Northern Health Trust reviews delivery of general surgery at its hospital sites

The Northern Health Trust is reviewing how it delivers general surgery across its hospital sites.

General surgery incorporates two strands - emergency general surgery, focusing on complicated/urgent cases, and cases of a less serious nature.

BBC News NI understands various options are being discussed, including consolidating emergency general surgery on a single hospital site.

This would be either Antrim Area or Causeway Hospital.

At present, both the Antrim Area and Causeway hospitals perform the surgery, which includes elective gall bladder surgery, and hernia and bowel repairs.

The move is part of the Northern Trust's bigger plan to reshape its general surgery model.

This does not affect the Emergency Departments (EDs) at either hospital.

In a statement, the trust said that following the Department of Health's 2022 Review of General Surgery in Northern Ireland, it was starting to engage with staff in relation to the provision of general surgery within the trust.

It said "engagement is at a very early stage" as it starts to consider options and that any proposed change would be subject to public consultation.

Earlier this week the Department of Health confirmed that emergency general surgery will be permanently moved from Daisy Hill Hospital to Craigavon.

The surgery service was temporarily withdrawn from Daisy Hill in Newry in February 2022 due to surgeon recruitment challenges.

The move was opposed by local people in Daisy Hill, including some politicians.

The Department of Health confirmed that Emergency General Surgery will be permanently moved from Daisy Hill Hospital to Craigavon

According to the Department of Health, an average of three patients a day have been directed to Craigavon from Daisy Hill for emergency general surgery.

The department's permanent secretary, Peter May, said the move "reflects the reality that all hospitals cannot provide all services".

It's understood there are similar staffing challenges in the Northern Health Trust.

Plan for change

New departmental standards for emergency and elective general surgery (non-emergency) with the current staff cannot be met.

Northern Ireland is experiencing workforce challenges across almost all specialities, which is driving forward consolidation of specialist services on fewer hospital sites.

Instead of being in a crisis situation where change is forced upon a service due to safety reasons, the preferred option is to plan for change.

While it means some people may have to travel further for surgery, the department argues that surgical hubs in one location means people should be seen quicker and by specialist staff who are spread across several hospital sites.

The Northern trust said it remains committed to maintaining acute services and ED at Causeway and is excited to explore how the hospital can develop and thrive.

Analysis

This is transformation of Northern Ireland's health service in action.

While that's significant in itself, it's even more so without a functioning Northern Ireland Assembly.

In fact, without local government and political opposition, some of the health trusts have been ploughing ahead with changing where and how services are delivered.

In the past 18 months, a new consultant-led minor injury unit opened at the Ulster Hospital in Dundonald, replacing units at Newtownards and Bangor community hospitals.

Amid public opposition to the move, the trust's plans were the subject of a 12-week public consultation.

Last year the Northern Trust moved all hospital births to Antrim Area Hospital, as opposed to maternity services being split across Antrim and the Causeway sites.

There was the withdrawal of emergency general surgery at Daisy Hill Hospital to Craigavon.

Daisy Hill maintains its Emergency Department.

Last year the Northern trust also said it was committed to maintaining acute services and an emergency department at Causeway.

According to health trust management and the Royal College of Surgeons, it is driven by ensuring patients are safe and staff are working in a safe environment.