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: Update on the Department of Health’s Level 5 Performance Accountability Process for Belfast Health and Social Care Trust
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Published at 2pm on Wednesday 22 October 2025
Mr Nesbitt (The Minister of Health): In my previous Written Statement to the Assembly published on 5 June 2025, I made clear my deep-seated concerns surrounding the findings of the Independent Review into the Cardiac Surgery service in Belfast HSC Trust and their potential wider applicability. I know Members across the House shared those concerns.
The behaviours detailed in the report were appalling and I committed to urgent action and oversight by way of engaging independent experts to support my Department's enhanced Support and Intervention processes, which were set at level 5, the highest level, for the Trust.
Since I last updated the Assembly, a significant amount of work has been completed, by the two independent experts I appointed, Mr Peter MrBride and Dr Jennifer Hill, and the Trust. This has been overseen at fortnightly oversight and accountability meetings managed by my Department and the Public Health Agency.
An action plan for improvement in relation to the specific Cardiac Surgery recommendations has been developed by the Trust and a number of actions have already been undertaken, relating to for example, Civility training, Governance and Leadership. The team have also had the critical support of one of the original report authors while they were developing and implementing appropriate actions to fulfil the recommendations.
I have today published the final report from my two appointed experts, and it is available on the Department's website via the following link:
www.health-ni.gov.uk/publications/mcbridehill-report-belfast-health-and-social-care-trust
The report is comprehensive and covers the response from the Trust on the specific recommendations of the original Cardiac Surgery report and their assessment of the degree to which the issues of poor culture and behaviours identified within Cardiac Surgery extended to the rest of the Trust. They also critically considered the management and governance oversight of issues and importantly, the effectiveness and level of staff confidence in the mechanisms for raising concerns within the Trust.
Their work included an open call for staff input by way of a questionnaire which was extensively shared across the Trust for a period of six weeks. This resulted in circa 17% or 3,429 Trust employees responding, with 710 providing follow up information and almost 200 requesting either an individual or group interview with the experts.
They also engaged widely with RQIA, NI Medical and Dental Training Agency, Patient and Client Council, Trade Unions, NI Public Service Ombudsman, Public Health Agency and the Department. They also sought out, or were contacted by, ex-employees of the Trust.
The McBride/Hill report has made 10 recommendations, the majority of which relate to action required by the Belfast Trust. However, there are also some which may support improvements across the region and my Department will ensure that any shared learning, or Departmental actions are promptly taken forward.
With an acceptance that culture change does not happen overnight, the Trust has been advised on the broad expectations which would form the Department's assessment of de-escalation. In short, this would require a significant demonstration of sustained improvement, implementation of all related recommendations for both Cardiac Surgery and across the Trust where appropriate.
To further support management reset and improvement, Mrs Jennifer Welsh has recently taken up post as the new Chief Executive of Belfast Trust and has been fully briefed by the independent experts and the Department and Public Health Agency.
I am confident that under Jennifer's leadership, the recommendations will be wisely considered and promptly implemented in the months ahead as the Trust moves through the implementation phase of the McBride/Hill recommendations.
As a further element of the support and intervention process and to assist the Trust Board, I have asked Dr Tony Stevens, former Chief Executive of the Northern Trust who was responsible for a significant turnaround in culture and performance at that Trust, to provide the Board with advice and support.
I also want to place on record my thanks for the ongoing support from Miss Patricia Gordon, who is the Trust's Vice Chair and current acting Chair while recruitment of a new Chair is underway.
Members will agree that patients and the safety of services provided to them must always be the overriding priority, and the Department will continue to monitor the Trust commitment to this in all its endeavours. It is important that the Trust continues to act openly and not be afraid to seek objective assessment, constructive challenge and learning from others. My support and intervention process seeks to assist the Trust in this regard.
In conclusion, I remain committed to ensuring that all staff across the HSC system experience work environments where they are valued and supported on a daily basis to perform according to their individual and collective strengths and where the enduring culture is one of openness, transparency, and respect.
Mike Nesbitt MLA
Minister of Health
