Read our proposals here: When Care Calls

Northern Ireland’s health and social care system is under sustained and growing pressure. Nowhere is this more visible than in emergency departments, where rising attendances, extended waiting times, and delays in patient flow have become persistent features of the system. These pressures are often framed as a consequence of increasing demand, but this explanation only tells part of the story. A key issue lies in how that demand is directed through the system.

Patients are required to make complex decisions about where to seek care, often in moments of uncertainty, and frequently without clear or consistent guidance. In the absence of a simple and recognisable access point, many default to emergency departments, even where more appropriate and timely care could be delivered elsewhere. This places unnecessary strain on acute services and undermines the efficiency of the wider system.

The result is a cycle of pressure. Emergency departments become congested with patients whose needs could be met in other settings, while those requiring urgent intervention face longer waits. Staff are left managing the consequences of a system that does not consistently guide patients to the right care, at the right time, in the right place.

There is now broad agreement that this model is unsustainable. The Department of Health has increasingly emphasised the need to “shift left”, moving care closer to home, strengthening community provision and focusing on prevention and early intervention. While this direction is both necessary and welcome, it relies on patients being able to access and navigate the system effectively. Without a clear and integrated front door to urgent care, the ambition to rebalance the system will struggle to deliver its full impact.

This report makes the case for the introduction of a single, integrated 111 service for Northern Ireland. Such a service would provide a 24/7 access point to urgent care, supported by clinical triage and direct booking into appropriate services. Properly implemented, it would improve patient experience, support better use of resources, and play a central role in reducing pressure on emergency departments.

It forms part of a series of proposals being brought forward by the SDLP aimed at delivering tangible improvements to our health service and ensuring that people can access care when they need it.