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Western Trust highlights independent evidence of safer Emergency General Surgery pathways following inaccurate public claims

Independent evidence has confirmed continued improvements in Emergency General Surgery patient pathways across the Western Trust, with both the RQIA Inspection Report and the independent CHKS review highlighting better patient outcomes, improved patient flow and enhanced patient safety.

The Trust is therefore setting out the findings of both independent reports following inaccurate public commentary which does not fully reflect their conclusions. While RQIA identifies areas for further improvement, its report does not reach that conclusion and records significant progress across the pathways, together with no evidence of patient harm in the incidents reviewed.

The Western Trust recognises staff concerns regarding patient transfers and delays and continues to take decisive action to address these issues.

The RQIA findings are consistent with the independent CHKS review, published in January 2026, which analysed patient outcomes over a two-year and five-month period from December 2022 to April 2025. That independent analysis confirmed substantial improvements in patient outcomes following the service changes, including:

  • 24% reduction in mortality
  • 28.5% reduction in complications
  • 22.5% reduction in readmissions

CHKS concluded: “Overall, the data shows a clear and statistically significant reduction in mortality rate for emergency surgery patients following the revision to surgical services.”

The RQIA report also recognises that 97% of patients requiring transfer from South West Acute Hospital are admitted directly to an inpatient surgical bed at Altnagelvin Hospital, helping to minimise delays in receiving specialist care.

In addition, an average of 5.6 patients each day continue to receive same-day or next-day treatment through the Emergency Surgical Ambulatory Assessment Unit at South West Acute Hospital, while an average of just 2.5 patients per day require transfer to Altnagelvin Hospital for inpatient surgical care.

These independent findings demonstrate continued improvement in patient outcomes while also identifying further opportunities to strengthen the pathways, which the Trust fully accepts and is actively implementing.

 

  • Trust highlights independent evidence of safer Emergency General Surgery pathways

    Western Trust highlights independent evidence of safer Emergency General Surgery pathways following inaccurate public claims

    Independent evidence has confirmed continued improvements in Emergency General Surgery patient pathways across the Western Trust, with both the RQIA Inspection Report and the independent CHKS review highlighting better patient outcomes, improved patient flow and enhanced patient safety.

    The Trust is therefore setting out the findings of both independent reports following inaccurate public commentary which does not fully reflect their conclusions. While RQIA identifies areas for further improvement, its report does not reach that conclusion and records significant progress across the pathways, together with no evidence of patient harm in the incidents reviewed.

    The Western Trust recognises staff concerns regarding patient transfers and delays and continues to take decisive action to address these issues.

    The RQIA findings are consistent with the independent CHKS review, published in January 2026, which analysed patient outcomes over a two-year and five-month period from December 2022 to April 2025. That independent analysis confirmed substantial improvements in patient outcomes following the service changes, including:

    • 24% reduction in mortality
    • 28.5% reduction in complications
    • 22.5% reduction in readmissions

    CHKS concluded: “Overall, the data shows a clear and statistically significant reduction in mortality rate for emergency surgery patients following the revision to surgical services.”

    The RQIA report also recognises that 97% of patients requiring transfer from South West Acute Hospital are admitted directly to an inpatient surgical bed at Altnagelvin Hospital, helping to minimise delays in receiving specialist care.

    In addition, an average of 5.6 patients each day continue to receive same-day or next-day treatment through the Emergency Surgical Ambulatory Assessment Unit at South West Acute Hospital, while an average of just 2.5 patients per day require transfer to Altnagelvin Hospital for inpatient surgical care.

    These independent findings demonstrate continued improvement in patient outcomes while also identifying further opportunities to strengthen the pathways, which the Trust fully accepts and is actively implementing.

    The Western Trust remains committed to maintaining safe, effective and sustainable services for our population and will continue to work closely with RQIA, our staff, the Northern Ireland Ambulance Service and partner organisations to implement the report’s recommendations and further strengthen the quality and safety of care for patients across the Western Trust area.

    To support openness and provide factual information for the public, the Trust has developed a dedicated online information hub setting out the Emergency General Surgery pathways, key milestones, timelines, independent reports and frequently asked questions.

  • Trust welcomes RQIA findings and remains committed to safe, effective and sustainable services

    The Western Trust has today received the RQIA Inspection Report following an unannounced inspection of Emergency General Surgery services undertaken between 12 November 2025 and 19 February 2026.

    Karen Hargan, Chief Executive, Western Trust, said:

    “We welcome the publication of the RQIA inspection report, and its recognition of the significant progress made across our Emergency General Surgery pathways, including improvements in patient flow, clinical outcomes and patient safety.

    The findings complement the independent CHKS review, which confirmed improved outcomes and a significant reduction in mortality following the service changes. The report also recognises the Trust’s achievement where 97% of patients requiring transfer from South West Acute Hospital are admitted directly to an inpatient surgical bed in Altnagelvin Hospital.

    In addition, an average of 5.6 patients per day with emergency general surgery-related conditions continue to receive same-day or next-day treatment through the Emergency Surgical Ambulatory Assessment Unit at South West Acute Hospital, while an average of 2.5 patients per day require transfer for inpatient admission to Altnagelvin Hospital.

    We remain committed to maintaining safe, effective and sustainable services for our population and welcome the recommendations identified by RQIA. We will continue to work closely with RQIA, our staff and partner organisations to implement these improvements and ensure the highest standards of care for patients across the Western Trust area.”

    The RQIA Statement and Report is available on the RQIA Website here: RQIA publishes Report of Inspection of the Emergency General Surgery (EGS) Pathways in the Western Trust, following the temporary suspension of services at SWAH | Regulation and Quality Improvement Authority

    Further information on Emergency General Surgery in the Western Trust

    The temporary suspension of Emergency General Surgery at South West Acute Hospital (SWAH) was implemented as an emergency measure and a matter of public safety in December 2022. This was due to significant and ongoing difficulties in recruiting and retaining the required consultant workforce, which meant that there were no substantive consultant general surgeons available to work on the emergency rota at the Hospital. This position was further influenced by the introduction of revised Emergency General Surgery Safety Standards by the Department of Health in June 2022.

    All Trusts in Northern Ireland participate in independent benchmarking through CHKS (Caspe Healthcare Knowledge Systems) which analyses clinical data to assess outcomes including mortality, complications, readmissions, efficiency, safety, and quality.

    This most recent CHKS Independent Review (January 2026) and analysis has confirmed improved outcomes for Western Trust patients relating to the period December 2022 through to April 2025 (2 years and 5 months), showing that *Mortality has reduced by 24%, Complications have reduced by 28.5% and Readmissions have reduced by 22.5%.

    These measurements reflect an improving picture in providing safer care and better recovery outcomes for patients across the Western Trust area. The CHKS have concluded:

    “Overall, the data shows a clear and statistically significant reduction in mortality rate for emergency surgery patients following the revision to surgical services.”

    The Trust is fully compliant with the revised Department of Health Emergency General Surgery standards introduced in June 2022. These standards were designed to ensure that patients across Northern Ireland receive safe, specialist emergency surgical care, regardless of where they live.

    Compliance has required a significant transformation of the Trust’s Consultant Workforce and the establishment of a 24/7 Upper Gastrointestinal Bleeding Pathway.

    “We recognise that this remains a sensitive issue for many people. Our responsibility is to ensure that services are safe, sustainable and we deliver the best possible outcomes for the population we serve and this independent evidence shows improved survival outcomes for patients requiring Emergency General Surgery.”

    The Western Trust have provided all relevant information on Emergency General Surgery online: Independent Review confirms “significant reduction” in Mortality following changes to Emergency General Surgery | Western Health & Social Care Trust

  • RQIA report on EGS Patient Pathways

    The Western Trust provided an official statement publicly and to all Public Representatives on 10 June 2026 in respect of the RQIA Inspection Report in respect of pathways for Emergency General Surgery.

    The RQIA Report is available on the official RQIA website: RQIA publishes Report of Inspection of the Emergency General Surgery (EGS) Pathways in the Western Trust, following the temporary suspension of services at SWAH | Regulation and Quality Improvement Authority

    As follow-up to this, it is important to correct inaccurate claims in recent days that Emergency General Surgery patient pathways are unsafe.

    The RQIA Inspection Report does not conclude that the service is unsafe and indeed recognises the significant progress made across Emergency General Surgery pathways, including improvements in patient flow, clinical outcomes and patient safety.

    The report also found no evidence of patient harm arising from the incidents it reviewed.

    The Trust has acknowledged that some staff expressed concerns to RQIA regarding aspects of the Emergency General Surgery pathways. The Trust has consistently engaged with staff across both sites and continues to work closely with them to address concerns and further strengthen the pathways and will continue to do so.

    RQIA’s findings in the report also record that:

    • there were effective mechanisms to identify, record and review risks;
    • no evidence of patient harm was found in the incidents reviewed;
    • improvements had been made in direct-to-bed admissions;
    • the independent CHKS review found a statistically significant reduction in mortality following the pathway changes; and
    • RQIA acknowledged improvements across a number of areas of the pathways while recommending further improvements.

    The Trust fully accepts the areas for improvement identified by RQIA and is actively implementing them and note that the report also contains significant findings including improvements in patient flow, governance, risk management and clinical outcomes. These findings provide important balance and reassurance for patients and the wider public and should form the basis of recent public statements.

    The RQIA findings are consistent with the independent CHKS review, published in January 2026, which analysed patient outcomes over a two-year and five-month period from December 2022 to April 2025. That independent analysis confirmed substantial improvements in patient outcomes following the service changes, with:

    • 24% reduction in mortality
    • 5% reduction in complications
    • 5% reduction in readmissions

    CHKS concluded:

    “Overall, the data shows a clear and statistically significant reduction in mortality rate for emergency surgery patients following the revision to surgical services.”

    The RQIA report also recognises that 97% of patients requiring transfer from South West Acute Hospital are admitted directly to an inpatient surgical bed at Altnagelvin Hospital, helping to minimise delays in receiving specialist care.

    In addition, an average of 5.6 patients each day continue to receive same-day or next-day treatment through the Emergency Surgical Ambulatory Assessment Unit at South West Acute Hospital, while an average of just 2.5 patients per day require transfer to Altnagelvin Hospital for inpatient surgical care.

    Taken together, the findings from both RQIA and the independent CHKS review demonstrate an improving picture of safer care, better clinical outcomes and effective patient pathways. 

    While we acknowledge there is more to do and fully accept RQIA’s recommendations for further improvement, it is important that public discussion reflects the evidence contained within these independent reports.

    The Western Trust remains committed to maintaining safe, effective and sustainable services for our population and will continue to work closely with RQIA, our staff and partner organisations to implement the report’s recommendations and further strengthen the quality and safety of care for patients across the Western Trust area.

  • Independent Review confirms “significant reduction” in Mortality following changes to Emergency General Surgery

    The Western Trust has today released independent outcomes data for Emergency General Surgery services confirming ‘a clear and statistically significant reduction in mortality rate’ during the period December 2022 to the end of April 2025.

    The temporary suspension of Emergency General Surgery at South West Acute Hospital (SWAH) was implemented as an emergency measure and a matter of public safety in December 2022. This was due to significant and ongoing difficulties in recruiting and retaining the required consultant workforce, which meant that there were no substantive consultant general surgeons available to work on the emergency rota at the Hospital. This position was further influenced by the introduction of revised Emergency General Surgery Safety Standards by the Department of Health in June 2022.

    All Trusts in Northern Ireland participate in independent benchmarking through CHKS (Caspe Healthcare Knowledge Systems) which analyses clinical data to assess outcomes including mortality, complications, readmissions, efficiency, safety, and quality.

    This most recent CHKS Independent Review (January 2026) and analysis has confirmed improved outcomes for Western Trust patients relating to the period December 2022 through to April 2025 (2 years and 5 months), showing that *Mortality has reduced by 24%, Complications have reduced by 28.5% and Readmissions have reduced by 22.5%.

    These measurements reflect an improving picture in providing safer care and better recovery outcomes for patients across the Western Trust area. The CHKS have concluded:

     “Overall, the data shows a clear and statistically significant reduction in mortality rate for emergency surgery patients following the revision to surgical services.”

    Western Trust Chief Executive Neil Guckian commented:

    “The independent evidence covering December 2022 to April 2025 confirms that mortality for Emergency General Surgery patients has reduced by 24%. That is a statistically significant and clinically meaningful improvement in survival. Patient safety was the reason for the temporary suspension, and the independent data demonstrates that survival outcomes have improved since that decision had to be taken.”

    The Trust is fully compliant with the revised Department of Health Emergency General Surgery standards introduced in June 2022. These standards were designed to ensure that patients across Northern Ireland receive safe, specialist emergency surgical care, regardless of where they live.

    Compliance has required a significant transformation of the Trust’s Consultant Workforce and the establishment of a 24/7 Upper Gastrointestinal Bleeding Pathway.

    Mr Guckian added:

    “We recognise that this remains a sensitive issue for many people. Our responsibility is to ensure that services are safe, sustainable and we deliver the best possible outcomes for the population we serve and this independent evidence shows improved survival outcomes for patients requiring Emergency General Surgery.

    In addition there are now 5.6 patients per day with emergency general surgery related issues who remain in South West Acute Hospital and receive same-day or next-day care through the Emergency Surgical Ambulatory Assessment Unit. A total of 2.5 patients per day require transfer for in-patient admission in Altnagelvin Hospital.”

  • Update on Emergency General Surgery and response to the SOAS Roadmap recommendations

    Following considerable feedback from staff and the public, the Western Health and Social Care Trust is providing detailed updates now in respect of the following:

    • Western Trust Response Brief to the SOAS Roadmap – 20 Recommendations – Download here
    • Western Trust Update Statement and current position in respect of Emergency General Surgery – Download here

    The Trust respects the work undertaken by SOAS in producing the Roadmap and appreciate the significant time and effort which the hospital campaign pressure group have taken to put forward its 20 recommendations. We recognise the deep interest and concern within the community about the future of health and care services in Fermanagh and West Tyrone.  We hope to work alongside local people through the networks and representatives they know and are familiar with to shape a vision for safe and sustainable health and care services into the future.

    SOAS have put forward 20 proposed recommendations.  We agree with some of these, as they align closely with work that we already have underway in the Trust, and with the Department of Health, or we have made clear are our strategic direction of travel. Others will require decisions or leadership at regional, national or cross-border level if they are to move forward.  We must be clear that a small number of recommendations cannot be supported, because they do not meet the Department of Health’s clinical standards for safe care of surgical patients or commissioning requirements.

    Our initial position on the Roadmap recommendations is set out in the attached summary brief, and we welcome dialogue with the SOAS group and all stakeholders as our work progresses.

    Commenting, Western Trust Chief Executive Neil Guckian said:

    “I want to acknowledge the strength of feeling in Fermanagh and West Tyrone about local health services and to thank everyone who has engaged with the SOAS Roadmap. We recognise how important South West Acute Hospital is to the community it serves.”

    “Patient safety must always be our first priority. The independent clinical evidence we have shows that outcomes have improved since the temporary service change in 2022, with fewer complications, readmissions and deaths. This matters because it means safer care for patients.”

    “Many of the Roadmap’s recommendations reflect work we are already taking forward, and we share the ambition to continue building strong, sustainable services locally. Where recommendations cannot be progressed, it is because they do not currently meet clinical safety standards or require decisions that sit outside the Trust’s control.”

    “We remain absolutely committed to SWAH as a vital acute hospital and to continuing open, honest and respectful engagement with the community as we develop a long-term vision for health and social care in Fermanagh and West Tyrone.”

    Update on Emergency General Surgery

    In addition, the Trust is providing a detailed update highlighting our current position in respect of Emergency General Surgery within the Trust area, since the temporary suspension of Emergency General Surgery at SWAH was implemented in December 2022. This change was an ‘Emergency Measure’ and a matter of ‘Public Safety’ due to significant and ongoing difficulties in recruiting and retaining the required consultant workforce, which meant that there were NO substantive Consultant General Surgeons available to work on the emergency rota at the hospital. This position was further influenced by the introduction of revised Emergency General Surgery Safety Standards by the Department of Health in June 2022.

    The Trust is now fully compliant with the revised Emergency General Surgery standards introduced in June 2022. These standards were designed to ensure that patients across Northern Ireland receive safe, specialist emergency surgical care, regardless of where they live.

    Compliance has required significant transformation of the Trust’s consultant workforce and the establishment of a 24/7 upper gastrointestinal bleeding pathway.

    Independent clinical data shows that patient outcomes have improved since the temporary service change in 2022, based on that analysis by Caspe Healthcare Knowledge Systems (CHKS), which benchmarks all Trusts in Northern Ireland. These improvements indicate safer care and improved recovery outcomes for patients across the Western Trust area.

    In addition, a significant number of patients are now safely treated each year through ambulatory pathways at SWAH and Altnagelvin. Over 5 patients per day presenting at SWAH receive same-day or next-day assessment and treatment, and 2.5 patients per day are transferred for inpatient care and treatment to Altnagelvin Hospital.

    Mr Neil Guckian, Chief Executive:

    “These improvements mean that patients across the Western Trust, wherever they live, now have a better chance of survival and better recovery outcomes,”

    The Trust will continue to work closely with staff, patients, communities, elected representatives and partner organisations to ensure that future services are safe, sustainable and responsive to local needs.

  • Trust's Response to the SOAS Roadmap - 20 Recommendations

    The Western Trust met with local campaign Group on 6 February 2026, and talked through in detail the Trust’s Response to the SOAS Roadmap and in particular the 20 Recommendations  provided in the SOAS document.

    The Trust respects the work undertaken by SOAS in producing the Roadmap and appreciate the significant time and effort which the hospital campaign pressure group have taken to put forward its 20 recommendations. We recognise the deep interest and concern within the community about the future of health and care services in Fermanagh and West Tyrone.  We hope to work alongside local people through the networks and representatives they know and are familiar with to shape a vision for safe and sustainable health and care services into the future.

    SOAS have put forward 20 proposed recommendations.  We agree with some of these, as they align closely with work that we already have underway in the Trust, and with the Department of Health, or we have made clear are our strategic direction of travel. Others will require decisions or leadership at regional, national or cross-border level if they are to move forward.  We must be clear that a small number of recommendations cannot be supported, because they do not meet the Department of Health’s clinical standards for safe care of surgical patients or commissioning requirements.

    Our initial position on the Roadmap recommendations is set out in the attached summary brief, and we welcome dialogue with the SOAS group and all stakeholders as our work progresses.

    Response to the SOAS Roadmap – Download here

  • Trust provides Independent Improved Outcomes Data for Emergency General Surgery Patients to Assembly Committee for Health

    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.”

    NI Assembly Committee For Health Visit To South West Acute Hospital (1)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.”

    NI Assembly Committee For Health Visit To South West Acute Hospital (3)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.

    Read the full briefing presented by the Western Trust Chair and Chief Executive to the Health Committee 

  • Trust begin stakeholder pre engagement meetings schedule

    The Western Trust has commenced a series of Stakeholder Pre Engagement Meetings as part of a new ‘Communications, Engagement and Information’ campaign throughout Fermanagh and West Tyrone. As part of Trust Board’s approach to ensure an open and transparent communications process, there will be a comprehensive pre-engagement programme carried out and this has initially involved meetings with Staff, Public Representatives, including Councils, MLAs and MPs. Media and other Stakeholder Groups who have engaged with the Trust.

    Having met with the Fermanagh and Omagh Council Health and Social Care Sub-Committee in October, the Trust has also presented to Derry City and Strabane District Council on Thursday 13 November, following a presentation to the Council by SOAS previously. Engagement meetings have also been planned in the weeks ahead with the political party groups, where the Trust will present a range of detailed information, on the Trust’s new approach for Visioning work for ‘Future Health and Care Services in Fermanagh and West Tyrone’ and service information updates, including patient outcomes information under the emergency general surgery pathways.

    In addition to Staff and Public Representative engagement meetings, there will also be a sequence of meetings with other key stakeholder groups who have written directly to the Trust and these include Fermanagh pressure group ‘Save Our Acute Services’ (SOAS), Business Leaders Groups and others.

    Details of these planned engagements will follow on the new online Hub – Fermanagh and West Tyrone Future Health and Care Services | Western Health & Social Care Trust.

    In particular, the Western Trust is very hopeful of having an initial engagement meeting with SOAS. The Group have submitted a wide range of enquiries and FOIs to the Trust over a period of time and the Trust has reached out to the SOAS Committee in the hope that a mutually agreeable engagement meeting could be setup to provide all up to date information from the Trust, talk through the Trust’s position on the SOAS Roadmap and talk through the list of concerns and enquiries which have been submitted.

    Following correspondence received from SOAS, as part of the Trust’s ongoing open and transparent approach to informing our staff and the public, we are publishing this information on our information hub.

    Correspondence between SOAS and the Western Trust can be found on the official Correspondence letters below:

    To note: On 7 October 2025, the Trust Board formally agreed to close the Public Consultation and also approved the start of new work to design and develop a Vision Plan — a forward-looking programme that will focus on the people and places of Fermanagh and West Tyrone. Trust responses to all correspondence received prior to this date asking for the Trust’s next steps in this process, could only be issued following this decision.

  • SOAS decline offer of Initial Meeting with Western Trust Executive

    Following correspondence received from SOAS, as part of the Trust’s ongoing open and transparent approach to informing our staff and the public, we are publishing this information on our information hub.

    SOAS decline offer of Initial Meeting with Western Trust Executive

    Following a considerable number of communications between SOAS and the Trust in recent weeks, SOAS declined the meeting with the Trust at 5pm on Thursday 20 November and they notified the Council that the meeting would not be going ahead. The Trust has not refused to meet with SOAS and indeed have asked the local group to reconsider and that the opportunity remains open to proceed with a meeting in the future with suggested balanced arrangements to include an agreed agenda, an independent chair without a prior public position on the SOAS Roadmap, and a non-livestreamed initial meeting. The Trust has also provided an option for both parties to be invited to Council to present equally there.

    The Trust’s intention in requesting a first ever engagement meeting between the Trust Executive team and the SOAS committee has been to establish a constructive, balanced, and transparent basis for dialogue. We also recognise the strength of feeling within the community, and nothing in our correspondence with the group would ever be intended to diminish that.

    A mutually agreed agenda is standard practice for any engagement of this nature. The items proposed by the Trust – such as patient outcomes, clinical standards, and workforce considerations – are integral information to the issues raised publicly by SOAS and are essential for an informed and transparent discussion.

    Similarly, our suggestion of an independent chair for a specific engagement which required discussion on the SOAS Roadmap, could not be a chair who has a prior public position of endorsement on that Roadmap. This was intended to ensure impartiality and definitely not to exclude any individual or organisation and we have been very clear on this point with SOAS and the Chair of the Council, with whom we have a very good working relationship. Livestreaming is something we remain open to for future sessions, once an initial meeting has established a constructive foundation and again provides an engagement where we can begin to build a way of working at these meetings, together.

    The Trust are publishing all correspondence between the Trust and SOAS as part of a clear and open, transparent communications and engagement process moving forward. This will be available on the Trust website here: Western Trust begin stakeholder pre engagement meetings schedule | Western Health & Social Care Trust

    Correspondence between SOAS and the Western Trust can be found on the official Correspondence letters below:

  • Trust Board close Public Consultation and move forward on visioning work

    The Western Trust Board has met to discuss the recent pause to the Public Consultation on the permanent change to Emergency General Surgery in the Western Trust.

    Trust Board has taken the decision to close this current Public Consultation and will now move forward on visioning work for ‘Future Health and Care Services in Fermanagh and West Tyrone’.

    In July 2025, the Health Minister asked the Trust to end the current consultation and begin the process of producing a vision plan, emphasising how the South West Acute Hospital will meet the health needs of its current and future population.

    Following the Trust Board decision, Chief Executive Neil Guckian commented,

    “Since pausing the Public Consultation, we have reflected on what we have heard and it is important that I acknowledge the tremendous depth of feeling and concerns raised by people who have written to us and spoken to us directly.

    “As Chief Executive, I accept that there were flaws in our planned process. The previous process from the public’s perspective felt rushed and we should have spent more time engaging with the local community before the launch of the consultation process. The timing of the public events was wrong, and we underestimated the number of people who would want to attend our public meeting in Fermanagh.

    “We have apologised for these shortfalls and the fact that they caused a lot of unnecessary anxiety and uncertainty. We will learn from this moving forward as we develop our plans for the period ahead.

    “We are steadfast in our commitment to the long-term sustainability and development of South West Acute Hospital (SWAH) as a vital and successful hospital within the HSC regional network of hospitals. We will now work with all relevant stakeholders to develop a clear vision for health and social care provision in Fermanagh and West Tyrone, including SWAH as an integral part of how we serve this community.

    “This detailed analysis will focus on ‘Future Health Services in Fermanagh and West Tyrone’ which will be informed by population needs and will build on the Fermanagh and West Tyrone Pathfinder engagement previously undertaken. Pathfinder was seen as an excellent example of positive and meaningful engagement with our local population. The feedback was very useful and highlighted a very clear focus by the majority of service users on community services. Moving forward with this vision planning it will be crucial to plan for a strong community aspect to services to support SWAH.

    “Careful consideration will also be given to key strands of policy and research (see note (b) below) which will help shape the strategic and policy framework going forward.

    “In recent weeks, the Trust has received and collated many views and opinions from a wide range of stakeholders including Save Our Acute Services (SOAS). This will all help to inform and influence work to develop the vision, ensuring that the approach is shaped by the needs and experience of patients, clients, carers and communities. We will work closely with our staff, trade unions, community leaders, elected representatives and the public and there will also be discussion on areas for potential future collaboration with the Health Service Executive, Republic of Ireland (HSE).”

    SWAH remains an Acute Hospital with a type 1 Emergency Department

    The Department of Health and the Minister have re-iterated that SWAH will have a critical role to play going forward and will continue to provide services to patients not just across Fermanagh and parts of Tyrone but across Northern Ireland. SWAH remains an important Acute Hospital within the NI hospital network and its acute services provision has not changed. SWAH provides a 24/7 Type 1 Emergency Department, maternity services (Obs and Gynae), full resuscitation facilities and ICU, in addition to being a part of the major trauma network.

    Chief Executive Neil Guckian confirmed that while work to complete the vision is carried out, the temporary suspension of Emergency General Surgery (EGS) at SWAH, in place since December 2022, will continue to remain in place.

    “To date the independent analysis shows that after the temporary change, patients in the Western Trust who have had emergency general surgery have improved outcomes with decreased mortality, a lower surgical complication rate and a lower rate of re-admission after discharge. We want to reassure the public that the clinical pathways in place are in line with all required clinical standards and they continue to be monitored carefully.”

    The Western Trust is currently developing a comprehensive communications programme to help better inform staff and the public and this will be implemented alongside the stakeholder engagement programme in the months ahead.

  • July 2026 Emergency General Surgery Consultation Updates

    WHSCT EGS Consultation Update – 17 July 2025

    Trust Board members agreed today to pause and reconsider our consultation approach

    We fully respect the Minister’s request this week to take cognisance of the feedback to date around the content, scheduling and timescales of the consultation process

    The Trust supported by the DoH remains fully committed to the long term development and vision for SWAH. The Trust would highlight that the South West Acute Hospital continues to be a successful acute hospital, providing high quality care with a Consultant-led Emergency Department

    It is important for the public to note that the temporary transfer of emergency general surgery to Altnagelvin Hospital continues to be in place.

    In conclusion, the Board does wish to apologise for the uncertainty that has been created for the public as a result of these events and clearly our commitment is to address these issues and through a revised process of consultation and engagement.

    Western Trust statement – 16 July 2025

    Emergency General Surgery (EGS) Consultation

    The Western Trust, following a high level risk assessment, in the interest of public safety and due to the anticipated numbers attending took the decision on 11 July 2025 to postpone the first consultation event for the proposed changes to Emergency General Surgery in the Trust area at the Killyhevlin Hotel, Enniskillen on Tuesday 15 July 2025.

    The Trust issued a postponement notice on the 11 July 2025 to all those who registered on the Eventbrite system and communicated this publicly through the media, online channels and public representatives.

    Regrettably a follow up automated reminder was issued in error via the Eventbrite system on 15 July 2025 to those people who had registered for the Killyhevlin event after the event had been postponed.  The Trust took immediate steps to make contact with the people who received this reminder to alert them to the error. We apologise for any inconvenience this may have caused.

    Given this week’s developments and listening to public opinion the Trust is now in the process of resetting its consultation approach and have decided to postpone the planned event at the Waterfoot Hotel, Derry/Londonderry on 17 July 2025. We want to ensure the consultation is inclusive and engaging for all individuals, groups and organisations.

    The Trust wants to engage with as many people as possible in in a meaningful and engaging way and provide the time and space for them to have their voices heard.

    Information with respect to next steps will be published as soon as details have been confirmed.

    Emergency General Surgery (EGS) Consultation – 11/07/2025

    EGS Consultation update 11/7/25

    Whilst we are pleased with the high level of interest in the public events for the consultation on Emergency General Surgery in the Western Trust area, following a high level risk assessment based on the anticipated numbers registering to attend and in the interests of public safety, the Trust has taken the decision to postpone the event on 15 July 2025 in the Killyhevlin Hotel.

    We apologise for any inconvenience this may cause.

    We are keen to engage with as many people as possible in a safe and suitable environment and therefore are committed to organising three face to face events in the Fermanagh area, 1 in the Tyrone area and 1 in Derry/Londonderry. These additional public events, alongside the virtual event and targeted engagements are designed to provide the time and space for everyone to have their voices heard.

    New dates for the consultation events will be publicised as soon as possible. These will be ticket only events.  For reasons of public safety these will be ticketed only events and we cannot provide access to people without a registered ticket.

    Emergency General Surgery Consultation Update – 10 July 2025

    We can confirm that the Changing Emergency General Surgery Public Consultation Session, scheduled for Tuesday 15 July 2025 at the Killyhevlin Hotel, Enniskillen is now fully booked.

    Anyone who attends the public consultation sessions on Tuesday 15 July (Killyhevlin Hotel, Enniskillen) or Thursday 17 July (Waterfoot Hotel, Derry~Londonderry), should have registered via the Trust’s website and have a ticket for the event. In the interest of public health, safety and security, we cannot go over the venue capacity. Therefore it is important that you do not attend if you are not registered for the event.

    We are pleased with the response to date and we are keen to engage with as many people as possible over the 14 week period of the consultation. We are committed to ensuring the public have every opportunity to attend a public consultation session, either face to face or virtually.  We want to reassure anyone, who wanted to attend Tuesday’s event, that we will now hold a second face to face Session in the Fermanagh and Omagh District Council area. Details of this date will be issued as soon as possible on Trust channels.  The Trust has set up a ‘waiting list’ on Eventbrite for anyone who wanted to attend Killyhevlin but was unable to get a ticket.  The Trust will be in contact with those that have registered on the waiting list to inform of any future public events.

    Whilst the consultation session in the Killyhevlin Hotel on Tuesday 15 July is fully booked, there are still spaces available for the face to face consultation session on Thursday 17 July at the Waterfoot Hotel and the virtual consultation session on Wednesday 27 August. There will be at least one additional face to face consultation event given the level of interest in Tuesday’s event.  We will be flexible during the consultation period to ensure effective engagement with all impacted groups.

    The Trust has significant learning from the previous consultation on the temporary change to EGS at SWAH.  This was discussed with the Patient Client Council (PCC).  During our meeting we highlighted that a targeted engagement approach was a more effective means of consultation.  It is important to clarify that the PCC did not tell us how to consult or approve the content of our plans as this is the responsibility of the Trust.

  • July 2025: Emergency General Surgery Consultation Launched

    Emergency General Surgery Consultation | Western Health & Social Care Trust

    08/07/2025

    surgeon

    The Western Trust is proposing that all Emergency General Surgery services for the Trust’s area are delivered from the Altnagelvin Hospital site on a permanent basis supported by Ambulatory and Elective General Surgery on both the South West Acute Hospital (SWAH) and Altnagelvin Hospital sites.

    The proposal to consult on this was approved at a meeting of the Western Trust’s Trust Board on Thursday 03 July 2025 and the consultation will be formally launched on Tuesday 08 July 2025 for a period of 14 weeks. The consultation will close on 14 October 2025 and the outcome of the consultation will be considered at a Trust Board meeting thereafter.

    For further information and consultation events registration, visit our Emergency General Surgery Consultation Page

    Since the 19 December 2022, as a temporary measure, in response to difficulties in recruiting and retaining consultant general surgeons resulting in the inability to sustain a 24/7 consultant rota, the Western Trust consolidated Emergency General Surgery to Altnagelvin Hospital to maintain the safety of the service for all patients. Ambulatory surgical services were established at both the South West Acute and Altnagelvin Hospital sites at this point.

    Speaking at the Trust Board meeting, the Chief Executive, Neil Guckian said:

    “Since the temporary suspension of Emergency General Surgery at the South West Acute Hospital, patient pathways put in place have been working effectively and there has been no evidence of any patient safety concern.

    “The Trust has carefully monitored all aspects of the temporary change throughout the past 31 months and independent data indicates that patients who require Emergency General Surgery that come to Altnagelvin for their treatment, have better clinical outcomes.

    “The publication of the Review of General Surgery – Standards and a Way Forward (June 2022) set the regional standards to ensure the best clinical outcomes for patients who need Emergency General Surgery. It is not possible to meet these important safety standards in SWAH. Our Surgical team advises that delivering all inpatient Emergency General Surgery from the Altnagelvin site, 24 hours a day, seven days a week is the only way we can safely meet these regional standards.”

    Mark Gillespie, Director of Surgery, Paediatrics and Women’s Health said:

    “It is important that I say to the public that the provision of acute services at the South West Acute Hospital is a top priority for the Trust, and it will remain an acute hospital site with 24/7 Type 1 Emergency Department services, full resuscitation facilities, ICU and is part of the major trauma network. SWAH has a wide range of vibrant medical specialties and is a teaching hospital.

    “The Trust supported by the Department of Health remains committed to the long-term development and vision for SWAH, which has been evident in the success of the Regional Elective Overnight Stay Centre. SWAH is delivering its full commissioned elective capacity and we want to expand that.”

    “I know there is a tremendous depth of feeling on this locally and I would encourage everyone to respond to our consultation document.”

    The Trust’s Medical Director, Dr Brendan Lavery said:

    “An independent organisation called CHKS analyses all hospital admissions in Northern Ireland, England and Wales and provides outcome data which can be used as safety measures for patient care. This has shown that mortality or risk of death has decreased since the temporary suspension of Emergency General Surgery in SWAH with approximately one life being saved every 40 days. Surgical complication rates have fallen by 17.1% and readmissions after 30 days is significantly below that of our previous service in SWAH. All of the available independent data has shown improved clinical outcomes for patients with surgical pathology who would previously have been cared for in SWAH.”

    The Public Consultation is open to 14 October 2025.

    In addition to responding to the consultation document, the Trust will be holding two face-to-face public consultation sessions on the proposed permanent changes to Emergency General Surgery across the Western Trust area. The sessions will take place on:

    • 15 July 2025 at the Killyhevlin Hotel, Enniskillen from 7pm to 9pm
    • 17 July 2025 at the Waterfoot Hotel, Derry/Londonderry from 7pm to 9pm

    In order to facilitate everyone the Trust will also be hosting a further virtual online event:

    • 27th August 2025 from 7:00PM – 9:00PM

    For further information and consultation events registration, visit our Emergency General Surgery Consultation Page

  • Fact Checker – Emergency General Surgery, South West Acute Hospital

    Click on the link below for the official page 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.”

  • July 2023: Findings Report on SWAH Emergency General Surgery Consultation Published

    The ‘Findings Report’ on the Western Trust’s consultation on the temporary suspension of Emergency General Surgery at South West Acute Hospital was tabled today (06 July 2023) at the monthly Trust Board meeting.  The consultation was carried out in accordance with the Department of Health Circular on ‘Change or Withdrawal of Services’ and in line with the Trust’s consultation scheme.

    The extensive and wide ranging consultation included seven face-to-face and two online events, alongside staff engagement and information sessions. The Trust is required under these arrangements to seek out ‘viable alternatives’ to the temporary pathways which were put in place, through consultation with the public and staff. The Trust is satisfied that the consultation process has fulfilled this requirement.

    The Findings report reflects the breadth of views expressed during the Trust’s 12 week consultation. The report identifies key themes emerging from the responses to the consultation and aims to assist the Trust to listen to the concerns of the community they serve and enabled the Trust to answer a range of questions which arose relating to the decision.

    Western Trust Chief Executive Neil Guckian said:

    “This was a very difficult and challenging process and we fully acknowledge the concerns raised by the local communities.  I want to thank everyone who has put their views forward and pay tribute to all of the staff who supported the extensive consultation process.”

    “The decision to temporarily suspend Emergency General Surgery at the SWAH was taken to protect public safety.  The Western Trust is fully committed to protecting the safety of our patients who require Emergency General Surgery and we will continue to focus on providing high quality care to them.

    “Although there was very significant objections to the temporary change, the new pathways put in place have been working effectively.  An average of two patients per day have been admitted to Altnagelvin for Emergency General Surgery since 19 December 2022, and we are pleased to report there is no evidence that the temporary change to the pathways at SWAH has negatively impacted on patient clinical outcomes.”

    “We recognise how difficult it will be to reinstate Emergency General Surgery at SWAH due to both recruitment challenges and the requirements for access to other clinical services within the new regional standards for General Surgery, published by the Health Minister. South West Acute Hospital falls some way short of meeting the requirements of these standards.

    “Delivering safe care to the population of the West was the primary reason for this temporary change. We are satisfied that the temporary suspension of Emergency General Surgery at SWAH and the new pathways put in place to assess patients in our ambulatory pathway at SWAH, and to treat patients requiring admission at Altnagelvin, has significantly mitigated the patient safety risks which arose from the challenges in the Consultant General Surgeon workforce.

    “The alternative clinical pathways for the treatment of emergency general surgery patients at SWAH are carefully monitored by the Trust and this will continue at this time.”

    Download and Print the Findings Report 

    Download and Print the Equality and Human Rights Screening

  • November 2022: Emergency General Surgery Consultation for Temporary Change

    For the full information page on the Temporary Change to Emergency General Surgery Services at SWAH – click on the link below

    The Western Trust will temporarily withdraw Emergency General Surgery Services at South West Acute Hospital from 18 December 2022. The Western Trust has faced challenges recruiting general surgeons to cover the emergency general surgical rota. This unplanned change is necessary to protect the health and safety of patients in the area who require access to Emergency General Surgery. The Western Trust is working to establish an overnight elective centre at the hospital in the near future.

    Read the full statement.

    Download a copy of the Public Information Guide on Emergency General Surgery at South West Acute Hospital.

    Public Consultation

    Visit our Public Consultation page for information on the Public Consultation and public events Emergency General Surgery at South West Acute Hospital.

    Fact Checker

    Visit our Fact Checker page to answer questions you may have about Emergency General Surgery at South West Acute Hospital

    Care Opinion

    Visit Care Opinion and tell us about your experience of Emergency General Surgery at South West Acute Hospital.

    Temporary Patient Pathways for South West Acute Hospital Emergency General Surgery

    The Western Trust has developed a number of patient pathways to support the temporary unplanned changes taking place with Emergency General Surgery at South West Acute Hospital from 18 December 2022. Patient pathways is a term used to describe how patients move though the health care system. The Western Trust has engaged with partners in the Southern Trust, Northern Ireland Ambulance Service (NIAS), Sligo General Hospital and the Trauma Network to establish the following patient pathways: