Health Minister Unveils Hospital Reconfiguration Framework

Health Minister Mike Nesbitt has launched a new framework aimed at reconfiguring hospitals across Northern Ireland to create a more sustainable and efficient network of care.

The document, titled 'Hospitals – Creating a Network for Better Outcomes', outlines the key principles that will guide the reorganisation of hospital services. It will be the subject of a public consultation.

Minister Nesbitt emphasised the need to view hospitals as interconnected parts of a broader network rather than standalone units. He acknowledged the challenges faced by some hospitals in recruiting staff and maintaining services, but stressed that a collaborative approach is essential to deliver better outcomes for patients and staff.

"Reconfiguration of some services is required," Minister Nesbitt stated. "The roles of some hospitals will have to change to keep pace with modern medicine and deliver better patient outcomes."

He assured communities that the reconfiguration is not about cutting costs or closing hospitals but rather about managing change in a controlled way and demonstrating the benefits. "It's about showing how each hospital can fit into the network and best serve patients," he explained.

Minister Nesbitt highlighted the increasing shift towards centres of excellence, such as standalone elective care hubs, as an example of the ongoing reforms. He encouraged everyone to participate in the public consultation to ensure their voices are heard in shaping the future of hospital services in Northern Ireland.

The framework categorises NI hospitals into four main types:

• Local Hospitals, which is a diverse group delivering primary, secondary and community services in support of the area and general hospitals.

• General Hospitals, delivering defined secondary care services including unscheduled care, geared to a specific, more isolated geographical location. These hospitals also play an important part in the delivery of elective care to the region. • Area Hospitals, delivering a full range of secondary care services, both unscheduled (un-planned) and elective (planned) treatment, to the communities within a geographical area currently defined by the distribution of integrated services delivered by our five geographic Health and Social Care Trusts (HSCTs).

• Regional Centres, delivering specialist regional inpatient services for the whole population of Northern Ireland.

Some hospitals by nature of their locality or range of services may be included in more than one category, as listed in the document.

Local Hospitals: Ards Hospital, Bangor Hospital, Dalriada Hospital, Downe Hospital Downpatrick, Lagan Valley Hospital, Lurgan Hospital, Mid-Ulster Hospital, Moyle Hospital, Omagh Hospital and Primary Care Complex, Robinson Hospital, South Tyrone Hospital, Waterside Hospital, Whiteabbey Hospital.

General Hospitals: Causeway Hospital, Daisy Hill Hospital, Southwest Acute Hospital.

Area Hospitals: Altnagelvin Hospital, Antrim Area Hospital, Craigavon Area Hospital, Belfast Hospitals Campus (includes Royal Victoria Hospital, Mater Hospital, Royal Jubilee Maternity Hospital and Royal Belfast Hospital for Sick Children) and Ulster Hospital.

Regional Centres: Altnagelvin North West Cancer Centre, Belfast City Hospital including the Cancer Centre, Musgrave Park Hospital, Royal Belfast Hospital for Sick Children, Royal Jubilee Maternity hospital, Royal Victoria Hospital, Ulster Hospital Regional Centre for Plastic Surgery and Maxillofacial Surgery.

A key aim is to identify the core services in each of these types of hospitals and address the key challenges to sustainably deliver these.

Modern medicine – not least increasing levels of clinical specialisation and sub specialisation – means change cannot be avoided. The challenge is to deliver change on a planned basis rather than through service collapse.

In key specialties, when hospitals have lower patient numbers, this can create significant issues for professionals working in key specialties. These include rota/on-call pressures inherent in smaller clinical teams, as well as insufficient case mix to support specialisation, training and skill development. These issues inevitably have consequences for recruitment and retention, adding to the challenges of maintaining services.

The Framework also sets out 5 enablers and 13 actions to support reconfiguration and the delivery of a connected Hospital Network.