Causeway Hospital – A Strategic Vision

Causeway Hospital is and will remain an important part of our acute hospital network, and will continue to play an important role in the health and wellbeing of our local population.

We understand that Causeway is highly valued by the local community and people are concerned about its future.

That is why we want to restate our commitment to Causeway as an acute hospital, and describe our vision for how it can develop and thrive.

This document sets out the context that is driving change and shaping our services, along with our strategic, long term ambition for the Causeway site.

Much to be proud of

Causeway may be one of NI’s smaller acute hospital sites but it provides a significant volume of activity.

Staff working in Causeway Hospital delivered over 180,000 patient contacts in the 2022/23 financial year – that is 500 people every day benefiting from Causeway’s services.

Our staff work tirelessly all year round to provide the highest quality of care they can, and our community holds the hospital in very high regard.

Causeway in numbers – 2022/23 financial year

47,000 Emergency Department attendances
83,000 Outpatient appointments
10,700 Unscheduled admissions
7,800 Planned procedures
32,500 Outpatient diagnostic tests

Serving our community

Our population is changing.

Projections show that over the next 20 years the number of people living in the Causeway Coast and Glens area over the age of 75 will increase by 56%; at the same time the number of under-20s living in the area is expected to fall by almost 20%.

This means we will need to deliver services increasingly focused on a frail, older population with multiple health conditions, working with primary and community care and other partners to keep people healthy and independent for as long as possible.

CCG population % change 2023-2043

CCG population projection by age band

Source: NISRA 2018-based population projections for areas within NI www.nisra.gov.uk

Policy and evidence

The Bengoa Report in 2016 underlined the need for transformation in Health and Social Care.

The Review of General Surgery (2022) set standards for emergency general surgery which are difficult to meet in a smaller acute hospital. At the same time the Nuffield Trust has published a number of papers stressing the importance of smaller hospitals as part of a broader acute network.

The Department of Health’s Reconfiguration Blueprint when published is expected to set out some further direction for the future shape of hospitals across the region, while the Integrated Care System will bring local partners together to plan services based on the needs of our local population.

Workforce

We cannot deliver any services without the right workforce.

There is no doubt that attracting specialist staff to a smaller hospital can be a challenge, but that is why we are setting out a strong, compelling future vision for the site.

Alongside our vision for service development we will take forward an ambitious but deliverable workforce plan, showing how we intend to develop, attract and retain the staff we need to build resilient, sustainable services.

Working in partnership

No hospital is an island.

Causeway can only thrive by working in partnership – with primary and community care, with the community, voluntary and independent sectors, with the NI Ambulance Service and others.

Joint working with the clinical teams in Antrim Area Hospital will help strengthen and support services in Causeway.

And there are important interdependencies between services on the Causeway site that need to be considered when any service change is being planned.

Finance

We are in a period of very challenging financial constraints.

That doesn’t mean we are proposing to cut services to save money.

It does mean that we need to make sure we are delivering value with the resources that we have, and not trying to provide services in a financially unsustainable way.

In the past 12 months we have seen £1.8m invested into urgent and ambulatory care, £1.2m into solar energy and £1m in the form of a new CT scanner, and we expect to add an MRI scanner to this list in 2025.

But we need to keep demonstrating to commissioners that Causeway is a good place to invest, so we can secure more resources for staff, infrastructure and equipment as they become available.

Our ambition

Firstly we are restating our commitment to a 24/7 Emergency Department and acute inpatient services in Causeway Hospital.

We believe it is important for our staff and our community to reiterate this point: we have no intention of ‘downgrading’ Causeway Hospital or converting it to a ‘cottage hospital’.

Causeway is and will remain an acute hospital, with services for both adults and children.

This does not mean however that Causeway can stand still. There are many ways in which Causeway can develop to serve its community and beyond, and our ambition for the hospital covers a number of areas where we believe we can build services and attract investment.

Same Day Emergency Care

Ambulatory or Same Day Emergency Care means getting patients who need senior medical assessment, diagnostics and/or treatment to that care without going through an Emergency Department or spending a night in hospital.

In Causeway we have recently received an investment of £1.8m to develop urgent and ambulatory pathways, and we plan to carry out estates work to create a bigger space for our ambulatory unit.

The future of ambulatory care in Causeway is to provide a wider range of specialist services: cardiology, respiratory, surgery, cancer and frailty, where older patients can receive support from doctors, nurses, Allied Health Professionals, pharmacists, social workers and others.

Integrated Care

The Causeway locality can lead the way in providing integrated care as part of the regional development of the Integrated Care System.

This is really important for frail older people who need to be able to transition seamlessly from home to hospital and back again, with the support they need to maintain their independence.

As we develop services in the hospital we will work with our partners in primary and community care, and the community, voluntary and independent sectors, to provide joined-up care to our population.

Elective Care

Alongside its focus on unscheduled acute care, Causeway is well positioned to deliver elective services.

This could include planned surgery, endoscopy, diagnostics and other procedures.

We already provide thousands of procedures each year to Northern Trust patients in Causeway Hospital, and we will deliver a significant investment in the provision of a much needed MRI scanner.

Our ambition is to see Causeway operate as an elective and diagnostic hub for the north west, delivering services to patients from well outside its natural catchment area.

Mental Health

Finally we know that there is an increasing incidence of mental health issues and dementia, both among older people and in the community at large.

The development of Birch Hill, the new inpatient mental health unit in Antrim, gives us an opportunity to rethink and reshape how we provide mental health services in Causeway, in line with the Regional Mental Health Strategy.

A bright future…

We firmly believe that Causeway has a bright future as part of our acute hospital network and as a key player in health and social care provision for the local area.

By focusing on the right things, attracting investment and building our workforce, we are confident that Causeway can continue to serve its population for many years to come.

Causeway Hospital Strategic Vision (PDF, 16 pages, 4 MB)
Causeway Hospital Strategic Vision Easy Read

Causeway Hospital Strategic Vision (British Sign Language)

Causeway Hospital Strategic Vision (Irish Sign Language)