Future of Emergency General Surgery
28th September 2023
The Southern Health and Social Care Trust has recommended that all Emergency General Surgery Services for the area are delivered from the Craigavon Area Hospital site on a permanent basis.
The decision was made at a meeting of Trust Board today (Thursday 28th September), following the presentation of a feedback report on a 12 week consultation.
Presenting the outcome of the consultation, Trust Medical Director Dr Stephen Austin said: “Meeting the clinical standards to ensure the best outcomes for all patients living across the entire southern area, has been our absolute priority throughout this process.
“Having trialled this approach for over 18 months, delivering all Emergency General Surgery from the Craigavon site, 24 hours a day, seven days a week is the only way we can maintain a safe and effective service.”
In response to a shortage of general surgeons and to maintain safety of the service, in February 2022, emergency general surgery was consolidated from two hospitals, Daisy Hill and Craigavon, to a one site model at Craigavon.
Under the Trust Board recommendation, it is proposed that this consolidation is made permanent.
Recruitment and retention of general surgical consultants has been an ongoing challenge across Northern Ireland.
Dr Austin also stated: “Hospitals with lower volumes of emergency general surgery find it difficult to recruit and retain doctors and many are not able to provide the supporting services that modern surgical centres require.
“Splitting services and staff across both sites is simply not sustainable. A one site model is much safer, with support from sub specialist colleagues and intensive care, if needed at Craigavon, to give patients the high quality care that they deserve.”
General Surgery specialises in abdominal organs such as stomach, gallbladder and bowel. ‘Emergency General Surgery’ is the overall term for the unscheduled service provided by the team, this could mean specialist advice, admission for tests and for some patients, an operation. An average of three patients each day are directed to Craigavon from Daisy Hill for this service.
Delivering Emergency General Surgery from the Craigavon site on a permanent basis will also help ensure the service meets the regional standards set out in the Review of General Surgery, published by the Department of Health in June 2022.
Cathrine Reid, Director of Surgery and Clinical Services added: “We thank everyone who took time to respond to the consultation, attended events and shared feedback on the proposals.
“We acknowledge concerns raised, particularly from some living in the Newry, Mourne, South Down and South Armagh areas about access to the service and understand that people would value a service closer to home, but we must always prioritise patient safety.
“Patients should continue to phone first or attend their nearest Emergency Department with any seriously urgent symptoms. Daisy Hill continues as a Type 1 consultant led ED, assessing all medical and surgical patients, 24/7.
“We have pathways for those who need transferred to Craigavon, to be directly admitted to the Surgical Ward, so it is important that Newry and Mourne patients attend Daisy Hill first to benefit from this process. It is rare for someone to need very immediate surgery for a life-threatening condition, but we can assure local people that we have arrangements in place for the patient to be operated on at Daisy Hill should this happen.”
Work is ongoing on the implementation of the stabilisation plans for acute inpatient medicine at Daisy Hill and the longer term for vision for the hospital.
The hospital has been appointed as a regional elective overnight stay centre for patients requiring planned surgeries.
Cathrine Reid continued: “With emergency surgery concentrated at Craigavon, we now have additional theatre time at Daisy Hill to benefit more people waiting on planned procedures. We have excellent surgical facilities at Daisy Hill and following investment in training and equipment, we can now take on most specialties, recently undertaking urology and breast procedures for the first time at the hospital.
“We are continually striving to improve and develop services and the ongoing electrical upgrade and new MRI scanner offer further potential. Daisy Hill’s surgical team has been working hard to increase theatre activity over recent months and are looking forward to welcoming their first regional patients in the coming weeks.”
The Trust Board recommendation will now be considered by the Department of Health.
Click here for the ‘Provision of Emergency General Surgery in Southern Health and Social Care Trust – Public Consultation Feedback Report – September 2023. Consultations | Southern Health & Social Care Trust (hscni.net)