Health bosses have drawn up controversial plans to close six hospital wards in Belfast – along with beds for cancer patients and the elderly.
The Belfast Telegraph has seen the minutes of a meeting held between trade union representatives and the executive director of nursing with the Belfast Health and Social Care Trust on January 17 this year.
The trust document outlines several issues which were discussed at the meeting, including a number of proposals under "present consideration".
• The closure of six wards in acute services.
• The closure of a small number of older people's beds.
• The closure of some beds in cancer and specialist services.
The document does not elaborate further on which hospitals could see ward closures, but does warn that "where there is a reduction in beds, there will be a reduction in the nursing workforce".
The trust confirmed that a "decrease" in the number of inpatient beds was being considered as part of modernisation plans.
But Patricia McKeown from public service union Unison rejected the claim – saying the proposals were based on saving money rather than modernisation.
"This is about cuts and nothing else," she said.
The minutes also show that the sickness level among trust nurses is currently running at 11%, "the highest that it has ever been".
"Every effort needs to be made to reduce this," it adds.
Unions reacted angrily to the suggestion that bed and staff numbers could be cut as the health service across Northern Ireland struggles to cope with demand.
They have claimed the high sick levels demonstrate the pressure being experienced by frontline hospital staff.
Ms McKeown added: "Latest figures show our A&Es cannot cope with patient numbers and more and more people are facing lengthy and unacceptable waits on trolleys.
"There is a major issue in our hospital that no one seems to want to deal with, and that is the fact that trusts are running bed capacity at 95% plus.
"That is precisely what causes queues in our A&Es. If there are no beds available in wards then there is nowhere for patients in A&Es to go to, and that is when our A&Es get snarled up.
"Now we learn the Belfast Trust is thinking about closing six wards, which can only lead to further chaos, and it is wrong to think that this won't impact on neighbouring trusts."
Janice Smyth, director of the Royal College of Nursing (RCN) in Northern Ireland, said a range of subjects were discussed during the meeting, including proposals for ward closures, bed closures and the impact on patients.
"The RCN notes the references to high vacancy levels within nursing with vacant posts being left unfilled, and the reference to high sickness absence levels," she said.
"The RCN has been raising for some time its concerns about pressures on frontline nursing staff. The information detailed in the trust record of the meeting confirms that these concerns are not without justification."
A trust spokesman said "improvements will result in the number of inpatient beds required to decrease over a two-year period".
"Where inpatient bed numbers decreased, nurses working in these areas would be redeployed and there would be sufficient turnover of staff over the period of implementation to allow for this," he said.
He said sickness and absence levels are currently a source of concern and there is a programme of work to address this.