TRADE unions representing frontline workers have written to Belfast trust chiefs warning of a "total breakdown" of services and staffing due to escalating pressures.
In a letter seen by The Irish News, members of Unison, Nipsa, the British Medical Association and the Royal College of Nursing outline their fears for the months ahead at a time when the workforce is facing severe shortages.
The correspondence was issued to trust chief executive, Dr Cathy Jack, and sets out the need for an urgent meeting with her, the organisation's executive team and trust board officials.
High vacancy levels, increased sickness rates, stress, exhaustion and an "ever growing" staff retention problem are among the difficulties cited, with unions noting "winter pressures have been here all year".
It is understood the meeting took place yesterday - a week after eight ICU nurses quit their jobs due to burnout.
There are also mounting concerns about staff cover over Christmas, with sources revealing that some bigger agencies have written to the trust about limited availability from the third week of December to early January - saying they cannot guarantee the numbers they're currently providing.
The letter states: "While management and trade unions share the same concerns and agree on many issues in relation to the current situation, we are highly concerned that the perfect storm of problems...will cause a total breakdown of staff and services."
Sources say there are growing calls to incentivise bank nurses to work extra shifts by increasing their pay rates to allow permanent frontline staff Christmas leave.
Fears have also been expressed about GP cover over the festive period following the suspension of the Beldoc out-of-hours service over several weekends in the summer.
The correspondence warns of the "the inability to deliver safe and effective care when there are insufficient staff and resources".
The unions stress the need for nursing and social work staff to be retained with more support for community services.
"People are the most important bit of this crisis, therefore we need to enable and empower HR to urgently address issues identified in this crisis," the letter adds.
"We are not asking you or the trust board to resolve all the problems facing the service but to take on board our honest concerns for staff and the patients of the Belfast trust."
The Belfast trust last night said it remains under severe pressure and shares the unions' concerns.
A spokeswoman confirmed it had facilitated a series of meetings with union representatives and senior trust managers to "identify solutions to safeguard services over the coming weeks as well as considering longer term solutions".
She added: "We have developed a Winter Workforce Plan and have agreed a number of actions to enhance staffing. Our patients remain our first priority and we will continue to work in partnership to support our staff and ensure the delivery of high standards of patient care."
