The historic Mater hospital in Belfast has been earmarked for the North’s first overnight centre for planned operations as part of a drive to overhaul general surgery and tackle spiralling waiting lists.
Founded by the Sisters of Mercy in 1883, there were growing fears about the long-term future of the hospital which became renowned for its expertise in the treatment of pancreatic and liver cancers, housing a regional surgical unit.
The north Belfast facility — known for its strong Catholic ethos but established to “care for the poor of the city” and the first to treat injured British soldiers at the beginning of the Troubles — stopped performing operations when it became a specialist Covid hub during the pandemic.
Announcing a detailed review aimed at transforming how general surgery is performed in hospitals across Northern Ireland on Thursday, Northern Ireland health minister Robin Swann confirmed the establishment of the new overnight centres.
They will treat “high volume intermediate complexity cases” where at least one night in hospital is required.
Mr Swann said the case for reshaping the current system is “unanswerable”.
Waiting lists for surgery in the North are the worst in the UK, with general surgery — a wide ranging speciality relating to diseases of the digestive tract — in the top four for longest delays.
The review document calls for a greater separation between emergency and planned (elective) general surgery, and sets out a range of standards required with different hospitals specialising in different services.
These standards will help inform the wider design plan being developed for the future of the North’s vast hospital network — which has now been subject to seven major reviews over the past 20 years yet waiting lists are consistently the worst in the NHS.
Professor Mark Taylor, a high-profile surgeon who led the review, said change was “rarely easy” in healthcare but stressed its importance in order to benefit patients “no matter where they live in Northern Ireland”.
Asked by The Irish Times if the Mater hospital will remain as a centre of excellence for pancreatic surgery, Professor Taylor replied:
“There’s always been the worry with The Mater hospital as we go through change as to what the long term plan is. We’re putting more surgery back into the hospital but not only that, we’re putting overnight stay surgery back in.
“It may not remain as a centre of excellence for pancreatic surgery ... All of our staff are very much aware of this plan and we support it. The hospital will be a regional teaching hub for general surgery in Northern Ireland.”
The review document warns the current model for delivering general surgery is “neither sustainable nor providing uniformly high quality care”.
Prof Taylor added: “The changing nature of surgical speciality means delivering emergency general surgery across multiple smaller sites with a lower patient turnover is becoming increasingly difficult in terms of rotas, staff recruitment and retention, skill mix, and maintaining quality care.
“If we don’t secure change in a planned way, it will happen anyway in an unplanned and piecemeal fashion as services in a number of locations increasingly struggle to keep going.”