Debate contribution: Reconfiguration Framework: Consultation

Debate contribution by Mr Mike Nesbitt on 1 October 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

1 October 2024

Type

Debate contribution (made as a minister)

Business

Ministerial Statements

Heading

Reconfiguration Framework: Consultation

Assembly identifier

Official Report component 4562351

Read the official Assembly record

Text

Thank you, Mr Deputy Speaker. I am making a statement on the launch of the public consultation on the hospital reconfiguration framework document, which is entitled 'Hospitals — Creating a Network for Better Outcomes'. I am pleased to have the opportunity to share the framework document with Members today in advance of the imminent launch of a 16-week consultation period. That will commence tomorrow and will run until 21 January 2025. I am aware that some people tend to promote the belief that there has been no clinical involvement or engagement with health service front-line staff on the development of the framework. That is simply not the case, and I want to set the record straight. It is not something that civil servants have simply cooked up with no outside input. 'Hospitals — Creating A Network For Better Outcomes' has been co-produced with the trusts and the Public Health Agency (PHA), which have involved a wide range of clinicians in the process, as well as senior managers and chief executives. Furthermore, during July and August of this year, my officials carried out an extensive pre-consultation exercise that involved engagement with all the royal colleges, as well as with trade unions and service users. The feedback from that very useful pre-engagement exercise has been incorporated into the final draft of the document, which is presented to the House today. At its heart, the work is about how we can improve the sustainability of hospital services and, ultimately, provide an assurance that none of our acute hospitals will close. The draft framework aims to describe our acute hospital system. Its underlying principle of local provision where possible and central where necessary is key to the document. A fundamental concept is that of an integrated Northern Ireland hospital network. Within that network, each hospital has been identified as part of a particular tier, combining to form an interdependent network. The types of hospitals described in the framework are local, general, area and regional. That network approach will ensure a brighter and more secure future for all our hospitals. I want to be clear in the message that this is not about cutting costs or closing hospitals but about managing change in a controlled way and demonstrating the benefits, which have to be better outcomes. We will continue to need every square inch of our hospital estate. It is about showing everyone how each hospital fits into the network, determining what the most valuable role for each one to play is and delivering the best outcomes for patients. To embed sustainability and resilience, taking account of our workforce, safety considerations and advances in modern medicine, it is simply not possible to deliver all services in every hospital. It is already the case that different hospitals have different services available. The network approach will ensure that people can still get the right treatment in the right place by the right person, even if it is not necessarily in the hospital closest to their home. I recognise that there are difficult judgement calls to make around that. My view is that patient safety must always come first. When hospitals have lower patient numbers, that can create significant issues for professionals working in key specialties. They include the rota and on-call pressures inherent in smaller clinical teams, as well as an insufficient case mix to support specialisation, training and skills development. Those issues inevitably have consequences for recruitment and retention, adding to the challenges of maintaining services. That, then, potentially compromises patient safety and often leads to poorer patient outcomes. We have seen in recent years a number of examples where changes have been made as a direct result of service collapse rather than planned improvement. Research shows that the vast majority of people — in fact, in the region of 80% — say that they are willing to travel for elective care in order to receive treatment from the best and most skilled experts as quickly as possible. However, I recognise, of course, that there are some for whom any additional travel will be a cause for concern. That is why a section on patient travel is included in the draft framework, setting out the supports available for the public. It is important to note that 'Hospitals — Creating a Network for Better Outcomes' will not itself reconfigure any specific services; instead, it provides a strategic context and structure for future reconfiguration decisions. It is underpinned by a number of existing service reviews and strategies, which were clinician-led and developed in partnership with those who use the services. Future reconfiguration decisions will continue either to come from regional service reviews or to be trust-led. I am committed to ensuring that such decisions include appropriate engagement with, for example, staff, service users and the local community. In closing, I encourage Members to take the time to respond to the consultation and make their views known. As I encourage Members to look on our hospitals as a network, in the same way I encourage them to regard this statement as one of a series about reform of healthcare delivery that will come in the coming weeks. I commend the statement to the House.

865 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 11:16 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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