A recent review of the temporary suspension of emergency general surgery at South West Acute Hospital (SWAH) has concluded that no immediate patient safety concerns have arisen. However, the report highlighted several issues that need urgent attention to improve patient care and streamline surgical services at the County Fermanagh facility.
The suspension of emergency general surgery at SWAH occurred in December 2022, prompted by difficulties in recruiting permanent surgical staff. The Western Health Trust (WHT) announced the suspension as a necessary step to ensure patient safety, citing the inability to sustain the service without a full complement of experienced surgeons. While the suspension was framed as a temporary measure, no clear timeline for the resumption of services was provided.
The Regulation and Quality Improvement Authority (RQIA), which conducted the review, found that the suspension had not compromised patient safety in the short term. However, it also noted that patients faced significant challenges, particularly with transfers to other hospitals. Many patients assessed at SWAH were being transferred to Altnagelvin Hospital in Londonderry for surgery, where they often had to endure a “double wait” first at SWAH and then again at Altnagelvin’s emergency department. The review recommended that these patients be directly admitted to surgical wards at Altnagelvin to avoid unnecessary delays.
Furthermore, the review raised concerns over the adequacy of ambulance cover, given the increased number of transfers to Londonderry. The need for a review of ambulance provision was emphasized to ensure that patients could be transferred swiftly and safely in critical situations.
Trust Chief Executive Neil Guckian reiterated that the decision to suspend the service had not been made lightly. He expressed that the lack of permanent consultants meant that it was no longer possible to maintain emergency general surgery safely. Despite the suspension, Guckian noted that emergency general surgery patients transferred to Altnagelvin had shown good outcomes, with no indication that their condition worsened as a result of the change.
While the review report did not specifically address the decision to remove the emergency general surgery service, it has become a point of contention for campaign groups such as Save Our Acute Services (SOAS). The group has been vocal in its opposition to the suspension and has held meetings and vigils to demand the return of general surgery to SWAH. SOAS representative Donal O’Cofaigh criticized the report’s limited scope, stating that it failed to fully consider the implications of the service’s removal. He highlighted the long travel times up to two hours between SWAH and Altnagelvin, a distance that could be critical in emergency or trauma scenarios.
Health Minister Mike Nesbitt addressed the concerns raised in the review, clarifying that the report was an assessment of the arrangements put in place after the suspension, not a review of the suspension itself. While acknowledging that there were no immediate safety issues, Nesbitt noted that improvements were needed in patient pathways. He pledged to work with the Western Trust to implement the review’s recommendations and improve patient care.
In response to the ongoing concerns, SOAS has proposed a roadmap for the restoration of services at SWAH. Their plan suggests that the Department of Health should reinstate emergency general surgery, designate SWAH as a receiving center for major trauma stabilisation, and establish it as a center for specialist procedures. The group advocates for a more robust healthcare framework at SWAH that could help alleviate pressure on other hospitals while meeting the needs of the local population.
Emergency general surgery covers a range of critical procedures, including the treatment of acute abdominal pain, infections, bleeding, and trauma. Without timely intervention, these conditions can rapidly become life-threatening. The Western Trust had previously stated that SWAH dealt with about five such cases daily, a caseload that, in their view, was insufficient to support a dedicated surgical team. This decision to suspend services remains controversial, with local residents and healthcare professionals alike calling for a more sustainable solution that ensures accessible and timely care for all.
As the debate continues, it is clear that restoring and enhancing healthcare services at SWAH will be vital in addressing the community’s growing concerns and ensuring that patient safety remains a top priority.
