Edwin Poots expected to outline residential home cuts in major health shake up

Northern Ireland is expected to lose a number of its residential homes as part of major changes to the health service. Edwin Poots Health Minister Edwin Poots is to address Stormont on changes to health services

The details will be included in the health minister’s statement to the Stormont Assembly later on Tuesday.

Edwin Poots is due to address MLAs on the next stage of how he intends to transform the delivery of health and social care services.

While job cuts are likely, it is expected that the impact of compulsory redundancies will be minimum.

Independent living

The purpose of Tuesday’s statement is to put the proposals to consultation.

Included in the health minister’s statement will be proposed changes to how the service will cater for those with mental health problems.

Under the Bamford Review, the priority remains to promote independent living with a number of units on acute hospital sites instead.

It is highly unlikely that Mr Poots statement to the Assembly will contain many specifics.

While each health trust’s plan may differ slightly, the main issues are the same.

For instance, how to provide for a growing and ageing population; tackling diverse health inequalities hampered by obesity and alcohol related problems; an increasing prevalence in long-term conditions such as cancer and an increasing reliance on hospital beds.

Future planning

But just how much priority each trust gives to an issue, such as services for asthma sufferers or even breast feeding support, is determined by so-called population plans.

These figures spell out what services are required now and also highlight which services will be required in the future.

For example, the number of older people in Northern Ireland is expected to increase by 18% by 2022.

The over-65 age group will require specific services.

As 2,667 people are currently registered with dementia in Belfast alone, the city’s health trust is aware it will have to increase service provision for that generation in the next 10 years.

Through its population plan, the Southern Trust is aware it has the highest rate of births and therefore will need suitable maternity services to support this trend.

The number of Accident and Emergency departments remains controversial.

With a benchmark of one acute hospital per every 250,000 to 350,000 people – some of the health trusts, especially the Northern Trust, may find it difficult to justify having two, currently based at the Causeway Hospital in Coleraine and the Antrim Area Hospital.

Community care

The minister’s statement is based on the Transforming Your Care document – published in December 2011 – which sets out the plan for how health service provision is likely to be developed.

The time frame for change to unfold is between three to five years.

The overarching theme remains for care to be transferred away from hospital and into the community instead.

In principle, that means patients should be able to access services closer to home or in the community “hub”, which will be their local health centre.

Integrated primary and community teams will be established to monitor and manage the health of their local populations.

According to the Transforming Your Care document that means a “core team will comprise of community nurses, occupational therapists, social workers and GPs with a specialist interest, supporting a cluster of GP practices and working closely with community pharmacists.

“The core teams will be based in a well-being and treatment hub and local health and community facilities, which will also provide bases for a range of assessment and treatment clinics and support and advice services provided by community and voluntary organisations. Some services currently provided in hospital will transfer to the hubs.”


In order to deliver this plan, it is thought that about 5% of the hospital budget will be transferred to the community budget instead.

The British Medical Association (BMA) said that while it welcomed the idea of change, it was concerned about whether enough resources would be pumped into supporting the new system.

The document will be unveiled by the minister on Tuesday afternoon and will then be put out to consultation for 12 weeks.

While there may be little detail in Tuesday’s announcement, it is worth remembering that when discussing potential change the minister, Edwin Poots, described it as “radical”.

However, the word “journey” has also been used, which, in local terms, normally means taking the long way round to get there.