Written Ministerial Statement

The content of this written ministerial statement is as received at the time from the Minister. It has not been subject to the official reporting (Hansard) process.

Department of Health - Ministerial Written Statement for the Assembly IRO of Accountability and Oversight Arrangements for the Implementation of the Belfast Trust Cardiac Services Review Recommendations

Published at 2.30pm on Thursday 5 June 2025

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Mr Nesbitt (The Minister of Health): The Assembly will be very aware of my deep-seated concerns at the findings of the Independent Review into the Cardiac Surgery service in Belfast HSC Trust. I know Members across the House share those concerns.

As I have stated publicly, the behaviours detailed in the report are appalling and bring shame on our health service.

I have left the Trust in no doubt that I expect a comprehensive response to the Review’s findings and recommendations. An action plan for improvement must be implemented with the urgency that is plainly required.

I have held meetings within the past week with both the Belfast HSC Trust Chair, Mr Ciaran Mulgrew, and trade unions and professional bodies. These meetings have been and will continue to be important – our discussions have been informative, constructive and challenging where necessary.

Further engagement is planned in the weeks and months ahead. I am determined that this issue will receive the attention and focus it deserves.

Last week, I announced that I was finalising a series of Departmental interventions. The purpose of this Written Statement is to detail these interventions.

I can today inform the Assembly that the Department’s performance accountability process for Belfast Trust has been raised to Level 5, the highest level.

Level 5 is set out within my Department’s Support and Intervention Framework (SIF), which is overseen and managed by DoH’s Strategic Planning and Performance Group (SPPG) and the Public Health Agency (PHA).  This level is expected to be required in only the most serious and exceptional cases.

A decision to escalate any HSC organisation to the highest level in the SIF framework is taken by myself as Minister with advice from senior officials.

As Members will be aware, the Independent Review into the Cardiac Surgery service was commissioned by SPPG and PHA in 2024 to assess the impact of ongoing team issues on the safety and quality of the service. The publication of the report and the serious information it contained clearly underscored the need to increase the level of escalation.

Level 5 intervention is not about blurring lines of responsibility. To be clear, it is the responsibility and duty of Belfast Trust – its senior executives and Board – to deliver the action plan for improvement, and to ensure that it leads to tangible improvements in the culture and working environments for this important service in Belfast Trust.

Level 5 is about ensuring support, oversight and sustained focus. It will assist the Trust to achieve stabilisation, ahead of its management reset with the appointment of a new chief executive.

To that end, I am putting in place external expert support for the Trust and have enhanced Departmental accountability, now formalised as a Departmental Accountability Team.

The first individual who has agreed to form part of my intervention team is Peter McBride, who has extensive experience in senior leadership across public and third sector organisations. I have known Peter for seventeen years and trust him implicitly. His area of expertise includes working place culture and behaviours. Peter has previously reported to the Board of the Belfast Trust on workplace issues. I have asked him to form a view on how widespread the cultural and behavioural issues evident in the cardiac surgical unit may be across the Belfast Trust. That will inform next steps.

The second individual, whom I hope to name soon, is an expert on clinical cultural change.

I have emphasised the need to ensure that the overall culture of the entire HSC system is welcoming for all those who work there. Every employee with concerns about bullying or other unacceptable behaviours must be properly listened to and supported.

I know all Members will agree with me that patients and the safety of services provided to them must always be the overriding priority.

Notwithstanding the damning findings of the Independent Review, we can draw some comfort from its observation that outcome data reviewed for the Royal Victoria Hospital’s cardiothoracic services compared favourably with all UK benchmarked data.

I know Belfast Trust has been working actively to reassure patients.

I have asked the Patient and Client Council (PCC) to work with the Trust to support those who may be concerned by recent revelations. The PCC acts independently to provide advocacy support and advice to the public in health and social care. The PCC can be contacted by email at info@pcc-ni.net or via their Freephone number 0800 917 0222, where their independent services can be directly accessed.

They will work with the Trust and members of the public to ensure individuals get the information, advice and support they need to feel assured about their forthcoming treatment or to raise any concerns they have.

It is important that we build and maintain public trust in this regional cardiac surgical unit.  I am committed to ensuring that the patient’s voice and lived experience is at the core of how we respond. Likewise, I am also committed to ensuring that all staff across the HSC system come to work in environments and settings which support and value them and enable them to give their best to the patients they serve. We are all patients or prospective patients, so we all have a key stake in ensuring that care is delivered in a safe, courteous and compassionate environment.

A year ago, I said I wanted every action I take as Minister to be judged by whether it delivers Better Outcomes – for patients, service users and each and every individual delivering healthcare in Northern Ireland. That remains my motivation.

The independent report on the cardiac surgery unit makes recommendations. I shall be meeting the Trust chair again later this month to receive an update.