People living on the north coast could have to make a three-hour round trip for hospital treatment under a radical overhaul of the health service in Northern Ireland.
Plans to move hospital services from the Causeway Hospital in Coleraine to Altnagelvin Hospital in Londonderry is just one proposal in a major review of how health and social care is to be delivered here.
The Transforming Your Care (TYC) document also examines how the number of Government-run residential care homes could be slashed over the next five years.
The move would see around 28 of the current 56 facilities shut their doors, with at least 750 residential home places being lost as a consequence.
The document recommends the eventual closure of all such facilities.
Unions have reacted angrily to the proposals, which include cutting the number of healthcare jobs in Northern Ireland.
Around 1,600 healthcare jobs — 3% of the workforce — are set to go in the next five years under the plans.
It comes just hours after public service union Unison revealed nurses in Northern Ireland are stretched to the limit — unable to provide adequate care to patients and attend important training.
Kevin McAdam, the regional officer for Unite, said: “This Transforming Your Care is about changing what you have now into a whole lot less, thereby saving the department a lot of money.
“It is about transforming the NHS into a specialist service outside of which you can buy your own.
“This is akin to the English model of privatisation only here we do it by saying there aren't enough who want NHS provision so go get it yourself. Unite cannot see that this transformation amounts to anything but window dressing on massive cuts.”
The proposals are among a series outlined by Health Minister Edwin Poots (below) to the Assembly as he provided more details on what TYC will potentially entail.
- The development of six acute inpatient mental health facilities.
- The implementation of a non-emergency 111 helpline.
- Hospitals working together in five regional networks each serving a population of about 400,000.
- The resettlement of long-term learning disabled residents .
- A formalised relationship with health authorities in the Republic of Ireland to ensure a joined-up approach to the care of border residents.
- Provision of specialist cardiac services at two centres in Belfast and Derry.
- The number of hospital beds reduced by 180.
Mr Poots, who first announced the major health service shake-up last year, has now asked the public for feedback.
“The proposals in Transforming Your Care present a vision of a new model of care which is focused on ensuring that more services are provided in the community, closer to people's homes where possible,” he said.
6 issues in report
More care will be delivered in the community with less reliance on hospitals.
More minor surgical procedures and appointments with consultants will happen in GP surgeries.
It is hoped this will cut waiting times for outpatient appointments.
Specialised care will be delivered in centres of excellence.
Hospitals will operate in networks serving populations of about 400,000.
While some acute hospitals will remain they won’t deliver acute care.
There are three proposals for the Causeway Hospital in Coleraine — maintain the status quo, share services with Altnagelvin or move the hospital into the Western trust.
2. Mental health and learning disabilities
People who depend on social services could be given more say over their care. It recommends more people receive direct payments to decide what services they want to help them live in the community.
It has called for all long-term institutions for people with mental health and learning disabilities to close by 2015.
Six acute inpatient mental health units will be developed across Northern Ireland.
With more people living longer, an increasing number are being diagnosed with a range of medical conditions.
Transforming Your Care will encourage telemonitoring, allowing patients to monitor conditions at home.
Clinicians have quick and easy access to results and can treat patients before a problem develops. This could reduce admissions at A&Es.4. EMERGENCY CARE
There would be access to 24/7 emergency/urgent care on both Antrim and Causeway sites. However, this could mean health bosses will want to remove 24-hour A&E services from Coleraine site and replace it with a GP-led urgent care unit. Opening hours at Lagan Valley A&E could increase.
Some staff who currently work in a hospital, may find that they will be fulfilling an unchanged or very similar role to their present one but more often in a primary or community care setting. There is expected to be a reduction in the overall workforce of around 3% in the next three to five years.
Many of the proposals will be supported and enabled by new investment in ICT.
There will be increased sharing of information across HSC organisations where this supports clinical decision making about diagnosis or treatment.
Everyone will have an Electronic Care Record to provide clinical staff with the information they need to provide the right treatment.