Northern Ireland

'Last chance saloon' for Northern Health Trust

Image caption The BBC understands there are to be few, if any, additional workers in the new unit

The opening of the new £14.2m emergency department at Antrim Area Hospital should be a time of great optimism and celebration.

But instead there is an air of nervous tension among staff no matter what their rank.

Not to put too fine a point on it - the Northern Health Trust is running out of chances and excuses. The pressure is now on to make this new building work.

But is the new build enough?

One of the biggest problems facing what will soon be referred to as the "old A&E" was lack of space.

Designed for about 40,000 people attending a year, most recently double that amount has been going through its doors.

The impact was a building left bruised and bursting at the seams; a workforce disgruntled and at breaking point.

In fact, several reports and reviews in the past two years have documented a catalogue of disasters.

The Rutter/Hinds review in 2012 was the most embarrassing. It criticised a "lack of dignity" in care and said systems were too bureaucratic. Clearly a larger building will not fix that.

In 2012, the Accident and Emergency department was "understaffed and under strain". While things have improved considerably, the hospital is continuing to breach its four hour targets. That said, so is every other health trust.

While a bigger space will help staff cope with larger numbers, the BBC understands there are to be few, if any, additional workers. That is what is required to make this large wheel turn; more nurses on the ground and more senior consultants working a seven day week.

Additional staff would mean those who already work there being allowed to do their job instead of constantly paddling up stream.

'Old fashioned principles'

It has been a turbulent ride. There have been three chief executives in as many years with the chairman, Jim Stewart, sacked by the health minister in the run up to Christmas.

Within months, the chief executive stepped aside to another job, this time in the health board.

Like many things in the health service, Sean Donaghy's salary will not change. Challenged on the floor of the Northern Ireland Assembly, the minister, Edwin Poots, said the decision was justified.

Interestingly, the two posts at the very top are temporary; let's face it who would want the responsibility?

While all eyes over the next few days are on the spanking new building, in the weeks and months to come focus will move to people.

The interim medical director is Calum McCleod. His wife, Olivia, is the director of nursing.

Mary Hinds and Paul Cummings are on temporary secondment from the Public Health Agency and the Health and Social Care board to lead the delivery of the change.

Mrs Hinds said on BBC Radio Ulster that deep down she was just an "old-fashioned girl with old fashioned principles".

Some would argue that a dose of some old fashioned care on the wards, including between managers and their staff, would go a very long way to get this new emergency department off to a very good start.

This really is the last chance saloon for the Northern Health Trust.

With the future of Causeway Hospital also in the balance it really cannot afford to mess this up.

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