Causeway Hospital set to lose maternity services as all births in Northern Trust to take place at Antrim Area Hospital

The Northern Health and Social Care Trust board approved the recommendation at a meeting in the Royal Court Hotel in Portrush on Thursday. It follows a 14-week public consultation on the future of maternity services in the region.

Clinicians have advised the Trust the current provision of maternity services at Causeway Hospital in Coleraine is “unsustainable because of falling birth rates, workforce challenges and the absence of neonatal special care baby unit facilities at the hospital”.

Board members were told of falling birth rates in the Causeway area and “higher risk” deliveries already take place at a different hospital. There were 862 births at Causeway Hospital last year.

Suzanne Pullins, director of nursing, told the board just 57 per cent of expectant mothers choose to have their babies at Causeway Hospital at present.

Some pregnant women who are assessed as “low risk” in the Causeway area will still be able to have a home birth. One of the options presented in the consultation was the possibility of a stand-alone midwifery-led unit at Causeway Hospital.

However, the Trust indicated this option cannot proceed at the current time ahead of the completion of a Department of Health (DoH) review that includes service provision at such units.

“Given the extreme fragility of maternity services in the Northern Trust, the midwifery-led unit option has therefore been discounted at the present time and will be kept under review pending the outcome of this DoH led review,” the Trust has said.

“It has therefore been concluded that the only viable option at this point is the transfer of all births to Antrim Hospital.”

The Trust’s recommendation will now be assessed by the Department of Health. Currently, there are two or three births daily at Antrim Hospital.

The board heard labour induction slots can be increased from five to seven days per week and 10 birthing rooms can be made available with a room retained for “emergency situations”.

Head of midwifery Caroline Diamond said: “We believe with contingency planning, we will be able to absorb any additional activity. We are confident we are able to respond to emergency and elective activity.”

Suzanne Pullins noted antenatal care would be provided at clinics in Causeway Hospital and a helpline would be available 24/7.

“In response to feedback, our priority is to provide safe and sustainable maternity services. We strive to ensure there is support for ante and post-natal care in the local community.”

The board was told travel is a “real concern” for some women and one of the key issues highlighted during the consultation.

The Trust acknowledged concerns over travelling to Antrim Hospital, in particular, for those who may experience a quick labour and birth before arriving at hospital. In 2021 and 2022, there were 14 babies born outside hospital.

However, it was stressed the recommendation is in response to “sustainability of service”.

Board chair Bob McCann asked if the Trust would consider locating its maternity unit in Coleraine instead of Antrim.

Dr Dave Watkins, the Northern Trust’s medical director, explained: “On the basis of infrastructure, it would be extremely difficult to shift neo-natal services into Causeway. It would be extremely challenging and not really feasible.”

“The majority of Northern Trust service users are not in the northern part of the Trust,” he added.

Mr McCann also asked why staff could not be rotated between the two hospitals.

Suzanne Pullins said staff would be “spread too thinly” and “less valuable travelling rather than in birthing rooms for the majority of their work”.

Dr Watkins added: “Only by consolidation of services we can increase resilience of the workforce going forward.”

Commenting after the meeting, he said: “Our ultimate aim is to have a new-build women and children’s unit on the Antrim Hospital site. This will provide high-quality, purpose-built accommodation for maternity and paediatric services.

“However, it is subject to business case approval and funding availability and is unlikely to be commissioned for service before 2027/28 at the earliest.

“In recommending the transfer of all hospital births to Antrim, that does not prevent us revisiting the possibility of setting up a midwifery-led unit in the Trust at some point in the future, should the outcome of the Department’s review offer that flexibility.”

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