02/12/2025
The Western Trust was pleased to host the Northern Ireland Assembly Committee for Health at the South West Acute Hospital on Thursday 27 November.
Western Trust Chair, Dr Tom Frawley and Chief Executive, Neil Guckian, outlined to Committee Members the significant and growing challenges facing the Western Trust, including rising population needs, pressures on mental health and social care, increasing financial constraints, and ongoing medical workforce difficulties. They also provided an update on the developments in both Emergency General Surgery (EGS) and elective services, set against persistent winter pressures and increasing Emergency Department demand.
The Committee received a presentation from Save Our Acute Services (SOAS) outlining their views on EGS at South West Acute Hospital.
Following this, Mr Guckian emphasised the Western Trust’s commitment to strengthening engagement:
“The Western Trust recognises that the previous EGS consultation did not meet expectations, and we are committed to significantly improving how we engage. The Trust Board has now directed the development of a new vision for Health and Care Futures in Fermanagh and West Tyrone, with South West Acute Hospital playing a central and important role within that vision.”
He added that this work will reflect the specific health needs of the population – including rurality, ageing demographic trends, and the vital importance of strong community and primary care services – while also exploring further opportunities through cross-border partnerships.
Mr Guckian also outlined the ongoing shift across Northern Ireland and the UK towards day-case and ambulatory surgery, noting that,
“Hundreds of patients every year are now safely treated through ambulatory pathways at South West Acute and Altnagelvin Hospitals, with over five patients per day presenting at South West Acute Hospital receiving same-day or next-day assessment and treatment, and 2.5 patients per day transferred for inpatient care and treatment to Altnagelvin Hospital.”
A central theme of the Western Trust’s update was the continued improvement in outcomes for EGS patients since the temporary change in 2022. Mr Guckian confirmed:
“The Western Trust is fully compliant with the revised Emergency General Surgery standards introduced by former Minister Robin Swann in 2022. These standards were created to ensure that no matter where a patient lives in Northern Ireland, they receive safe, specialist care that meets the highest clinical benchmarks. Compliance with these standards has required significant transformation of our consultant workforce and the establishment of a 24/7 upper gastrointestinal bleeding pathway.”
All HSC Trusts in Northern Ireland have contracts with a benchmarking organisation, CHKS, who receive raw data which they analyse to produce mortality, flow, efficiency and safety and quality metrics. This independent CHKS analysis shows that since the introduction of the new clinical pathways, outcomes for general surgery patients across the Trust have continued to improve. Mortality has reduced by approximately 14%, complications by 21%, and readmissions by 22% – important indicators of safer care and better recovery for patients.
“These improvements mean that patients across the Western Trust, wherever they live, now have a better chance of survival and better recovery outcomes,” Mr Guckian said.
Committee Members asked about the possibility of reinstating Emergency General Surgery at SWAH, to which Mr Guckian explained:
“To return EGS to South West Acute Hospital, the service would need to fully meet the Minister’s revised standards for emergency general surgery. These standards are essential safeguards for patient safety. To achieve compliance, substantial investment would be required in interventional radiology, renal services and in establishing an accredited bleeding rota. These services would need to be commissioned by the Strategic Planning and Performance Group. Only the Health Minister can approve a permanent change to EGS provision.”
The Trust also highlighted the many areas of strong performance across South West Acute Hospital and the wider organisation, including continuity of GP care provided patients in communities as the Trust have stepped in to take over five GP Practices, reductions in the number of children on the Child Protection Register, improvements in endoscopy waiting times, significant progress in infection prevention and control, radiography achievements, and ongoing success in meeting staff absence targets.
As part of the visit, MLAs were provided a tour of South West Acute Hospital to meet staff in Theatres and Cardiology services. The visit showcased the professionalism, commitment and expertise of staff who continue to provide high-quality care to local people every day.