New ED consultants will strengthen under pressure workforce, says minister
The Department of Health said some of the consultants are already in post, with the others set to begin in their roles across all five health trusts by the end of the year.
It said funding for the new posts comes from reducing spending on locum doctors in emergency departments and that it comes as part of work to find roles for newly-qualified consultants in the health system.
Mike Nesbitt said everyone was "acutely aware of the very significant pressures" on emergency departments.
"Both staff and patients want us to do all we can to alleviate those pressures and that's been a central focus for my department and trusts in recent months."
He added that, at a meeting with the Royal College of Emergency Medicine (RCEM) last year, he recognised that it was "incongruous" for Health and Social Care (HSC) to train emergency medicine doctors but then have no vacancies for them, while also "spending around £30m a year on locum cover for emergency departments".
Prof Lourda Geoghegan, deputy chief medical officer, said she was "very encouraged" by early reports on the impact of the new consultants, who had not only helped reduce locum spending but also increased the "presence of senior decision-making in emergency departments".
Dr Russell McLaughlin, vice chair of RCEM Northern Ireland, said its research showed there was a critical shortage of emergency medicine consultants, with only half the recommended number in place.
"The need for expansion is clear," he added.
"It's vital our departments have these senior decision makers, who are qualified and ready to step into these roles, which are critical for patient safety."
Northern Ireland's emergency departments have been under severe pressure for years.
On New Year's Eve figures showed that more than half of the 892 people who attended emergency departments (EDs) had to endure a wait of more than 12 hours.
Figures released by the Department of Health (DoH) revealed that there was a 7.6% increase in hospital attendances over a 12-month period, with 63,347 attendees in December 2024 compared to 58,875 in December 2023.
Dr McLaughlin said the situation in EDs was "deteriorating" as the health service "pushed through" another "hugely challenging winter".
The figures showed that the number of ED attendees waiting more than 12 hours in December 2024 was 12,281, an increase from 10,597 in December 2023.
The number of patients discharged or admitted within the target of four hours was highest in October 2024 (45.6%) and lowest in December 2024 (40.6%).
Compared to December 2023, fewer people (-1.4%) spent under four hours in emergency departments, which had a figure of 42%.
ED situation 'deteriorating', NI doctors warn
Emergency departments have no space, says doctor
'We're at breaking point' - says ED doctor
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Medscape
22 minutes ago
- Medscape
New First-Line Option for Advanced Bladder Cancer
The National Institute for Health and Care Excellence (NICE) has recommended the combination of enfortumab vedotin (Padcev, Astellas) with pembrolizumab (Keytruda, MSD) as a first-line option for adults with unresectable or metastatic urothelial cancer who are eligible for platinum-based chemotherapy. More than 1200 people in England are expected to benefit each year. Clinical experts described the combination therapy as a "step change" in bladder cancer management. Until now, treatment options for this patient group have seen little meaningful progress since the 1980s. Enfortumab vedotin is an antibody-drug conjugate consisting of an antibody targeting Nectin-4, a protein highly expressed in urothelial carcinoma cells. After binding, it causes the cells to release monomethyl auristatin E, resulting in cell death. Pembrolizumab, its combination partner, is a PD-1 inhibitor. High Disease Burden Urothelial cancer accounts for around 90% of bladder cancers, affecting more than 18,000 people annually in England. Prognosis is poor, with only 10% of patients with stage 4 disease surviving for 5 years or more. Current standard treatments include platinum-based chemotherapy ( cisplatin or carboplatin with gemcitabine), followed by avelumab maintenance therapy if the cancer has not progressed. However, only about 12% of patients see improvement with chemotherapy, underscoring the need for better options. Patient experts described living with metastatic urothelial cancer as "intensely challenging and emotionally exhausting', affecting work, travel, and physical activity. Action Bladder Cancer UK called the announcement a 'very welcome, and significant, step forward for this hard-to-treat cancer'. Clinical Evidence The recommendation in final draft guidance was supported by results from the phase 3 EV-302 trial, which enrolled 886 adults with untreated, unresectable, locally advanced, or metastatic urothelial cancer. Participants were randomly assigned in a 1:1 ratio to receive either enfortumab vedotin–pembrolizumab or standard chemotherapy. Enfortumab vedotin–pembrolizumab nearly doubled the median time to disease progression or death to 12.5 months, compared with 6.3 months for chemotherapy. Median overall survival was also improved, at 33.8 months versus 15.9 months with chemotherapy. Helen Knight, director of medicines evaluation at NICE, said the drug combination is 'highly promising and effective,' adding that these clinical trial results highlight the 'tremendous difference' it could make to the length and quality of people's lives. Cost and NHS Access Enfortumab vedotin is listed at £578 per 20 mg vial or £867 per 30 mg vial. Pembrolizumab costs £2630 per 100 mg vial, excluding VAT. The drugs will be supplied through confidential commercial arrangements with the NHS. NICE's appraisal committee applied a severity modifier, reflecting the high disease burden, and concluded that the therapy met acceptable cost-effectiveness thresholds. The treatment will be available immediately across the NHS in England, with funding required within 90 days of final publication of the guidance.
Medscape
an hour ago
- Medscape
Safety Watchdog Flags Ongoing Maternity Risks
The Health Services Safety Investigations Body (HSSIB) has released a preliminary report on maternity and neonatal safety in England. The exploratory review, carried out in spring 2025, highlighted concerns across the entire maternity and neonatal care pathway despite years of initiatives aimed at improvement. The review comes after a series of high-profile scandals, including at Shrewsbury and Telford Hospital NHS Trust and Nottingham University Hospitals NHS Trust. The Shrewsbury inquiry, led by senior midwife Donna Ockenden, found that approximately 201 babies and nine mothers might have survived if they had received better care. The Nottingham review — also led by Ockenden — remains ongoing. Safety Concerns and Baby Deaths The HSSIB's latest report indicates that safety concerns persist. Between October 2023 and June 2025, the board received 35 reports of safety concerns in maternity or neonatal services. These accounted for about 10% of all safety concerns received during that period. All cases involved "very serious harm", including 10 baby deaths. Sixteen incidents occurred during labour, and 12 during the neonatal period. Most reports came from women or family members, although some were submitted by healthcare staff. Full Investigation Paused The board had begun a scoping exercise to assess the need for a full investigation. However, the work was paused in June after the Secretary of State for Health and Social Care announced a national investigation into maternity and neonatal services, due to report in December 2025. Health Secretary Wes Streeting said that multiple reviews into local trusts had found "similar failings in compassionate care" after maternity service failures "that should never have happened". He acknowledged "systemic" failings dating back more than 15 years and said families had been "gaslit" in their search for answers about their babies' deaths. Although pausing its work, the HSSIB published its exploratory findings to support the national investigation. These were based on the 35 recent safety reports, meetings with 17 stakeholders, and a 2021 report by its precursor organisation, the Healthcare Safety Investigation Branch. 'Compounded Harms' to Families The report identified 11 key themes. Progress had been made in maternity and neonatal outcomes, staffing levels, and governance, but disparities in care and outcomes persisted, partly due to health inequalities. The HSSIB found that maternity and neonatal systems were overly complex, with inconsistent collaboration and poor information sharing. Local governance often operated in isolation, and services struggled to identify and respond to clinical risks or to learn from the harms that happened to women and babies during pregnancy, labour, and birth. "Patients experience compounded harm due to issues within the wider healthcare system," the report concluded. It highlighted that local investigations, complaints processes, and legal proceedings such as inquests often caused additional harm. "Staff and trusts can lose sight of compassion during this process," it said. Four Areas for Further Review The HSSIB recommended four areas for potential further investigation: National structures responsible for providing direction and oversight for maternity services. Local governance and its relationship to national bodies. Standards and approaches of local investigations when things go wrong. Education, training, and professional standards for clinicians. Staff Experience Cumulative Stress The report said that maternity and neonatal staff also experienced cumulative stress and harm. It raised concerns about the standards set in undergraduate and postgraduate education, and whether these could be met in practice, noting that too many recommendations were being made, with limited implementation. The HSSIB warned that multiple, high-profile maternity investigations and inquiries had eroded public confidence in maternity services. Some women were avoiding hospitals that had been the focus of national investigations, undermining recruitment and damaging staff morale. The report cited instances of midwives receiving death threats or being berated for working in 'failing' services. Stakeholders had told the HSSIB that clinicians had also become more risk-averse for fear of blame, a defensive approach that "drives the behaviour that compounds the harm women and families experience".
Medscape
5 hours ago
- Medscape
Vitamin D Deficiency Tied to Cataract Risk in Young Adults
TOPLINE: Severe deficiency of vitamin D (< 25 nmol/L) has been associated with a significantly increased risk for cataracts, particularly in people younger than 50 years. METHODOLOGY: Researchers examined cross-sectional and longitudinal associations between serum levels of 25-hydroxyvitamin D and the risk for cataracts, using data from the UK Biobank. The cross-sectional analysis included 442,255 participants with data on serum levels of vitamin D; among them, 427,923 participants (mean age, 56.2 years; 53.6% women) without cataracts at baseline were followed up for an average duration of 10.8 years in the longitudinal analysis. Based on serum levels of vitamin D at baseline, participants were categorized into those with severe deficiency (< 25 nmol/L), moderate deficiency (25-49.9 nmol/L), insufficiency (50-74.9 nmol/L), or sufficiency (≥ 75 nmol/L). Cases of cataracts were confirmed from hospital records and self-reported information. TAKEAWAY: Of the 442,255 participants in the cross-sectional analysis, 3.24% had cataracts, and of the 427,923 participants in the longitudinal analysis, 13.02% developed the condition. In cross-sectional analyses, individuals with vitamin D levels < 25 nmol/L had a 12% higher risk for cataracts than those with levels ranging from 50 to 74.9 nmol/L (adjusted hazard ratio [aHR], 1.12; 95% CI, 1.04-1.21). In the longitudinal analysis, participants with vitamin D levels below 25 nmol/L had an 11% higher risk of developing cataracts than those with levels of 50-74.9 nmol/L (aHR, 1.11; 95% CI, 1.07-1.15); the risk was even greater among people younger than 50 years (aHR, 1.27; 95% CI, 1.07-1.49), whereas those aged 60 years or older had a 9% increased risk (aHR, 1.09; 95% CI, 1.04-1.14). IN PRACTICE: 'The study identified significant cross-sectional and prospective associations between vitamin D deficiency and increased cataract risk, with younger individuals being more susceptible,' the researchers reported. 'These findings suggest a potential critical period in early adulthood when vitamin D supplementation may be most effective for cataract prevention, warranting further investigation into age-specific intervention strategies,' they added. SOURCE: This study was led by Yu Peng and Yuzhou Zhang, of the Chinese University of Hong Kong, Hong Kong, China. It was published online on August 18, 2025, in the British Journal of Ophthalmology. LIMITATIONS: Not all cases of cataract may have been identified in this study. This study relied on baseline measurement of vitamin D levels, which did not account for variations during the follow-up period. The findings may not be generalizable to other populations as nearly 95% of participants in the UK Biobank were of White ethnicity. DISCLOSURES: This study was supported partly by the General Research Fund, Research Grants Council, Hong Kong; Collaborative Research Fund; Health and Medical Research Fund, Hong Kong; and other sources. The authors declared no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
