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Northern Ireland health service cuts: Northern Trust's £13m savings proposals

The Northern Trust covers the council areas of Antrim and Newtownabbey District, Causeway Coast and Glens District, Mid and East Antrim District and Mid Ulster District. It is to make £13m of savings.

'Major or controversial' savings

End reliance on non-contract agency nursing and high cost Locum Doctors - £2.4m

This will: Reduce number of acute beds 16 to 20 at  Antrim Hospital and in Causeway Hospital, which both regularly operate above capacity. Additional capacity would not be available. Reduced number of Rehabilitation beds at Whiteabbey Hospital - 44.

Temporarily closure of Rehabilitation Services at Whiteabbey Hospital and redirect Trust employed staff to temporarily work at Antrim Hospital. The hospital uses a high number of agency staff given sickness levels and unfilled positions.

Reduce non-urgent elective day surgery - £2m

Cut in core elective work, day surgery and inpatient surgery for non-urgent patients  and "manage" the surgical bed capacity. Staff diverted to emergency and urgent care services.

2,400 elective procedures cut.

Inpatient and day surgery are provided in Antrim and Causeway acute hospitals; day surgery is provided at Mid Ulster and Whiteabbey Hospitals.Antrim and Causeway Hospitals largely provide inpatient and day surgery for a significant number of confirmed / suspect cancer surgery and urgent procedures, while Mid Ulster and Whiteabbey day case theatres provide for more of the non-urgent / routine cases. This proposal would down turn the routine/ non urgent work from Mid Ulster and Whiteabbey sites and displace urgent cases to either Antrim or Causeway Hospitals.

Nursing staff who work in day surgery in Whiteabbey Hospital are already currently based at Antrim Hospital therefore will remain on site to support services. Nursing staff at Mid Ulster will be temporarily redeployed to Antrim or Causeway Hospitals to enable reduced used of agency and other flexible staffing.

Reduce number of community based rehabilitation beds - £450,000

Community rehabilitation beds cut by 25 plus delay in discharges from hospital. Impact on independent providers of Nursing and Residential care in terms of reduced income for contracted rehabilitation beds.

Action to present "particular challenges" over winter months for finding beds.

Containment of growth in community care home placements and domiciliary care packages - £1.475m

37 domiciliary care packages affected but level of service not reduced. Increase in waiting times and delays in discharging patients from hospitals.

Ending meals on wheels - £60,000

103 people affected.

Reduce use of non-emergency ambulance use - £20,000

Increase in car parking charges - £75,000

Increase in 20p per hour for parking of less than 1 hour and 30p for parking of over 1 hour at Causeway and Antrim hospitals.

'Low impact' savings

Continued savings programmes - £800,000

Absence management - £400,000

Limiting spending outside salaries for example travel, printing, stationery, adverts and "robust management of procurement contracts - £500,000

Slippage through deferral of service developments - £2.025m

Delay in resettling Muckamore Hospital residents - £564,000

Technical adjustments with "no impact" on front line services - £2.031m

In a statement, the Trust said: "The Trust recognises the vital importance of our community services in caring for people close to their families and homes. So we have protected as far as possible our Community Hospitals and other community facilities. We have however proposed to contain the growth of domiciliary care and placements."

Northern Trust Chief Executive, Tony Stevens said: "We are part of a system that is under significant financial pressure but the HSC system is working collaboratively to find solutions. We will prioritise services to protect the sickest and most vulnerable. The proposals that we have put forward today seek to minimise any adverse impact on our ongoing plans for reform and modernisation. The proposals, if implemented, will however have an immediate and direct impact on current service provision. There will be no direct impact on current staff, but the Trust will maintain its current vacancy management processes. We will continue to seek to find ways to mitigate this impact and I would encourage everyone, public service users and staff to engage in this important consultation.”

Full consultation document available here

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