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Northern Health and Social Care Trust Winter Plan 2025/2026

Introduction

This information is to help us share with the public, our plans for health and social care services over the winter months. Winter is always a challenging period for our Health and Social Care system, with demand for services typically increasing at this time of year. A busy winter period means increased pressures on primary care, our hospitals and community services. As we prepare for another winter season, the Northern Trust has set out its annual Winter Preparedness Plan which outlines actions and measures being put in place to manage this anticipated increase in demand on our services, particularly around emergency care. During the coming months, we may find it difficult to provide all of our planned services whilst also managing the expected increase in demand for unscheduled or critical care. Patient safety will always be our priority, whilst we balance these risks. Regardless of the pressures on the health and social care system, we remain committed to providing the highest standards of care with our community, in our community. We hope you find this information helpful.

Context

We expect the winter months to be challenging given the continuing and sustained demand on services all year round. Our staff are our greatest resource and we will continue to support them to stay healthy and well. Health and Social Care relies on the commitment and resilience of our staff who deliver our services with compassion and care. This Winter, three areas have been identified as key areas for focus to support people to stay well, remain at home and avoid hospital admission. Maximising ambulance capacity and reducing ambulance handover times Timely hospital discharge for patients who are medically fit Introduction of the Hospital at Home Service Our Winter Plan also identifies key enablers which will be crucial to our success, including our staff’s health and wellbeing, providing additional capacity to assess and treat patients, and comprehensive local and regional oversight arrangements.

Financial Constraints

Across Health and Social Care Services, there continues to be a sustained focus on maximising efficiency and productivity to deliver annual cost reductions and savings whilst balancing the needs of the community we serve. We are actively working to mitigate the impact of these savings for our patients and wider community.

Working with us

Across our hospital sites, we anticipate an increase in demand for inpatient beds. Therefore, timely discharge of patients once medically fit, remains key to ensuring all patients can be admitted in a timely way. It is our priority to ensure patients are discharged safely from hospital to the most appropriate place; however this may not always be to your preferred option. We ask for support and flexibility from families and carers with discharge planning arrangements to help us achieve a safe discharge and to ensure beds are available for other patients who require inpatient assessment and treatment. Despite the best efforts outlined above, there will be times that patients have to stay in the ED whilst waiting for a bed to become available in a ward. Further surges of respiratory illnesses will impact on service delivery and bed availability.

How you can help?

Selfcare: To treat an ache, pain, upset stomach, cough or cold and get plenty of rest, take simple pain killers if needed and use over the counter medicines.
Children’s symptom checker: If your child is feeling unwell, you can use our symptom checker to gain a better understanding of what might be happening and where to get treatment.
Your local pharmacist: They are there to give confidential, expert advice and can treat a number of minor aliments such as aches and pains, skin conditions, allergies, eye conditions, upset stomach and emergency contraception.
Your GP: They will give expert medical advice and diagnosis, referring you for further care or consultation as needed.
Primary Eyecare Assessment and Referral Service: Treats sudden eye conditions such as red eyes, sudden reduction in vision, eye pain or a foreign body in the eye. Find out more on the HSC website.
Mental healthcare: If you are experiencing mental health difficulties there are a range of services available to help you. More information is available on the NI Direct website.
Emergency Dental Treatment: If patients have an urgent dental need they can follow advice on the HSC website.
Minor Injuries Unit: Treats injuries that are not life threatening such as broken bones, sprains, bits and burns.
Urgent Care Centre: Treats injuries that are not life threatening such as broken bones, sprains, minor scalp wounds and suturing of minor wounds.
Emergency Department: Provides the highest level of emergency ease for patients, especially those with acute illnesses or trauma, such as heart attacks, stroke, serious accidents or head injuries.

Winter Plan 2025/26

Improving Ambulance Handover Times

Our Phone First service will be in operation at Antrim and Causeway Hospitals to direct patient flow to Emergency Departments and make best use of available resources. We will work together with the Northern Ireland Ambulance Service to ensure that our patients are transferred into the care of our Emergency Department team in a timely way. This is supported by repurposed funding to: Enhance Senior Nursing within Antrim and Causeway Emergency Departments Develop the ED InReach Front Door Frailty Service in Antrim Area Hospital Enhance the Early Intervention Team in Antrim and Causeway Hospitals Introduce Anticipatory Care Planning for Care Home Residents in the East Antrim Locality Expand the Early Review Team.

Timely Hospital Discharge

We will continue to help patients discharge from hospital as soon as it is deemed appropriate by our clinical teams. Our site co-ordination hubs at Antrim and Causeway Hospitals will continue to focus on expediting discharges and reducing delays. We will continue to work with the Regional Co-ordination Centre and work collaboratively to reduce delays across the HSC system. Our Early Review Team will promote independence for those patients who have been discharged with home care packages through early review. We will work with our independent sector providers to maximise care home bed availability including beds which offer an enhanced level of care for those with complex needs. We will optimise the use of intermediate care beds to support patient discharge and support your recovery and independence. We will enhance key support services which facilitate timely diagnosis and discharge of patients, such as labs, MRI, CT and pharmacy.

Hospital at Home

This Winter, we will focus on establishing Phase 1 of a Hospital at Home Service, which will provide care to patients in their usual place of residence. This community based service will primarily focus on our frail, older population and provide high-level care for conditions which would normally require inpatient care in an acute hospital bed, it will provide an alternative to hospital admission and ensure care is delivered in the best place possible. Dedicated consultant input will prevent unnecessary emergency department and acute hospital admissions and avoid premature admission to long term care.

Protecting Elective Care

Our daycase treatment, day surgery and ambulatory pathways will be maximised in order to reduce demands on inpatient beds. We will continue to focus on optimising the elective theatre capacity. We will ensure the funding allocation for additional waiting list activity is maximised.

Key Enablers

Protecting and Promoting Staff Health and Wellbeing

We are committed to building staff resilience and support staff through a comprehensive health and wellbeing strategy which provides a range of additional support. We will continue to have a focus on staff mental health and wellbeing. We will maximise the uptake of the flu vaccination across our staff. We will encourage staff to take their breaks and annual leave.

Primary Care

The Health and Social Care system relies on the availability and sustainability of patient care outside of hospital and public confidence in other services. We will continue to work closely with Primary Care to promote direct access pathways where appropriate. Partnership working between the Trust and Primary Care services will ensure the smooth transition of patients between services. We are committed to ongoing collaboration on services for the benefit of our patients.

Communications

We recognise there is further work to do to raise awareness of the alternative options to our Emergency Departments to receive timely assessment and treatment and to build the confidence of our communities to access alternative services. We are committed to clear, transparent and timely communication with our partners and wider communities. The Phone First service for adults with minor injuries is operational for both Causeway and Antrim Emergency Departments and provides a first point of contact for advice, assessment and signposting to the most relevant local service.

Additional Capacity

We will work with our staff to cover critical areas in times of pressure and provide additional staffing in key areas such as: Increased medical staff across Emergency Departments and inpatient wards to assess patients and reduce the impacts on waiting times. Increased AHP and nursing staff across key areas to support access to timely care, rehabilitation and discharge. We will ensure robust risk assessments and Infection Prevention Control measures remain in place to keep our patients and our staff safe during times of increased demand.

Northern Trust Winter Plan 2025/2026 (PDF)