A plan to reconfigure how surgeries are carried out in Northern Ireland will deliver safer and more consistent care for patients, the Health Minister has said.
Robin Swann was commenting as he published a review into general surgery provision in the region. The review, which was led by consultant surgeon Professor Mark Taylor, has produced a new set of standards that hospitals will be required to meet to continue to provide emergency and planned general surgeries.
The plan envisages greater separation of emergency and elective surgery provision, with different hospitals specialising in the different services. The exercise is part of the wider plan to reshape health delivery in Northern Ireland.
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The health service reform plans include a restructuring of the hospital network, with a focus on creating hubs to deliver key specialisms. Northern Ireland currently has the longest hospital waiting lists in the UK and experts have warned the structures are not sustainable.
The review published by Mr Swann involves changes to the pattern of services. This will include creating overnight stay centres for elective surgery. These will involve planned procedures for high-volume cases of intermediate complexity where at least one night in hospital is required.
The Mater Hospital in Belfast will be the location for the first of these new centres, with further sites to be identified at a later date.
Mr Swann said there had been major changes in general surgery over the last 20 years, with surgeons now more specialised and focused on specific areas.
He said this had created a need for larger staffing teams, which had led to recruitment issues and an increased reliance on locum cover. The minister also said radiology and endoscopy facilities were not consistent across the hospital network.
He said there was a wide variation in performance across surgical specialities both with regard to time spent in hospital and the levels of surgery carried out as day cases. Mr Swann said a further challenge with the current system was the number of elective procedures that were cancelled due to emergency surgery cases requiring staff and theatre space. The plan would address this issue by creating more separation between elective and emergency surgery provision.
"I very much welcome the development of these standards for emergency and elective general surgery," Mr Swann said. "They will be used to drive decisions on the reshaping of services and will help inform the wider design plan initiative which I recently announced for our hospital network.
"The Review of General Surgery has been clinically led and I am very grateful to the review's chair Professor Mark Taylor and colleagues for this vitally important work. The case for reshaping general surgery services is unanswerable. As this report underlines, we are not currently providing the best possible care for all our patients.
"Whilst our surgeons and wider multidisciplinary teams do outstanding work, current arrangements do them a disservice. We must press ahead with changes to ensure better, safer and more consistent care for patients, wherever they live in Northern Ireland."
Prof Taylor added: "I believe this review will make an important contribution to the transformation of our health service. I am very pleased to have been involved in this work and I would like to express my sincere thanks to the many individuals who have contributed to it.
"The changing nature of surgical speciality means delivering emergency general surgery across multiple smaller sites with a lower patient turnover is becoming increasingly difficult in terms of rotas, staff recruitment and retention, skill mix and maintaining quality care.
"If we don't secure change in a planned way, it will happen anyway in an unplanned and piecemeal fashion as services in a number of locations increasingly struggle to keep going."
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