Debate contribution: Healthcare: Integrated 111 Service
Debate contribution by Mr Philip McGuigan on .
- MLA
- Mr Philip McGuigan
- Party at the time
- Sinn Féin
- Date
- 18 May 2026
- Type
- Debate contribution
- Business
- Opposition Business
- Heading
- Healthcare: Integrated 111 Service
- Assembly identifier
- Official Report component 5548783
Read the official Assembly record
Text
There will be little disagreement that our urgent and emergency care system is under sustained and growing pressure. The long waiting times in EDs, ambulance delays, overcrowded hospitals and the increasing difficulty in accessing a GP appointment have, unfortunately and regrettably, become almost normalised in our health service. Despite those pressures, healthcare workers across our system continue to provide extraordinary care with professionalism, compassion and commitment, and they deserve recognition and thanks for their dedication. However, it is also important that we recognise that the pressures facing emergency care do not exist in isolation; they are connected to the wider pressures right across the health and social care system. Last week, the Committee discussed the home care sector and the challenges facing home care providers, such as the difficulty in recruiting and retaining staff and the impact that it has on patients who are willing to leave the hospital. The delayed discharges have direct consequences right across the entire system. When patients cannot be discharged safely because care packages are unavailable, hospital beds remain unnecessarily occupied, which reduces hospital flow and increases the pressure on EDs, delays ambulance handovers, contributes to cancelled procedures and places even greater strain on staff. The crisis in home care is directly contributing to the crisis in our hospitals and emergency departments. If we are serious about reforming urgent and emergency care, we must think about the entire patient pathway and how services connect. A 111 service would not solve all the pressures facing health and social care: no single reform can. It is important that we approach the proposal realistically. The experience elsewhere has shown that 111 systems are not without challenges. In England, concerns have been raised about overly risk-averse triage systems, which can lead to unnecessary referrals to emergency departments or ambulance dispatches. Questions have also been raised about staffing pressures, public confidence and whether sufficient community services are available to provide meaningful alternatives to hospital attendance. It is equally important to acknowledge that elements of the approach are already being delivered here by the Ambulance Service’s Hear and Treat service and integrated clinical hub services. A number of weeks ago, I had the opportunity to meet with representatives of the Ambulance Service and hear directly about their increased use of clinician-led telephone assessments in how they triage patients' needs for ambulance dispatch or hospital attendance. I am always cautious about proposals that simply seek to replicate systems that have been developed elsewhere. Whilst we remain partitioned, we are a small health system. We also have different service structures and significant workforce challenges in many areas, as we have discussed in the Chamber on numerous occasions. Rural communities have more difficulty than urban communities in accessing community provision and urgent care alternatives. If those services are not strengthened first, there is real risk that a 111 system could create additional demand without delivering meaningful improvements for patients or front-line staff. Ultimately, though, the principle underpinning the motion is about ensuring that patients receive the right care in the right place at the right time. There is undoubtable merit in examining coordinated, clinically supported urgent care access. That could complement the shift-left agenda — the neighbourhood model — which is focused on prevention, early intervention and strengthening care within the community. The motion calls for proposals to be brought forward by 2026. That timeline appears to be somewhat ambitious, given the scale of workforce planning considerations, digital integration and service coordination that would be required, but I will leave the Minister or the motion's sponsors to comment on how realistic that time frame is. What matters most is that any future model is properly designed, properly resourced and genuinely capable of improving patient care and system flow — we all agree on that. It is about creating a more joined-up health system that helps patients access appropriate care more quickly, reduces avoidable pressures in hospitals and supports the wider transformation of our health service. That is required urgently.
665 words. Text as published by the Northern Ireland Assembly.
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