Emergency general surgery to be temporarily withdrawn from the South West Acute Hospital
The hospital in Enniskillen is the only one in County Fermanagh
The Western Health Trust blames a shortage of consultants to carry out the surgery
The move means patients will have to travel miles for surgery at other hospitals
The emergency department and other services will continue to operate as normal
In a further move the hospital is to become Northern Ireland's third elective surgical hub
That's all from us for tonight.
There'll be lots more reaction across BBC News NI tomorrow, starting on Good Morning Ulster on BBC Radio Ulster from 06:30 GMT.
We'll have follow-ups on the BBC News NI website and on BBC Newsline and BBC Radio Ulster bulletins throughout the day.
Goodnight for now.
BBC News NI
We're drawing our live coverage to a close shortly but we'll leave you with a summary of the big announcement this evening.
Emergency general surgery is to be temporarily withdrawn from the South West Acute Hospital (SWAH) in Enniskillen, says the Western Health Trust.
Image source, PacemakerThe trust says the decision is necessary to protect the public's safety after it had problems recruiting surgical staff.
Despite saying the move is temporary, the trust isn't saying when it expects emergency general surgery will resume at the hospital.
The emergency department and other services including obstetrics will continue to operate as normal.
About four or five patients a day will be affected by the decision to halt emergency general surgery at the South West Acute Hospital, according to the Western Health Trust.
Its medical director Dr Brendan Lavery expects that those operations will instead take place at Altnagelvin Area Hospital in Londonderry, with the possibility of using Craigavon Area Hospital for some cases.
Dr Lavery says he wants to reassure the public there are "no planned changes of any kind" to emergency C-section births after a review of the hospital's maternity services.
“We have no intention or plans of making any other changes,” he says.
Matt Fox
BBC News NI
"I was ordered out the house by my mother… she said: 'The fish and chips can wait until later - your life depends on this.'"
Anna Hassard from Enniskillen followed her 85-year-old mother's order to get down to the Town Hall to protest about the "absolutely shocking" news about the cut to emergency general surgery at the South West Acute Hospital.
Ms Hassard says: "She’s very upset by it - she wouldn't be fit to travel up that road [to another hospital]."
The South West Acute Hospital (SWAH) is not the only hospital in Northern Ireland to have faced difficulties with its emergency general surgery service.
Daisy Hill Hospital in Newry announced a temporarily halt to emergency surgery from the end of February this year due to a shortage of staff.
Only one of six general surgical consultant posts were filled at the time so patients in the Southern Health Trust were being sent to Craigavon Area Hospital instead.
In June the Department of Health published a review of general surgery across Northern Ireland.
The report highlighted the workforce difficulties and raised the potential for planned surgical hubs that would become centres of excellence for planned, non-emergency surgery.
Matt Fox
BBC News NI
Diane McCaffery thinks the decision to cut emergency general surgery at the South West Acute Hospital (SWAH) is "shocking".
She and her husband Eunan are among the protesters outside Enniskillen Town Hall.
Eunan and Diane McCaffery are attending a meeting at Enniskillen Town Hall
Ms McCaffrey is a retired emergency care manager from the cardio assessment unit at the SWAH and says she has seen how emergency surgery has saved lives.
"Fermanagh are the poor relatives of this country... the west has been forgotten about,” she says.
She explains that a burst appendix could turn septic by the time it takes a patient to get to Altnagelvin Area Hospital in Londonderry or Craigavon Area Hospital for surgery.
DUP MLA Deborah Erskine says that she understands the concerns of her constituents in Fermanagh and South Tyrone about the withdrawal of emergency general surgery at the South West Acute Hospital.
But she says there is good news for the hospital's future with the announcement that it is to become a new centre for planned surgery.
"The pressures with surgeons date back to 2018 in the Western Trust," she says.
"We need to have a system, we need to have a way forward in which we ensure services are safe for both the workplace in the SWAH and also for our patients."
Increasing subspecialisation within general surgery is one of the main difficulties when it comes to recruiting staff to provide emergency services at the South West Acute Hospital, according to the medical director at the Western Health Trust.
Dr Brendan Lavery says the general surgeon "that was trained 20 years ago quite frankly doesn’t exist anymore".
"Down here you’d be part of a smaller team and a lot of the younger surgeons who are coming off the training schemes would prefer to be part of a larger team in a different hospital," he says.
Dr Lavery also says that providing incentives like higher salaries and longer contracts probably isn’t the solution.
Image source, Getty ImagesThe South West Acute Hospital first opened its doors in June 2012.
But in spite of its "state-of-the-art" facilities, it has consistently struggled to recruit and retain specialist staff.
One of the most recent examples was in June when a shortage of neonatal nurses at the hospital led to a reduction in cots in a unit providing special care for sick and premature babies.
Matt Fox
BBC News NI
A bitterly cold November night has not put off protesters as they stand outside Enniskillen Town Hall in objection to the cut to emergency general surgery at the South West Acute Hospital.
At one stage the passionate crowd broke into song - "we shall overcome" echoed across the town's Diamond.
Drivers of passing cars are waving and tooting their horns in support.
A meeting of Fermanagh and Omagh District councillors and representatives from community groups has just started inside the town hall.
All of the staff at the South West Acute Hospital will still be needed because of the decision for it to become a new centre for planned or elective surgery, says the Western Health Trust.
Its acute services director Geraldine McKay says she sympathises with staff who are anxious during what is a "challenging period" after the announcement of the suspension of the hospital's emergency general surgery service.
She says the trust has reassured staff that they won't lose their jobs as a result of that decision.
"We will need every single member of staff and we will work now to put that [elective surgery centre plan] in place," says Ms McKay.
The Western Health Trust is "fully committed" to developing and enhancing the South West Acute Hospital even though it has had to cut its offer of emergency general surgery, says chief executive Neil Guckian.
"SWAH has a very busy emergency department, fantastic facilities and a wide range of very vibrant specialities," he says.
“We ask for public support and understanding as we continue to work through the challenges to develop a solution that meets the future needs of our population."
While the decision has been made to temporarily cut emergency general surgery at the South West Acute Hospital (SWAH), it has also been announced that the hospital will become a dedicated centre for planned surgery in an attempt to tackle lengthy patient waiting lists.
Planned surgery - often referred to as elective surgery - is a procedure that is scheduled in advance because it does not involve a medical emergency.
The SWAH will become Northern Ireland's third elective surgical hub.
The Mater Hospital in Belfast was announced as the first of those new facilities in June and Daisy Hill Hospital in Newry was earmarked as the second in an announcement by the then Health Minister Robin Swann last month.
Matt Fox
BBC News NI
Carmel Tracey and her daughter Emily are among a growing crowd of people protesting outside Enniskillen Town Hall.
Ms Tracey says the people of counties Fermanagh and Tyrone "deserve better" than to have cuts to the services available at the South West Acute Hospital (SWAH).
"Having to be transferred [to another hospital for emergency surgery] could put your life at risk," says Carmel.
Asked if she thinks the suspension of the emergency surgery will remain a temporary measure as the Western Health Trust claims, Ms Tracey says she hopes so.
"We’re going to make much more noise about this."
The withdrawal of emergency surgery at South West Acute Hospital (SWAH) means patients will have to go elsewhere - so what are the alternatives?
There are two hospitals within a 60-miles (100km) radius of the SWAH that offer emergency surgery services.
Altnagelvin Area Hospital (above) in Londonderry is operated by the Western Health Trust, which also runs the SWAH.
It has a 24-hours emergency department and is one of Northern Ireland's five designated cancer units.
Craigavon Area Hospital (above) in County Armagh provides emergency surgery services for patients in the Southern Health Trust area.
This week the hospital's emergency department said it was working "under extreme pressure" and "far beyond capacity".
There's been a cloud of uncertainty hanging over the future of the emergency general surgery service at the South West Acute Hospital for months.
The Western Health Trust had previously said it could soon become "impossible to sustain" safely and senior managers were preparing "for the future" in case attempts to recruit more staff were not successful.
Image source, Getty ImagesThe trust has the budget to fill six surgical positions but only three people have been in post.
The staff surgeons were being supported by a team of locums.
The public need "clarity and honesty" about the cutting of emergency general surgery at the South West Acute Hospital (SWAH), says the MP for Fermanagh and South Tyrone.
Sinn Féin's Michelle Gildernew is demanding that from the Western Health Trust and the Department of Health.
Image source, Pacemaker"We need to know the steps they have taken over the last number of months to ensure that the SWAH is adequately staffed to make sure this is not a permanent measure," she says.
"Patients, staff and our community deserve transparency from the trust on all these issues."
Image source, Getty ImagesThe emergency department at South West Acute Hospital will continue to operate as normal, says the Western Health Trust.
There will be "minimal to no impact" on other services available at the hospital, it confirms.
The Western Health Trust has had a "very fragile" emergency general surgical service for several years, says its acute services director Geraldine McKay.
She says that "as a trust we have done everything we can to maintain the general surgical rota" at the South West Acute Hospital, including holding six rounds of recruitment since 2016.
"We have recruited five consultants in that time but we have also lost six others - three to retirement and three to moving on elsewhere," she says.
"Bringing a patient into the South West Acute Hospital with no general surgical consultants would not be safe at this time and therefore we have had to put other arrangements in place."
Matt Fox
BBC News NI
People are starting to gather outside Enniskillen Town Hall, reacting to the news that emergency general surgery is to be withdrawn from South West Acute Hospital in the town.
Jimmy Hamill (above, right), originally from Clones over the Irish border in County Monaghan but now living in Fermanagh, thinks the move is "lunacy".
"Fermanagh is so isolated. It's madness. People will die," he says.