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Urgent and emergency care in Northern Ireland faces review

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A review of urgent and emergency care across Northern Ireland’s hospitals has been announced by the province’s Department of Health.

It said the review would aim to establish a new regional care model for Northern Ireland, with “particular focus” on meeting the needs of the rising proportion of older people in the population.

“We need to fundamentally change the way we do things”

Richard Pengelly

It highlighted that hospital emergency departments had been experiencing “intensifying pressures” over recent years, with growing numbers of patients facing long waits for admission.

Another difficult winter period was “anticipated” for hospitals in Northern Ireland and across the UK, it noted in a statement announcing the review.

The review will specifically consider the most appropriate arrangements for the assessment and admission of older people, as well as providing the best appropriate care for people of all ages.

It follows a Population Health Needs Assessment carried out by Dr David Stewart, a retired public health doctor who held a number of senior positions in the health service in Northern Ireland.

His research highlighted that demographic change was a major factor behind growing demand for urgent and emergency care, with pressures due to intensify significantly in coming years.

For example, during the 10 years between 2016 and 2026, the Northern Ireland population is projected to grow by a further 77,600.

Of this overall increase, the rise in the population aged 65 and over is projected to be 74,500.

“We have to be honest and accept that this will be a difficult period once again for patients and staff”

Richard Pengelly

Richard Pengelly, Department of Health permanent secretary, said: “The pressures faced by our emergency departments reflect pressures right across the health and social care system – with the rising demand for services outstripping our capacity to provide it.

“Patients are experiencing unacceptable waits and staff are being increasingly stretched,” said Mr Pengelly.

“We need to fundamentally change the way we do things,” he said. “That’s why we have announced this review, which will be clinically led.”

He added: “The current model for urgent and emergency care in Northern Ireland is unlikely to keep up with the changing needs of our population in the years ahead. Signs of this are already emerging.

“Improvements in the integration of primary and secondary care services will be among the priorities, as well as the provision of more urgent treatment centres such as the facility recently opened at Omagh Hospital,” he said.

This review will “carefully examine” the evidence provided in Dr Stewart’s report and recommend potential solutions, according to the department.

It also said the public, healthcare staff and other stakeholders would have the opportunity for their “voices to be heard” in a public consultation on the emerging proposals from the review.

Outlining preparations for this winter, Mr Pengelly added: “A series of detailed winter resilience initiatives have been planned to mitigate pressures in the weeks and months ahead.

Northern Ireland

Richard Pengelly

Richard Pengelly

“We have to be honest and accept that this will be a difficult period once again for patients and staff,” he said. “It is expected to be the same for hospitals right across these islands.

“Once again, we will be heavily indebted to the health and social care staff who will be looking after us all,” said Mr Pengelly.

“We can also all help the health service to help us. That includes using services appropriately and taking the right steps to keep ourselves well,” he added.

The resilience plans focus on providing appropriate alternatives to hospital, ensuring patients can leave hospital quickly when fit, and improving ambulance turnaround times at emergency units.

Priorities include an increase in bed capacity, an increase in staffing both in hospital and in the community, investments in primary care services, and more intermediate and ambulatory care.


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