26 risks identified by Western Trust at Altnagelvin
Obstetrics and Gynaecology consultant workforce on Trust’s Corporate Risk Register
Western Health and Social Care Trust currently has 26 identified risks on its Corporate Risk Register, including the Obstetrics and Gynaecology consultant workforce at Altnagelvin.
According to the Corporate Risk Register and Assurance Framework briefing note prepared for the Trust Board meeting of May 7, 2026, the 26 risks were approved at the Trust Board meeting of March 5, 2026.
The risks also include, areas of concern in the Phlebotomy Service, which conducts blood tests; and children’s safeguarding documentation on encompass, the newly-introduced single, digital care record for every person in the North.
In terms of Obstetrics and Gynaecology, the briefing note states that the post for a clinical lead in the northern sector of the Trust, which serves Derry, Strabane and Limavady, remains vacant.
The Friday antenatal clinic has also been stood down “due to reduced obstetric staffing” and the preterm birth clinic was “unable to be established”.
There is currently no colposcopy lead for the Trust. A colposcopy is a detailed 15-to-20 minute examination of a woman’s cervix using a magnified microscope (colposcope). It is typically recommended after an abnormal cervical screening (smear) test to identify or treat abnormal cells before they can turn into cancer.
In addition, the briefing note states the Trust has a Perinatal Mortality Review Tool (PMRT) backlog of cases because “only two consultants have two hours per week to review cases”.
The PMRT is a standardised clinical review system used by maternity and neonatal units to investigate stillbirths, neonatal deaths, and post-neonatal deaths. It helps healthcare professionals and parents understand the circumstances of a baby’s death and identify areas where care can be improved.
At the May Trust Board meeting, a new risk regarding the Phlebotomy Service was also added to the Corporate Risk Register, from the Unscheduled Care, Medicine, Cancer and Clinical Services Directorate Risk Register.
‘Trust has a Perinatal Mortality Review Tool (PMRT) backlog of cases because “only two consultants have two hours per week to review cases’
The Trust Board briefing note explained: “With the introduction of Encompass this has affected the WHSCT phlebotomy services including; user errors – requesting bloods and not completing several different new workflows; no administrative resources; and increased workloads not manageable on snap boards
“The phlebotomy workload in WHSCT has been impacted, as a result of the Northern Ireland General Practitioner (GP) contract being imposed for 2025/2026.
“GP practices across the region are taking collective action to protect the future of General Practice and manageable workloads. Therefore, from September 2025 the GP practices will no longer be able to carry out tasks requested by secondary care, which includes blood tests ordered by hospital specialists.
“This has resulted in a significant increase in the referrals to the WHSCT phlebotomy services for taking secondary care bloods. .
“Some funding has been approved to stabilise the service however this is not yet in place. This funding will not address the user errors identified.
“With the impact of encompass workflow change evident, the development of the phlebotomy hub staffing model in the WHSCT requires future investment opportunities.
“With the limitation of space within the Outpatient Department the staffing model development would be the quickest and most cost effective pathway to stabilize phlebotomy services in the WHSCT,” it concluded.
Children’s Safeguarding Documentation on encompass has also been identified on the Trust’s Corporate Risk Register.
The Trust is progressing with a pilot project regarding the management of children’s safeguarding documentation on encompass, according to May’s briefing note.
“The pilot will ensure that children’s safeguarding documentation is behind appropriate Break the Glass so that information is available as required for safeguarding purposes and in line with sharing to safeguard principles,” it stated.
‘From September 2025 the GP practices will no longer be able to carry out tasks requested by secondary care, which includes blood tests ordered by hospital specialists’
“This will mean that staff will be able to ‘break the glass’ using their password and record their rationale for doing so in order to see children’s safeguarding documentation,” it added.
“This creates a new potential risk for safeguarding documentation to be accessed inappropriately.
“It is the assessment of professional social work that the risk of information being accessed inappropriately is more palatable than information being on the system and not being available to staff when it may be required for the purposes of safeguarding.”
Regarding child safeguarding, a spokesperson for the WHSCT told The Derry News: “Children’s Social Work and Social Care services are not yet live on the encompass system. To support safe information sharing in the meantime, a Children’s Safeguarding Encounter has been developed to allow staff to securely store and access safeguarding documentation where required. This functionality has been in place since November 2025.
“On behalf of the region, the Trust will commence a 12‑week Children’s Safeguarding Documentation Pilot from May 26, 2026. This pilot will test how safeguarding information is accessed and managed within the system with the aim of ensuring that staff who require access to safeguarding documentation will have the ability to access the correct information at the correct time to allow safeguarding steps to be taken if required.
“Robust safeguards are in place. During the pilot, all access to safeguarding records will be monitored. Oversight will be reported through established governance arrangements, including a multi‑disciplinary Risk Monitoring Group and regional encompass structures.
“This approach is designed to support safe, controlled access to safeguarding information while Children’s Social Work and Social Care services continue towards full implementation on encompass.”
In terms of, Phlebotomy, the spokesperson said: “The Western Trust is aware of increased pressures on its phlebotomy services. These pressures are driven by a combination of factors, including changes to regional GP arrangements and the introduction of new digital systems.
“The Trust is actively working to manage this increased demand and to ensure patients continue to receive safe and timely care. Actions include reviewing service capacity, progressing additional support for the service, and continuing to refine processes following the implementation of the encompass system.
“Additional funding has recently been secured to support improvements within phlebotomy services. This will enable the Trust to strengthen the phlebotomy booking function, helping to ensure patients are scheduled appropriately, and to provide a targeted increase in frontline staffing to better meet demand.
“Work is also ongoing to develop more sustainable service models to support demand over the longer term.
“Patient safety remains our priority, and we are working closely with regional partners to ensure services are delivered as effectively as possible.”
The Trust spokesperson added, in relation to the Obstetrics and Gynaecology consultant workforce that it has “experienced workforce challenges within its obstetrics and gynaecology services at Altnagelvin Hospital.
“We are pleased that recent recruitment has been successful, strengthening the consultant workforce and supporting the continued delivery of safe and effective services for women and families.”