Causeway Hospital Surgery Plans: Council Calls For Answers From Health Minister

Councillors have backed a call for Northern Ireland's Health Minister to intervene over the future of emergency general surgery at Causeway Hospital.

Causeway Coast and Glens Borough Council supported a notice of motion calling on the minister to overturn the decision to remove emergency general surgery from the hospital and provide urgent assurances about its long-term future as an acute hospital.

The motion, brought forward by Councillor Wilson, said the council recognised the staffing, sustainability and service-delivery challenges facing emergency general surgery across the Northern Health and Social Care Trust.

However, it stated that the council did not accept centralising the service at Antrim Area Hospital as the solution, warning that such a move could concentrate existing pressures at Antrim while creating difficulties for patients, staff and services across the Causeway area.

'An acute hospital is an ecosystem'

Speaking during the debate, Councillor Wilson acknowledged the workforce recruitment and retention challenges facing the trust and the need to maintain safe clinical standards across hospital sites.

However, he argued that recognising those challenges did not mean the trust's preferred option should be accepted without scrutiny.

He told councillors it was "absolutely not misinformation" to say the preferred proposal would remove inpatient emergency general surgery from Causeway Hospital.

Councillor Wilson said he had been contacted by consultants, surgeons, doctors, nurses and support staff with concerns about the proposals, as well as residents from across Causeway Coast and Glens.

He described an acute hospital as an "ecosystem" and questioned what removing emergency surgery could mean for the Emergency Department, intensive care, anaesthetics, diagnostics and other services.

The original motion warned that the removal of emergency surgery "cannot be viewed in isolation", arguing that it could have consequences for other acute and clinical services, ambulance provision, future investment and the overall sustainability of Causeway Hospital.

It also raised concerns that the change could make the hospital less attractive to consultants, doctors, nurses and other specialist clinicians, potentially creating wider recruitment and retention difficulties.

Rural communities and ambulance pressures

The motion called on the Health Minister to take account of the particular circumstances of the area served by Causeway Hospital.

These included its large rural geography and travel times to alternative acute hospitals, an ageing population with increasingly complex healthcare needs and the additional demands longer transfers could place on the Northern Ireland Ambulance Service.

It also highlighted the substantial number of tourists visiting the Causeway Coast and major events such as the North West 200, when tens of thousands of additional people are in the area.

During the debate, Councillor Wilson called for modelling of the additional demands any change would place on the ambulance service and journey and transfer times for patients from rural and coastal communities.

He also sought evidence about whether other hospitals had sufficient beds, theatres, diagnostic staffing and emergency capacity to safely absorb additional workload.

Councillor Wilson said the public deserved evidence and answers "sooner rather than later" and called for responses to the council's questions before the end of the year.

'Much more than one surgical service'

Councillor Tanya Elder supported the motion and raised concerns about what the proposals could mean for patients, staff and the wider future of Causeway Hospital.

She said: “This is about much more than one surgical service it is about the long-term future of Causeway Hospital. Removing emergency surgery could have serious consequences for patients requiring transfer, an already stretched ambulance service, families travelling greater distances and the hospital’s ability to recruit and retain experienced staff.

“The public need more than assurances. We need clear guarantees, proper evidence and a credible long-term plan to protect Causeway as an acute hospital. That is why I support Councillor Wilson’s motion and believe the Minister must answer these serious questions before any irreversible changes are made.”

During the debate, Councillor Elder also questioned what would happen if a patient arrived at Causeway Hospital's Emergency Department and was subsequently found to require emergency surgery.

She asked how long patients could have to wait to be transferred and what additional pressure this could place on the ambulance service.

Councillor Elder said the trust's concerns about staffing and long-term sustainability had to be taken seriously, but questioned whether one problem could be solved by moving it elsewhere and creating additional pressures.

Amendment falls

An amendment to the original motion was proposed by Councillor Lee Kane during the meeting.

The amendment would have recognised the pressures facing Emergency General Surgery across the Northern Health and Social Care Trust and stated that any service change should be based on clinical evidence, patient outcomes, workforce sustainability and the impact on patient safety.

It also sought to recognise the "vital role" of Causeway Hospital as an acute hospital serving Causeway Coast and Glens and welcomed the Northern Trust's commitment to maintaining its 24-hour Emergency Department.

Under the proposed amendment, the council would have called for that commitment to be reaffirmed by the Health Minister.

It also called on the minister and Northern Trust, before any final decision was taken, to fully assess and clearly communicate the implications of the proposed consolidation of Emergency General Surgery, including transfer times, ambulance capacity, workforce implications and the impact on services at Causeway and Antrim.

The amendment further sought a clear long-term plan from the trust which would protect and strengthen Causeway as an acute hospital while maximising opportunities to expand elective care.

However, Councillor Kane's amendment fell.

Previous loss of maternity services

The original motion also referred to the previous loss of maternity services at Causeway Hospital.

It stated that the council was "deeply concerned" that removing emergency surgery would represent a further erosion of services and could lead to consequential losses across other departments.

The motion called for the council to write immediately to the Health Minister seeking details of what action he will take to retain emergency general surgery at Causeway Hospital and how the challenges facing emergency surgical provision across the Northern Trust could be addressed without dismantling services at Causeway.

It also sought answers on how associated departments, ambulance provision and workforce recruitment would be protected, as well as long-term assurances about Causeway Hospital's future as a "strong acute hospital".

Following the debate and the defeat of the proposed amendment, councillors supported the original motion.

The council will now write to the Health Minister seeking intervention and an urgent response on the future of emergency general surgery and the wider future of Causeway Hospital.