Children's heart surgery to move from Belfast to Dublin
Northern Ireland's health minister has backed the establishment of an all-Ireland children's heart surgery centre in Dublin in the Republic of Ireland.
It means surgery in Belfast's Royal Victoria Hospital will cease.
Jim Wells made the announcement to the assembly on Tuesday, following a review of children's cardiac services.
In 2012, it emerged that services at the Royal were not sustainable with many operations taking place in either England or Dublin.
Mr Wells, a Democratic Unionist Party minister, told MLAs he was recommending the implementation of a new cross-border model of co-operation that would "deliver safe and effective cardiac care to children in Northern Ireland".
Children's heart surgery for the whole of Ireland will be based at Our Lady's children's hospital in Crumlin, south Dublin.
The Royal in Belfast would develop as a centre for diagnostics and cardio interventions.
Mr Wells said a single children's heart centre in Dublin would see children being treated in accordance the highest standards of care.
He said the model provided significant opportunities for enhancing the support available to families, involving their representatives, as well as clinicians, in governance arrangements and improving communication and the flow of information between clinical teams in Dublin and Belfast.
Analysis: BBC News NI health correspondent Marie-Louise Connolly
A leading international surgeon who has advised on the future of children's heart surgery in Northern Ireland has said there is a real willingness to make an "all-island" solution work.
In 2013, Dr John Mayer, was asked by the Department of Health in Northern Ireland to review existing services.
He looked at those in Northern Ireland and the Republic of Ireland.
His conclusion and recommendations will have major ramifications for the Northern Ireland health service.
In an exclusive interview with the BBC, the professor of surgery at Harvard Medical School said what was required was not difficult and should be achievable in a relatively short space of time.
The international panel that examined the cardiac services was chaired by leading surgeon Dr John Mayer from Boston.
In his report to the Department of Health in Northern Ireland he said surgical care of all children should be transferred to Dublin.
In a statement, Mr Wells and his counterpart in the Republic of Ireland, Leo Varadkar, said: "We recognise fully the importance of clarity for patients, their families, clinicians, and other stakeholders on the immediate implications for service delivery.
"The immediate impact of the removal of surgery from Belfast is that more children from Northern Ireland are likely to receive elective surgery at a specialist centre in Great Britain, as required, until appropriate capacity is in place in Crumlin."
In 2012, a national report said that that while safe, the unit at the Royal in Belfast was not sustainable. It said such cardiac centres across the United Kingdom must perform a minimum of 400 children's surgical procedures each year.
Hundreds of families have campaigned for heart surgery to be retained in Belfast.
Sarah Quinlan of the Children's Heartbeat Trust, an organisation that supports families of children with heart disease, said it was "very disappointing" to hear that surgery will be moving to Dublin.
"What this report does offer us, at last though, is an actual roadmap as to how they plan implementing this," she said.
"What really seems to be key within it (the report) is that this is a partnership.
"It isn't about Dublin, a one way road to Dublin but that Belfast is strengthened and enhanced and there's a lot of work and finance put into our cardiology in Belfast to ensure that children can receive the vast majority of their care still in Belfast.
"We would strongly say that at first sight all of these recommendations need to be implemented if this is going to work at all."
Key recommendations in the report:
•Establishing a family advisory group
•Establishing an single governance committee
•Establishing a database of congenital heart disease patients
•A flow of expert personnel between the two jurisdictions
•Expansion of paediatric cardiac ICU capacity in Dublin to at least 10 fully staffed beds
•Expanding and upgrading telemedicine links between Northern Ireland and the Republic
•Changing focus in Belfast to elective and lower complexity adult congenital cardiac services
•Enhancing services for all patients and their families who do not reside in Dublin
•Integrating the activities of advanced practice nurses to provide patient and family support and manage the transfers between Belfast and Dublin
•Establishing quarterly meetings between paediatric and neonatal transport services in both jurisdictions to facilitate safe transfers between outlying areas and Belfast and Dublin
•Continuing the upgrade of paediatric transport services
•Expanding case conferences to include cardiologists from Belfast Trust
•Monthly review conferences including cardiologists from both jurisdictions
•Mandating an annual symposium to include assessment of the current system