City A&E unit closure considered
Belfast City Hospital's emergency department could close permanently under proposals being considered by the health minister.
The Royal and Mater's A&E units would remain open supported by direct access to specialist services at the City, Edwin Poots said. He has ordered a consultation on the changes to emergency services in Belfast. The City's unit has been temporarily closed since 2011 because of a shortage of doctors.
Mr Poots said: "My department has obtained assurances from both the trust and the HSC (Health and Social Care) Board, as the commissioner of these services, that the preferred option will provide an emergency department service in Belfast that is safe and sustainable and that it will deliver high-quality care."
Health unions in the past have opposed plans to close an emergency department in Belfast but senior health officials maintained the move could create a more efficient health service.
A shortage of middle-grade doctors in emergency departments in Northern Ireland, part of a UK-wide trend, prompted the decision to temporarily close the City unit in November 2011, the Belfast Trust has said. Now a 13-week Northern Ireland-wide consultation by the Health and Social Care Board will be run on its permanent shut down, the minister told the Assembly in a written statement.
Mr Poots said the preferred option in the consultation document was that there should be two emergency departments in Belfast, at the Royal and the Mater, supported by direct access, via GPs, to a range of specialist services at Belfast City Hospital. In the past the trust has argued that accident and emergency would have to involve the Royal because it is Northern Ireland's regional trauma centre and has intensive care provision, cardiac surgery, neurosurgery, fracture clinic and also specialises in the treatment of stroke patients.
The organisation's director of acute services Dr Patricia Donnelly said the decision to temporarily close the City department was taken without public consultation because the shortage of middle-grade doctors in emergency departments meant administrators had to act quickly, Dr Donnelly said. The consultation will run until May 10.
Ulster Unionist health spokesman Roy Beggs said in December the percentage of patients waiting four hours or less was 66% in the Royal Victoria and Mater, against a target of at least 95%. "My party continues to totally oppose the closure of the A&E at Belfast City Hospital," he said. "On the evidence of the waiting times at Belfast's two remaining A&E units since its closure, it is clear that we cannot cope without it."
John Compton, chief executive of the Health and Social Care Board, said delivering emergency services from the Royal and Mater would provide a safer and more sustainable model of care. "Patients would continue to have access to emergency department services and through their GP would have direct access to medical assessment or admission to hospital; rapid response 24-hour care at home; better outcomes for stroke patients; and supported discharge home from hospital," he said.
Colm Donaghy, chief executive of Belfast Trust, said the proposed change gave the people of Belfast a sustainable, safe and resilient emergency service. "It will allow us to concentrate our senior clinicians more effectively and will ensure patients are seen more quickly, and therefore treated more effectively. Belfast City Hospital, as a centre of specialist services, will give GPs with patients in need of urgent care a direct and timely route to specialist teams, avoiding an unnecessary journey to an emergency department," he added.