a bed, Northern Trust leaders told MLAs.

Patients were waiting for care home places, rehabilitation or support to return home — exposing how shortages beyond hospital wards are restricting the beds available to those needing admission.

Yet a proposed expansion of Hospital at Home into Ballymena, intended to treat suitable patients without admitting them to hospital, has not progressed because of financial pressures. The Trust said extending the service fully into the area and strengthening its existing team would require more than £1 million.

The evidence emerged during the Assembly Health Committee’s briefing on winter preparedness on Thursday 5 November, when members challenged whether the Trust’s financial decisions were undermining its ambition to provide more care in the community.

The committee heard from interim chief executive Suzanne Pullins, director of operations Gillian Traub, director of finance Stevie Lennon, and director of surgery, women’s health and diagnostic services Lynne McCartney.

Ready to leave hospital but still needing support

Gillian Traub, the Trust’s director of operations, said 108 patients in Antrim Hospital and 51 in Causeway Hospital had been assessed by their medical teams as fit for discharge that morning.

That does not mean they could safely leave without help. The patients described to the committee still needed care, but no longer needed to receive it in an acute hospital bed once suitable onward arrangements were available.

Among the reasons given for delayed discharge, 56% of the patients were awaiting a care home bed, 19% needed further rehabilitation through an intermediate care pathway, and 11% were waiting for a home care package. These categories did not account for the full total.

Asked whether providers had enough capacity to take people on, Ms Traub said:

“No, there’s not enough capacity or sometimes there’s capacity but it’s in the wrong geography.”

Home care shortages hold up beds elsewhere

The Trust said 17 patients in its acute hospitals were waiting for home care packages: 10 in Antrim and seven in Causeway. A further 52 people in care homes or community hospitals were also waiting for that support, generally for longer.

Within that wider group, 39 people were occupying care home beds while waiting for packages that would allow them to return home. Providing that support would also release their places for other patients needing care home accommodation.

Around 80% of the Trust’s home care provision comes from 23 independent providers, with the Trust delivering the remainder. Officials said both the independent sector and the Trust struggled to recruit staff and expand capacity, while the longest waits were linked to rural locations.

Although more people had received packages over the previous six months, rising demand had pushed the number waiting back up. The Trust also reported recent pressure on general nursing home beds and continuing difficulty securing dementia placements.

Ballymena Hospital at Home expansion held back

Hospital at Home provides treatment in a person’s own home for patients who would otherwise need a hospital bed. It is separate from the routine home care support people may need for daily living.

The Trust said its existing service covered East Antrim, representing only around a quarter of its geographical area. It had developed a model and staffing requirements for expansion and held initial discussions with the Department of Health’s Strategic Planning and Performance Group.

Asked why it had not expanded the service, Ms Traub said that “we haven’t because of the financial position.” She estimated that extending it fully into Ballymena and bolstering the existing small team would require more than £1 million.

Committee members challenged why the Trust had not prioritised transferring existing resources into Hospital at Home, rather than seeking additional funding. Officials said that possibility remained under consideration through plans to move more care from hospitals into communities, but pointed to the immediate requirement to deliver savings.

Winter preparations alongside £53.8m savings requirement

The Trust has £2.6 million in temporary funding for winter planning — £600,000 less than previously. However, Ms Traub said a separate £2 million investment to improve ambulance handovers had supported many of the same areas facing winter pressure.

Winter measures include support for respiratory and cardiology services, emergency departments, community equipment, care home capacity and additional weekend services. The Trust acknowledged that services remained under considerable pressure despite its preparations.

Alongside that work, it must deliver £53.8 million in savings this financial year. Approved plans amounted to around £52.2 million, leaving a gap of approximately £1.6 million, officials said.

The committee also heard that the planned withdrawal of Phone First after 27 November had been paused for reassessment. The nurse-led telephone service helps people identify the appropriate urgent care service, and members questioned whether removing it would increase emergency department attendances.

Phone First pause leaves decision unresolved

Suzanne Pullins, leading the Trust delegation, told members:

“However, I have been advised today that the trust should pause the formal withdrawal to allow for reassessment.”

The pause was not a confirmed permanent reprieve.

Officials said further work was needed with the provider, while explaining that the original proposal had been developed as part of the Trust’s savings programme.

The Trust said about 65% of Phone First callers were directed to a Trust service, including emergency departments or minor injuries provision. Members challenged whether removing the advice service could lead people to attend an emergency department when another service would have been more appropriate.

Ms Pullins acknowledged why people seek help there:

“It’s just simply that sometimes you go to where you know you’re going to get someone to speak to.”

No start date for Ballymena expansion

To improve discharge arrangements, the Trust said it had established a single integrated team to coordinate patients’ onward care. Reviews of existing home care packages were also releasing around 380 hours each week for reuse — equivalent, it said, to about 36 care packages.

Officials were examining rehabilitation pathways, possible virtual wards and closer working with primary care. They said improving home care was central to releasing both hospital and care home beds.

But the briefing left a significant gap between that ambition and delivery in Ballymena: no start date was given for the Hospital at Home expansion, and funding remained unresolved while patients waited both to leave hospital and to access a bed.