Written Ministerial Statement

The content of this written ministerial statement is as received at the time from the Minister. It has not been subject to the official reporting (Hansard) process.

The Regulation and Quality Improvement Authority (RQIA) Review of the Pathways Associated with the Temporary Suspension of Emergency General Surgery at South West Acute Hospital (SWAH)

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Published at 4pm on Wednesday 29 January 2024

Mr Nesbitt (The Minister of Health): Today I am publishing the Regulation and Quality Improvement Authority (RQIA) Report into the pathways resulting from the temporary suspension of Emergency General Surgery (EGS) at South West Acute Hospital (SWAH) and the joint response from my Department and the Western Health and Social Care Trust. The RQIA Review was commissioned by my Department with the support of the Trust.

It should be noted that this report is not a review of the suspension of Emergency General Surgery at SWAH, but rather an assessment of the provision put in place following this decision.

The ultimate aim was to review the effectiveness of clinical pathways with a view to identifying any aspects for improvement.  First and foremost, the Review did not identify immediate patient safety issues arising from the pathways.  It did, however, identify areas where improvements to pathways can be made.  My Department, the Northern Ireland Ambulance Service (NIAS) and the Trust accept all of the recommendations of the Review and I am pleased to report that work is already in progress to take forward the recommendations arising. My Department will continue to work alongside to the Trust as the recommendations are implemented. 

In relation to the recommendation on direct admission at Altnagelvin (avoiding double ED waits), I am pleased to note that the Trust has already made considerable progress in this area with rates improving from 26% to 75%, with a 100% rate being achieved on occasions.   I also note that the Trust has daily engagement with NIAS to ensure best use of private ambulance provision to minimise any impact on capacity and that the Trust has had a significant focus on its ambulance turnaround times.  A repatriation pathway has also been introduced to support early transfer to SWAH after acute surgery.

I welcome the Trust’s focus on data, clinical evaluation, audit and quality improvement which will be supported by the introduction of Encompass in the Trust in early 2025. I also welcome the Trust’s plans to review existing surgical ambulatory care provision at SWAH within six months of this report to ensure maximum effectiveness of the service. 

Importantly, the Trust will continue to proactively seek patient experience on an ongoing basis, working with key staff and teams to develop a survey of affected inpatients and ambulatory patients through the Care Opinion Platform.

I am very clear on the benefits of such an independent Review during times of service change and I have no doubt that the recommendations will provide relevant learning for the wider health system and will help shape best practice principles for Trusts moving through service change in the future.

The Review reinforces once again the message from Professor Bengoa - that it is better to plan and manage change than manage service collapse and the subsequent impact of that on communities. Within the constraints of existing budgets, I remain committed to driving forward the much needed reform of health and social care to ensure safe, sustainable services for everyone in Northern Ireland

At the heart of the Review was the voice of those working in, and using the clinical pathways, who took the time to share their experience with the Expert Review Team and inform their work.  I am grateful to them all. 

The Report and Response will be available on the Department of Health website.