'It's dangerous': Campaigners reiterate concerns over SWAH emergency surgery suspension

More than 80,000 patients in Fermanagh and parts of Tyrone are located further than one hour from their nearest type 1 emergency department (ED), campaigners have claimed.

The data has been collated by those behind a campaign to save currently suspended general emergency services at the South West Acute Hospital (SWAH) in Fermanagh.

Emergency surgery was suspended at the hospital on 18 December 2022, with the Western Trust saying that was "unplanned" and partly down to a shortage of suitable consultants.

A consultation remains open until April, and the Department of Health (DOH) insists that the SWAH is still a type 1 ED.

There have been a number of protests since the decision last year, with the community outraged, as many fear it will become permanent. 

Speaking to UTV, campaigners described the changes as "dangerous" and "criminal". Some fear for their jobs, and many fear for their lives in the case of traumatic incidents or emergencies.

On Tuesday, campaigners presented their findings to local councillors at a meeting in Enniskillen.

Before that, crowds gathered for a peaceful protest outside.

Benny Cassidy, who is a medical porter at the SWAH, was among them.

"We have bad roads, we have a lot of farm machinery and everything that will slow down transport and it seems to be that they don't have a lot of ambulance service as it is," he said.

Inside the chamber, members of the public assembled and listened to the research given by Save Our Acute Services members to the local councillors.

Local solicitor and chair of the group, Reggie Ferguson, said that it was clear that since the pre-Christmas decision to suspend some services, things "have taken a turn for the worse" for the hospital that "was once a source of great pride and joy".

Kicking off proceedings, he said Fermanagh and Tyrone natives are "entitled to the same services as everywhere else."

Figures presented to those in attendance included claims that sending patients to the Altnagelvin Hospital in Londonderry means more than a two hour long journey for some, and a travel time of longer than one hour for every single person who lives in County Fermanagh and thousands more in parts of County Tyrone.

This, they said, is outside of the so-called "golden hour", during which patients are said to have the best chance of recovery.

However, a statement from the Western Trust and DOH said that in some ways, the golden hour concept is outdate, and that updated ways of dealing with trauma mean patients in need of orthopaedic surgery are never sent to a hospital where this cannot be provided.

"There have been multiple studies carried out across the world which have failed to find any significant survival advantage for trauma patients with shorter pre-hospital rescue times," the statement said.

It continued: "Trauma care has changed beyond recognition in the past decade initially across England, Scotland and Wales and more recently across Northern Ireland and ROI. Patients are now preferentially taken to the most appropriate hospital first for trauma care.

"Of note across GB, no patient with major trauma would be taken to a hospital which did not have Orthopaedic surgeons on site.

"The Northern Ireland Trauma Network set up a trauma triage tool which helps paramedics take more patients to the RVH which is the trauma centre and bypasses multiple other hospitals.

"Effectively Antrim, Ulster and Craigavon hospitals are bypassed in the majority of cases of significant trauma and the patient is taken to the RVH as the main trauma centre.

"Altnagelvin sees approximately one third of the numbers of patients with significant trauma that attend the RVH trauma centre.

"The RVH has also initiated a call and send model – this allows for a patient who fulfils major trauma criteria to be rapidly transferred from any ED to the RVH for ongoing management."

Essam Ghareeb, a well known retired consultant surgeon in the area, told the chamber that the solution, in his view, is that the SWAH stays as an acute hospital and that surgical specialties are created.

The Department for Health said it categorises Emergency Departments under three categories.

Type 1 is described as a "consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services 24 hours a day".

The statement also said that the "removal of general emergency surgery from SWAH does not change its Type 1 ED status.”

Meanwhile, the Western trust explained that the suspension of acute services was unplanned, and that a consultation remains open until April.

It has blamed the move on staff shortages and said it's actively trying to recruit surgeons. 

The Western Trust said both it and the Department for Health "are fully committed to the sustainability and the future of Obstetric and Gynaecology Services, including all Maternity services, at the South West Acute Hospital, Enniskillen".

"South West Acute Hospital (SWAH) is funded for 6 whole-time equivalent Consultant Obstetricians. Six Consultants are currently on the rota and the rota remains stable. This currently includes locum consultant cover due to sickness absence and cover for a Consultant who left to take up a post elsewhere. This would be a standard process for any service," the statement added.

"It is also important to provide some context again that the Health Service as a whole,throughout the UK and ROI, continues to experience ongoing challenges and pressures which has been seen in all Acute Hospitals in Northern Ireland. As a smaller rural Hospital, South West Acute Hospital has been and will continue to face workforce challenges."

In relation to emergency general surgery the statement read: "The Trust launched a 12 week public consultation on the temporary change to Emergency General Surgery at South West Acute Hospital, Enniskillen on 17 January 2023.

"Having already facilitated seven face-to-face public engagements across the Fermanagh and Omagh Council area, there are two further public virtual meetings now also to be facilitated, as well as ongoing engagement sessions for staff. The consultation will close in April 2023 and the outcome of the consultation will be considered at a Trust Board meeting in the Summer 2023."

Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To Know.