Review of general surgery aims to "future-proof services", says Northern Trust Medical Director

The consultation will run for 14 weeks
Author: Chelsie KealeyPublished 2nd Oct 2024

Proposals to transform general surgery services at Antrim Area Hospital and Causeway Hospital have been met with fresh concerns.

A 14 week consultation process is currently live and exploring the option of removing emergency general surgery from Causeway Hospital in Coleraine and consolidate provision in Antrim Area Hospital.

Both hospitals currently provide emergency general surgery and elective surgery.

However, Medical Director at the Northern Trust, Dr Dave Watkins, said the two surgical teams are "relatively small’ and that the Trust is "really concerned about the sustainability of services."

Dr Watkins said: “We know that a number of our surgeons are due to retire in the near future. And we have difficulty in recruiting to small teams because realistically we're in competition with other Trusts for the recruitment of new surgeons.”

Nevertheless, the campaign group SOS Causeway has expressed concerns about what the consultation process and proposed changes will mean for the Causeway Hospital and surrounding areas.

Adele Tomb the Vice Chair of the group has raised fresh worries that Causeway Hospital is being used to “prop-up” a failing Antrim Area surgical service.

She said: “That is what we are hearing from the staff at Antrim, and that is a fear as well, that if it does completely go, that Antrim will be a bit like Altnagelvin Hospital, in the sense that every other day you're seeing that their ED departments, etc, are overrun and they're asking people to only come if necessary.”

However, Dr Watkins has said that is not to case and has stressed both teams are under strain.

He said: “To say that we're propping up one service with another is really not right. I think the conception that the team in Causeway is entirely stable, when the team in Causeway is subject to some sustainability risks as well.

“So, what we actually have is two teams that are both at serious risk of collapse as people leave the team. We do have significant concerns about that. And so, what we're doing is trying to future-proof the service as well as provide a service by changing of the highest possible quality.

“Whilst some of the emergency surgery would be moving from Causeway to Antrim, you know, there is a quid pro quo with that, that we would be doing more of our waiting list work in Causeway and also by cutting down or by doing more of that waiting list work in Causeway, we will be able to safeguard those waiting list beds and we will be able to make a proper dent in our waiting list, which we recognise at the moment are too long.

“So, it does give us an opportunity to really work down our waiting lists by making this change. And a lot of that waiting list elective scheduled work will take place in Causeway Hospital.”

The Vice Chair of SOS Causeway has also questioned the potential “domino effect” on the Coleraine sites Accident and Emergency services.

Ms Tomb said: “We're also very concerned about the domino effect, if emergency surgery is taken away from Causeway and what it will mean for its acute hospital status.

“Will we continue to retain a fully operational ICU department, paediatric department, and emergency department? The Trust have made promises; however, can we trust that they will keep them?

“We are aware, and we have been contacted by clinicians and staff within the hospital that are not happy with these proposals, and we're concerned that their views will not be properly taken on board. We're very sceptical of this, as the Trust themselves stated their preferred option from the option appraisal before the consultation even went live, and before even one comment was read.”

Earlier this year the Trust published its strategic vision for Causeway Hospital which gives a commitment to it remaining a part of the acute hospital network within Northern Ireland.

Dr Watkins added: “There may be some shifts in emphasis as to what Causeway provides moving forwards. And I think in particular, we want to Causeway to become an elective and diagnostic hub for the whole of the Northwest. But we are fully committed to maintaining a fully functioning 24/ 7 emergency department in Causeway and to maintaining inpatient services within Causeway Hospital.

“I would really want to make that message very clear to the public, that Causeway is going to remain a very important hospital moving forwards. In terms of the changes and the potential effect on Antrim Hospital, we have a number of measures which we want to put in place to ensure that patients continue to get a safe service through Antrim. We are going to bolster our ambulatory services for both medical patients and surgical patients so that we can continue assessing those and where possible avoid an admission for patients.

Questions have been asked about the future of Causeway Hospital's ED

“And also we are going to increase the amount of ambulatory surgical capacity and medical capacity in Causeway Hospital.

"I would want to emphasize though that the vast majority of patients who go to Causeway Hospital with a surgical issue will still get a full assessment for that surgical condition within Causeway Hospital. There will still be surgical presence and senior surgical doctor onsite 24/ 7 in Causeway.

"And with our fully functional emergency departments, we would want to reassure patients that if they have a problem, they think they may need to see a surgeon, they should still go to Causeway Hospital."

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