The Trust considers that this option would “maintain safe and effective care for our population and would provide a sustainable model for the future provision of general surgical services”. Speaking at a meeting of the Trust board onThursday morning, chief executive Jennifer Welsh said: “The main driver for change is sustainability of services at both sites. Advertisement Advertisement Did you know with an ad-lite subscription to NorthernIrelandWorld, you get 70% fewer ads while viewing the news that matters to you.
“We do not have any concern about the safety of our surgical service at present but our concern about sustainability could make a safe service difficult to maintain in the future. “We want to engage with as many people as possible to explain how we have arrived at this proposal for change and provide reassurance about the future of surgical services.” Currently the Northern Trust provides a range of surgeries at both Antrim and Causeway Hospitals.
These are: emergency general surgery, the treatment of patients for acute abdominal problems, soft tissue infections, bleeding and trauma; general surgery that focuses on diseases of the digestive tract and abdominal cavity; elective general surgery that is planned in advance such as gall bladder, hernia repair and other minor surgeries as well as major colorectal such as bowel resections often for the treatment of cancer and high volume surgery such as gall bladder removal. Advertisement Advertisement The Department of Health Review of General Surgery has highlighted the importance of “separating as far as possible scheduled from unscheduled care”. The Trust has emphasised the importance of “planning its workforce pro-actively rather than waiting for and reacting to an inevitable collapse in the service”.
At present two-thirds of the Trust’s emergency surgery is managed at Antrim Hospital, treating approximately 6.600 patients each year, 12 per day in Antrim and six at Causeway. Antrim has nine funded consultant posts and Causeway, six.
The Trust says that it “cannot relocate surgeons to Antrim because a minimum of six is required to manage the on-call demands of emergency surgery in Causeway”. Advertisement Advertisement It has been stated that the Antrim surgical team has had to “reduce its elective activity to manage the emergency workload resulting in an increase in waiting lists for patients including those with a cancer diagnosis”. “Our ability to meet our targets for cancer waiting lists and red flag referrals continues to be a challenge without dedicated elective capacity and access for our patients”, the Trust says.
The Trust anticipates that a quarter of consultant surgeons are likely to retire in the next three to five years and says that there will “not be enough doctors completing general surgery training locally to fill all of the consultant vacancies that are expected to arise. “The inability to recruit and retain consultant surgeons in the future is a real risk to the sustainability of our general surgery service. Advertisement Advertisement “It is important to plan our workforce pro-actively rather than waiting for and reacting to an inevitable collapse in the service.
“A more efficient use of our resources would be to have one site specialising. in emergency and major colorectral surgery and the other focused on high volume procedures. “This would help us address our very long waiting lists for procedures which present a lower clinical risk but still have a significant impact on quality of life.
” The Trust also says that a “high volume elective unit on the Causeway site will help to bring down our very long waiting lists for procedures which have a lower clinical risk but still have a significant impact on quality of life”. Advertisement Advertisement “Our primary focus throughout our review of general surgery is the safety of our patients. While we do not have concerns about the safety of our current surgical services, we are concerned that the sustainability issues we have highlighted could make safe services difficult to maintain in the future.
“We would prefer to act in a planned way to protect the safety of our services and our patients rather than wait and respond to a crisis.” The Trust has also stressed that it will continue to provide “24/7 emergency departments” at both Antrim and Causeway Hospital sites. It has acknowledged that while staff “largely recognise the need for a reconfiguration of general surgery services.
there are considerable concerns about the safety and viability of the preferred option and about what it might mean by way of diminuition of services, a change of case mix and implications for job role and job location” Advertisement Advertisement Commenting on engagement with service users, the Trust said: “They told us that good clear communication with the public is vital. Some concerns have been raised to date about the future of Causeway Hospital and extra travel times.” The Trust says that Causeway Hospital will still be able to assess and diagnose the majority of patients with surgical issues.
The surgical assessment unit will extend its opening hours to seven days per week and senior surgical staff will be available “24/7 to respond to any patients presenting at the emergency department at Causeway Hospital”. It was also stated: “The Trust’s ‘Strategic Vision for Causeway Hospital (March 2024) includes a clear commitment to maintaining a 24/7 emergency department on the Causeway site and sets out an ambitious vision for the development and enhancement of services in Causeway”. “We want to see Causeway Hospital become an elective and diagnostic hub for the north-west and our installation of an MRI scanner on site early next year is an important first step in that direction.
” Advertisement Advertisement The Trust continued to say that it “recognises that a change to Causeway Hospital’s surgical service will bring additional demand to the Antrim Hospital site”. It says that it plans to open additional surgical beds and is discussing how to address “increased demand” which is anticipated for the intensive care unit. The Trust’s public consultation will run until November 29.
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