SWAH: Withdrawing some surgery deemed appropriate
- Published
The report found the failure to recruit surgeons was "not because of a lack of effort"
The withdrawal of emergency general surgery from the South West Acute Hospital (SWAH) has been deemed an "appropriate decision".
The ruling came in a joint submission by the Royal College of Surgeons in England and Edinburgh.
Surgery was temporarily withdrawn from the Enniskillen hospital in November.
As part of the Western Trust's consultation on the proposed changes, the document, seen by BBC News NI, spells out expert clinical assessment.
It found in light of the hospital not meeting the standards set by the Northern Ireland-wide review of general surgery which was published in 2022, the withdrawal of the service was appropriate.
The joint statement said on the back of the decision to withdraw, the issue of transfer and ambulance times needed to be balanced against the risk to patients "of a potentially sub-standard offering at South West Acute Hospital".
The judgement of the Royal Colleges was that the latter was a greater risk to patient safety.
"It has increasingly been the case that smaller rural hospitals across the board, in the UK and worldwide, have failed to recruit consultant general surgeons," the document said.
"It is important to note that this is not because of a lack of effort, nor is it a reflection on SWAH, the trust or other hospitals or the local areas in question.
"Fundamentally, modern medicine requires increasing subspecialisation to be at the highest standard and this inevitably requires centralisation of key services in centres of excellence."
The document highlighted the centres were predominantly located in urban areas with a large enough catchment area that the population base supports increased specialisation.
It is said that keeping an emergency general surgery unit at SWAH would also require higher levels of staffing of multiple roles across the surgical and peri operative team.
These include theatre nurses, anaesthetists, blood bank staff, radiology, endoscopy and other diagnostic services, as well as intensive treatment unit (ITU) provision, all on a 24/7rota basis.
People will have to travel to other hospitals for emergency general surgery
It added that it was not therefore the case that the addition of a given number of consultant general surgeons would allow the service to return.
"Increased specialisation is a fact across the entire surgical team, not just the surgeons themselves, leading to the same issues of recruitment into rural settings across these roles, not just for surgical consultants," the document said.
Speaking to BBC News NI's Good Morning Ulster programme, Helen Hamill from Save Our Acute Services said she understood the attempts to "regionalise and rationalise services" but added it could not come at the expense of lives.
"I think it is important for people to realise that the risk to us is because of the remote periphery rural geography and the catchment of our hospital," she said.
What is emergency general surgery?
Emergency general surgery relates to the treatment of patients with conditions such as acute abdominal pain, infections, bleeding and trauma.
It includes operations such as removing a patient's gall bladder, appendix or part of the bowel.
If left unattended these conditions can become life-threatening.
In November, the Western Trust said SWAH dealt with about five such cases a day - not enough to sustain a dedicated emergency general surgical team.
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- Published17 November 2022
