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Home About the Trust Fermanagh and West Tyrone Future Health and Care Services Vision

Vision

Background to this Vision Engagement work

On 7 October 2025, Trust Board approved the closure of the Public Consultation on Emergency General Surgery and formally agreed a sequence of steps towards the design and development of a new Vision Plan. This approach was requested by the Health Minister and is intended to be forward-looking, people and place based, and focused on the health and care needs of Fermanagh and West Tyrone, including South West Acute Hospital.

The background to this work includes the temporary suspension of Emergency General Surgery at SWAH in December 2022, which was implemented as an emergency measure due to significant and ongoing difficulties in recruiting and retaining the consultant workforce required to maintain a safe and sustainable emergency general surgery rota. That decision was taken in response to immediate operational risk and was not a decision on the permanent configuration of services.

The Trust subsequently undertook a public consultation on the temporary change to Emergency General Surgery at SWAH, with findings presented to Trust Board in July 2023. Trust Board later approved moving towards a public consultation on a permanent change in June 2025; however, that consultation did not proceed following the Minister’s request to pause and instead develop a broader Vision Plan for health and care services across Fermanagh and West Tyrone.

The Trust has also provided a significant suite of information on the current outcomes for patients who receive their emergency general surgery inpatient treatment in Altnagelvin hospital from an independent clinical benchmarking service (CHKS).  This has evidenced significantly  improved outcomes since the EGS change, including reductions in mortality, complications and readmissions. This information has been shared through public briefings, Trust Board updates, public representative sessions, council briefings and the Trust’s online information hub for Emergency General Surgery.

The Trust’s position remains that SWAH is an important acute hospital within the Northern Ireland hospital network. Its acute services provision includes a 24/7 Type 1 Emergency Department, maternity services, full resuscitation facilities and Intensive Care Unit. The  Programme will consider how SWAH, Omagh Hospital and community services can work together as part of an integrated future model for the area.

Context for the Vision Programme of work:

This Programme therefore moves the discussion beyond a single service issue and into a wider planning process which will consider the future role of SWAH alongside Omagh Hospital and Primary Care Complex, community services, primary care, and wider population health need.

This work is not about a single service. It is about taking a whole-system view of how the South West Acute Hospital and community services can work together to provide safe, sustainable and high-quality care. Like the rest of Northern Ireland, we are experiencing increasing demand, changing demographics and growing complexity in how care is delivered. The Minister has been clear that change is necessary to ensure services remain safe and sustainable into the future.

The Fermanagh West Tyrone Health and Care Futures Programme was established within a context of concern for the sustainability of services in rural communities, a destabilised primary care sector in the west (particularly in Fermanagh),  demographic change with a growing older population, increasing complexity of care for an older population, workforce recruitment and retention challenges in some hospital and community specialties and new opportunities presented by digital technology, and cross-border collaboration on prevention.

Key dependencies for the Programme agreed by Trust Board include:

  • Identification of population health needs and future projections
  • Consideration of primary care and community care interfaces
  • Research evidence on the role of rural hospitals
  • DoH policy developments on Neighbourhood Model
  • Enhanced public engagement & involvement

Comprehensive early engagement with stakeholders

Between October 2025 and May 2026, the Trust undertook an extensive programme of staff and external stakeholder pre-engagement to provide updates, listen to feedback, clarify information and gather insight to inform the next phase of the Programme.

The external engagement has covered a wide range of individuals and groups, with MLAs, MPs, local councils, the NI Assembly Health Committee, Fermanagh and Omagh District Council, Derry City and Strabane District Council, Fermanagh Business Stakeholders, Omagh business interests, Save Our Acute Services, Patient Client Council, Department of Health officials, SPPG, PHA, DAERA, CAWT, local media, service users and community planning partners.

The external stakeholder engagement log demonstrates a sustained programme of meetings, workshops and briefings, including party group meetings with elected representatives, briefings with council health and social care committees, engagement with SOAS on 19 December 2025 and 6 February 2026, meetings with the Fermanagh Business Stakeholders Group, engagement with the NI Assembly Health Committee at SWAH in November 2025, and discussions with the Patient Client Council on the approach to formal engagement. Information on a range of Stakeholder Engagement Meetings and the Trust’s response to the SOAS Roadmap can be found in the Engagement segment of this online hub.

This early engagement phase has helped to rebuild dialogue with staff and stakeholders, clarify the Trust’s position on key issues, improve transparency around Emergency General Surgery, test the emerging engagement approach and identify the need for clear, accessible public information. It has also reinforced the importance of using established community planning structures and trusted local networks to support engagement across rural communities and Section 75 groups.

The Trust remains committed to meaningful and ongoing engagement, ensuring that the views of staff, communities, partners and elected representatives help shape the Vision.

Next phase: Formal Engagement programme and timeline

The Trust Board has approved an Engagement Plan which sets out three connected strands of work: staff engagement, public and community engagement, and stakeholder and public representative engagement. These strands are supported by a communications and information campaign, central governance arrangements and a consistent approach to recording, analysing and reporting feedback.

Strand 1: Staff engagement. Staff engagement is a core strand of the Programme. The Trust has re-established a Staff Engagement and Advisory Group involving staff across the Fermanagh and West Tyrone geography, has established a community of engagement leads across services, and has put in place information and resources to support consistent communication, two-way feedback and structured reporting across directorates, services and teams.

Staff engagement will run through Directorate Engagement Leads, staff briefings, director-led sessions, established team and professional meetings, the Staff Information Hub, the We Are West App and online and paper questionnaire routes. The aim is to ensure staff understand the purpose and scope of the programme, have opportunities to contribute, and can help identify practical opportunities, risks and conditions for successful change.

Strand 2: Public and community engagement. Public engagement will be delivered from June to September 2026 (with provisional allowance that this may run through October 2026 – depending on competing demands). This will be delivered through online questionnaires, paper and accessible routes, pop-up engagement, community group sessions and targeted outreach. The Trust is working with Fermanagh and Omagh District Council community planning structures, including the Integrated Wellbeing Network and the Community and Voluntary Sector Forum, to reach rural communities, Section 75 groups and people who may not traditionally engage.

Strand 3: Stakeholder and public representative engagement. The Trust will continue direct engagement with MLAs, MPs, council representatives, party groups, key external stakeholder groups, business stakeholders, SOAS, PCC, DoH, SPPG, PHA, community planning partners and other relevant organisations. This will support informed discussion, consistent messaging, promotion of engagement opportunities and early identification of concerns or issues requiring follow-up.

The Engagement Plan is clear that this is not a formal consultation on specific service changes. It is an exploratory engagement exercise designed to understand population need, community expectations, attitudes towards potential future models of care, and what would need to be in place for change to be safe, trusted and sustainable.

Phase / period Key activity
October 2025 – May 2026 Pre-engagement, stakeholder briefings, rebuilding dialogue, communications and information campaign, staff engagement structures, engagement design and testing.
7 May 2026 Trust Board approval to proceed to the formal engagement phase.
4–11 June 2026 Staff and carers’ engagement events in Omagh and Enniskillen, with staff engagement structures mobilised at the Staff Engagement and Advisory Group Engagement Meeting.
16 June 2026 Formal launch of online engagement questionnaire and public engagement phase.
June – end September 2026 (may extend to November) Structured staff, public, community, stakeholder and public representative engagement, supported by FODC community planning structures and targeted outreach to rural and Section 75 groups.
September – October 2026 Review the engagement to date and the timeline of remaining engagement work, collate feedback, analyse emerging themes and identify actionable insights. Identify if there is a need to extend the engagement through November/December 2026.
From December  2026  Initial analysis to Trust Board, commencement of detailed Vision development informed by engagement, population health need focus, additional key inter-dependencies and strategic documents.  Trust Board to consider next steps and timeline for publication.

FWT – Communications, PR and information campaign

The Trust has delivered a sustained communications and information campaign to support openness, improve understanding and provide clear, factual information about current services and future planning. This includes the central online information hub, public representative briefings, PR features on hospital and community services, information days, staff features and clear responses to public enquiries.

The communications approach is intended to support informed public discussion, reduce misinformation, provide a single source of truth and encourage wider participation beyond those who traditionally engage. The Trust has also developed dedicated public information on Emergency General Surgery, the SOAS Roadmap response, CHKS outcomes information and frequently asked questions. All of this information is available publicly on this online hub.

There has also been a strong focus on ensuring elected representatives are fully informed through Public Representative Briefs and briefing sessions with MLAs and MPs, including live-streamed sessions with the NI Assembly Committee for Health, Fermanagh and Omagh District Council, and Derry City and Strabane District Council.

This activity has been supported through digital channels and media and will continue in the months ahead. Printed information will also be made available for the public.

Providing a clear narrative on why we are engaging

We are developing a Vision for the future of health and care services in Fermanagh and West Tyrone. To do this, we need to understand population need and how services should be delivered in the future. People’s needs are changing, with more people living longer and often requiring more support. At the same time, advances in technology and changing expectations are shaping how services should be provided.

This engagement provides an opportunity for people to share what matters most to them, what is working well and what could be improved. What we hear will help shape how services are planned and developed in the future.

We want to:

  • Help our staff and communities feel heard and understood
  • Build confidence in the future of health and care services
  • Attract voices from across the whole community, not just those who traditionally engage
  • Provide insights that support practical and achievable service planning
  • Strengthen political and community support for future transformation
  • Establish a foundation for ongoing engagement between the Trust and the communities it serves, creating real conversation leading to a more collaborative and sustainable approach
    to change.

Our commitment

We recognise that this is an important and sensitive piece of work. The Trust is committed to ensuring that the process is inclusive, transparent and shaped by those who use and deliver services. By working together, we aim to develop a clear and deliverable Vision that supports safe, sustainable and high-quality health and care services for Fermanagh and West Tyrone, now and into the future.