Fact Checker – Emergency General Surgery, South West Acute Hospital

Official statement from the Department of Health:

“The suspension of emergency general surgery from South West Acute Hospital does not change its Type 1 ED status or the acute status of the hospital.

“The definition of a Type 1 Emergency Department is ‘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.’

“No hospital in Northern Ireland provide all types of emergency surgical services and the definition does not require this. Even the larger hospitals with very busy EDs do not provide everything.

“In line with the definition, emergency general surgery is not a pre-requisite. What is required is emergency surgical services. The temporary (as currently the case in South West Acute Hospital) or permanent (as proposed for Daisy Hill Hospital) suspension of emergency general surgery is not a removal of emergency surgery and those changes will therefore not impact on the type of ED which it is.

“This is not a new policy position. It reflects existing policy.”

Emergency general surgery relates to the treatment of patients presenting with acute abdominal pain, infections, bleeding, and trauma. In children, the most frequently performed emergency surgeries are appendectomy, testicular conditions.

Despite our previous and ongoing efforts to recruit, we have not been successful to date in securing the necessary consultant workforce. The Trust is now unable to maintain a rota to sustain and deliver a safe emergency (unplanned) general surgical service to our population from South West Acute Hospital.

Trust Board met and approved on 17th November 2022, a recommendation for an unplanned temporary suspension of Emergency General Surgery at the South West Acute Hospital.

The current rota for emergency general surgery will be maintained up until 4 December 2022. Planned elective surgery at the hospital will continue.

• South West Acute Hospital status as an Acute Hospital WILL NOT change
• Obstetrics and gynaecology service are not affected.
• Acute Medical / Care of Elderly specialties / services are not affected
• Outpatient services including general surgery Outpatients are not affected
• Non-complex elective surgery is not affected
• Critical Care / ICU are not affected
• Emergency Department will continue to receive and treat more that 90% of current attendances
• Paediatrics and Cardiology services will continue.

Emergency General Surgery will be provided in Altnagelvin Hospital.

Complex elective surgery requiring overnight stay will be consolidated on the Altnagelvin Hospital site – example bowel cancer surgery.

Yes, maternity services have not been affected. Pregnant mothers WILL still have their planned or emergency C-section in South West Acute Hospital.

Patients who attend South West Acute Emergency Department who require admission for emergency surgical treatment will be transferred to the most appropriate hospital to meet their surgical needs. This will be based on the assessment of their presenting complaint.

999 should be called in the usual way. The South West Acute Hospital Emergency Department will continue as part of the Regional Trauma Network. Therefore trauma patients will still be treated at the South West Acute Hospital Emergency Department. There are some exceptions, such as penetrating trauma which may be bypassed.

Planned and emergency C-sections and gynae surgery will continue on the South West Acute Hospital site. Elective (planned) surgery will continue from South West Acute Hospital, Altnagelvin Hospital and Omagh Hospital and Primary Care Complex. It is hoped through the longer term plans that we will be able to enhance our surgical capacity across the Trust through the creation of a regional overnight stay centre in line with the regional review of General Surgery.

South West Acute Hospital Emergency Department will continue to operate 24 hours per day, 7 days per week. South West Acute Hospital will also remain as receiving trauma ED as part of the regional trauma network.

South West Acute Hospital ED remains absolutely essential in meeting the unscheduled care needs of our local population.

South West Acute Hospital is and will remain an acute hospital. Its acute status is NOT in question due to the temporary suspension of emergency general surgery. South West Acute Hospital is a very busy state-of-the-art hospital and an essential part of the Western Trust acute hospital network. It has a wide range of acute specialist services including paediatrics, obstetrics and gynaecology which are needed to serve our population of approximately 300,000 across the Western Trust area. We want to develop and enhance our Trust wide surgical service to offer the same safety, quality and care for all patients attending – South West Acute, Altnagelvin and Omagh Hospital and Primary Care Complex.

Download and print the infographic here 

Emergency Department Activity (December 2022 – July 2023)

South West Acute Hospital

Altnagelvin Hospital – Arrivals from Local Government Districts of Fermanagh and Omagh

Total number (Dec 22 – Jul 23) of ambulance arrivals at other Hospitals – patients with Fermanagh and Omagh post codes 

• Total: 103
  • Craigavon Hospital – 96
  • Royal Hospital Belfast for Sick Children – 7

Emergency General Surgery Admissions (December 2022 – July 2023)

Total number since December 2022 admitted for EGS in other hospitals with Local Government Districts of Fermanagh & Omagh

• Total: 49
  • Craigavon Hospital – 36
  • Royal Hospital for Sick Children – 13

Elective Overnight Stay Centre Activity (December 2022 – July 2023)

As of End of July 2023:

• Theatre Sessions – 37
• Patient Surgeries Completed – 144

Elective Procedures Completed at South West Acute Hospital (1 Jan 23 – 31 Jul 23) – 830

Procedure:

• Lap Cholecystectomy – 75
• Paediatrics – 33
• Hernia – 32
• Other – 4

Trust Area:

• WHSCT – 85
• SHSCT – 28
• SEHSCT – 26
• BHSCT – 5

Download and print the infographic here 

Emergency Department Activity (December 2022 – September 2023)

South West Acute Hospital

Altnagelvin Hospital – Arrivals from Local Government Districts of Fermanagh and Omagh

Total number (Dec 22 – Sep 23) of ambulance arrivals at other Hospitals – patients with Fermanagh and Omagh post codes 

• Total: 125
  • Craigavon Hospital – 117
  • Royal Hospital Belfast for Sick Children – 8

Emergency General Surgery Admissions (December 2022 – September 2023)

Total number since December 2022 admitted for EGS in other hospitals with Local Government Districts of Fermanagh & Omagh

• Total: 63
  • Craigavon Hospital – 47
  • Royal Hospital for Sick Children – 16

Elective Overnight Stay Centre Activity (December 2022 – September 2023)

As of End of September 2023:

• Theatre Sessions – 50
• Patient Surgeries Completed – 197

Elective Procedures Completed at South West Acute Hospital (1 Jan 23 – 30 Sep 23) – 941

Procedure:

• Lap Cholecystectomy – 91
• Paediatrics – 48
• Hernia – 51
• Other – 7

Trust Area:

• WHSCT – 101
• SHSCT – 43
• SEHSCT – 48
• BHSCT – 5

Download and print the infographic here 

Emergency Department Activity (December 2022 – December 2023)

South West Acute Hospital

Altnagelvin Hospital – Arrivals from Local Government Districts of Fermanagh and Omagh

Total number (Dec 22 – Dec 23) of ambulance arrivals at other Hospitals – patients with Fermanagh and Omagh post codes 

• Total: 148
  • Craigavon Hospital – 140
  • Royal Hospital Belfast for Sick Children – 8

Emergency General Surgery Admissions (December 2022 – December 2023)

Total number since December 2022 admitted for EGS in other hospitals with Local Government Districts of Fermanagh & Omagh

• Total: 80
  • Craigavon Hospital – 60
  • Royal Hospital for Sick Children – 20

Elective Overnight Stay Centre Activity (December 2022 – December 2023)

As of End of December 2023:

• Theatre Sessions – 73
• Patient Surgeries Completed – 290

Elective Procedures Completed at South West Acute Hospital (1 Jan 23 – 31 Dec 23) – 941

Procedure:

• Lap Cholecystectomy – 137
• Paediatrics – 54
• Hernia – 80
• Other – 19

Trust Area:

• WHSCT – 157
• SHSCT – 70
• SEHSCT – 53
• BHSCT – 10

Download and print the infographic here 

Emergency Department Activity (December 2022 – February 2024)

South West Acute Hospital

Altnagelvin Hospital – Arrivals from Local Government Districts of Fermanagh and Omagh

Total number (Dec 22 – Feb 24) of ambulance arrivals at other Hospitals – patients with Fermanagh and Omagh post codes 

• Total: 160
  • Craigavon Hospital – 151
  • Royal Hospital Belfast for Sick Children – 9

Emergency General Surgery Admissions (December 2022 – February 2024)

Total number since December 2022 admitted for EGS in other hospitals with Local Government Districts of Fermanagh and Omagh

• Total: 85
  • Craigavon Hospital – 64
  • Royal Hospital for Sick Children – 21

Elective Overnight Stay Centre Activity (December 2022 – February 2024)

As of End of February 2024:

• Theatre Sessions – 103
• Patient Surgeries Completed – 350

Elective Procedures Completed at South West Acute Hospital (1 Jan 23 – 29 Feb 24) – 1,907

Procedure:

• Lap Cholecystectomy – 150
• Paediatrics – 68
• Hernia – 96
• Other – 36

Trust Area:

• WHSCT – 198
• SHSCT – 74
• SEHSCT – 68
• BHSCT – 10

Download and print the infographic here 

Emergency Department Activity (December 2022 – March 2024)

South West Acute Hospital

Altnagelvin Hospital – Arrivals from Local Government Districts of Fermanagh and Omagh

Total number (Dec 22 – Mar 24) of ambulance arrivals at other Hospitals – patients with Fermanagh and Omagh post codes 

• Total: 176
  • Craigavon Hospital – 163
  • Royal Hospital Belfast for Sick Children – 13

Emergency General Surgery Admissions (December 2022 – March 2024)

Total number since December 2022 admitted for EGS in other hospitals with Local Government Districts of Fermanagh and Omagh

• Total: 91
  • Craigavon Hospital – 69
  • Royal Hospital for Sick Children – 22

Elective Overnight Stay Centre Activity (December 2022 – March 2024)

As of End of March 2024:

• Theatre Sessions – 103
• Patient Surgeries Completed – 364

Elective Procedures Completed at South West Acute Hospital (1 Jan 23 – 31 Mar 24) – 1,978

Procedure:

• Lap Cholecystectomy – 161
• Paediatrics – 68
• Hernia – 99
• Other – 36

Trust Area:

• WHSCT – 212
• SHSCT – 74
• SEHSCT – 68
• BHSCT – 10

Download and print the infographic here 

Emergency Department Activity (December 2022 – June 2024)

South West Acute Hospital

Altnagelvin Hospital – Arrivals from Local Government Districts of Fermanagh and Omagh

Total number (Dec 22 – Jun 24) of ambulance arrivals at other Hospitals – patients with Fermanagh and Omagh post codes 

• Total: 197
  • Craigavon Hospital – 183
  • Royal Hospital Belfast for Sick Children – 14

Emergency General Surgery Admissions (December 2022 – June 2024)

Total number since December 2022 admitted for EGS in other hospitals with Local Government Districts of Fermanagh and Omagh

• Total: 109
  • Craigavon Hospital – 83
  • Royal Hospital for Sick Children – 26

Elective Overnight Stay Centre Activity (December 2022 – June 2024)

As of End of June 2024:

• Theatre Sessions – 103
• Patient Surgeries Completed – 364

Elective Procedures Completed at South West Acute Hospital (1 Jan 23 – 30 Jun 24) – 2,412

Download and print the infographic here 

Emergency Department Activity (December 2022 – December 2024)

South West Acute Hospital

Altnagelvin Hospital – Arrivals from Local Government Districts of Fermanagh and Omagh

Total number (Dec 22 – Dec 24) of ambulance arrivals at other Hospitals – patients with Fermanagh and Omagh post codes 

• Total: 234
  • Craigavon Hospital – 220
  • Royal Hospital Belfast for Sick Children – 14

Emergency General Surgery Admissions (December 2022 – December 2024)

Total number since December 2022 admitted for EGS in other hospitals with Local Government Districts of Fermanagh and Omagh

• Total: 130
  • Craigavon Hospital – 104
  • Royal Hospital for Sick Children – 26

Emergency Surgical Ambulatory South West Acute Hospital Assessments (December 2022 – December 2024)

• Total Assessments: 1,809
  • Daily Average
    • December 2022 – March 2023: 2.6
    • April 2023 – March 2024: 3.1
    • April 2024 – December 2024: 4.3

South West Acute Hospital Transferred Patients Admitted Direct to Bed at Altnagelvin Hospital

South West Acute Hospital Theatre Activity including Regional Elective Surgery

Total number of patients operated at South West Acute Hospital (1 Jan 23 – 31 Dec 23) *This includes endoscopy: 2,921

Total number of patients operated at South West Acute Hospital (1 Jan 24 – 31 Dec 24) *This includes endoscopy: 4,468