Department announces review of urgent and emergency care

Date published: 26 November 2018

A review of urgent and emergency care across Northern Ireland’s hospitals has been announced by the Department of Health.

The review will aim to establish a new regional care model for the province, with particular focus on meeting the needs of the rising proportion of older people in the population.

Hospital emergency departments have been experiencing intensifying pressures over recent years, with growing numbers of patients facing long waits for admission.

Another difficult winter period is anticipated for hospitals in NI and across the UK.

Department of Health Permanent Secretary Richard Pengelly said: “The pressures faced by our emergency departments reflect pressures right across the health and social care system – with the rising demand for services outstripping our capacity to provide it.

“Patients are experiencing unacceptable waits and staff are being increasingly stretched.

“We need to fundamentally change the way we do things. That’s why we have announced this review, which will be clinically led.”

The review will specifically consider the most appropriate arrangements for the assessment and admission of older people, as well as providing the best appropriate care for people of all ages.

It follows a Population Health Needs Assessment carried out by Dr David Stewart, a retired public health doctor who held a number of senior positions in the health service in NI.

That research highlights that demographic change is a major factor behind growing demand for urgent and emergency care, with pressures due to intensify significantly in coming years.

For example, during the 10 years between 2016 and 2026, the N Ireland population is projected to grow by a further 77,600.  Of this increase, the rise in the population aged 65 and over is projected to be 74,500.

Mr Pengelly added: “The current model for urgent and emergency care in Northern Ireland is unlikely to keep up with the changing needs of our population in the years ahead. Signs of this are already emerging.

“Improvements in the integration of primary and secondary care services will be among the priorities, as well as the provision of more urgent treatment centres such as the facility recently opened at Omagh Hospital.”

This review will carefully examine the evidence provided in Dr Stewart’s report and recommend potential solutions.

The public, HSC staff and other stakeholders will have the opportunity for their voices to be heard on the future of this important service in a public consultation on the emerging proposals.

Outlining preparations for this winter, Mr Pengelly added: “A series of detailed winter resilience initiatives have been planned to mitigate pressures in the weeks and months ahead.

“We have to be honest and accept that this will be a difficult period once again for patients and staff. It is expected to be the same for hospitals right across these islands.

“Once again, we will be heavily indebted to the health and social care staff who will be looking after us all.

“We can also all help the health service to help us. That includes using services appropriately and taking the right steps to keep ourselves well.”

Notes to editors: 

1. In addition to addressing key lessons learnt from last winter, the winter resilience plans focus on: providing alternatives hospital admissions in appropriate settings; ensuring patients can leave hospital quickly when they are clinically fit; and in improving ambulance turnaround times at emergency departments.

Priorities include: an increase in bed capacity; an increase in staffing both in hospital and in the community; enhanced 7 day services; investments in primary care services; intermediate care/transitional services (to help people move from a hospital setting); ambulatory care (e.g. direct GP referral to avoid attendance at ED or avoid the need for admission via ED for investigation or treatment for certain conditions, including respiratory, gastroenterology, diabetes).

2. In addition, through transformation funding, a range of initiatives are being taken forward during 2018/19 including further development of the provision of Acute Care at Home services.

3. The HSC system has also invested in an enhanced flu vaccine this year, to help older people and other citizens stay well over the winter period.

4. Alternative Services: There are a range of alternative services that people can access if they do not need emergency care.  These include using the online A-Z symptom checker, seeking advice from a pharmacist, going to a Minor Injury Unit, or contacting a GP or the GP Out of Hours services (if their medical condition can’t wait until the GP surgery reopens).  People can also check the average waiting times in their local Emergency Department.

For more information on ‘Staying Well’ this winter go to the nidirect website

5. For media enquiries please contact the Department of Health Press Office team on 028 9052 0575 or email For out of hours please contact the Duty Press Officer on 028 9037 8110 and your call will be returned.

6. Follow us on twitter @healthdpt

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