No new funds for ambulance cover unless SWAH surgery removal made permanent
Campaigners say decision ‘a matter of huge concern’ for people of rural Co Fermanagh
Liam Tunney
16th May 2025 at 06:54
The Department of Health (DoH) will not provide additional recurring funding for ambulance cover in the Western Trust area unless the removal of emergency general surgery from a Co Fermanagh hospital is made permanent.
The service has been suspended at the South West Acute Hospital (SWAH) since December 2022 after concerns were raised over staffing levels at the Enniskillen site.
Pathways put in place following the decision mean that patients who require the service must instead travel to Altnagelvin Area Hospital (AAH) in Londonderry for treatment and assessment.
An RQIA review of those pathways earlier this year found patients who were transferred to the Derry site under the arrangements waited an average of 18 hours and 16 minutes before they could be admitted to hospital.
“Any such funding would be non-recurrent, reflecting the temporary arrangements” – Department of Health
The review said the NI Ambulance Service (NIAS) – which has faced scrutiny in recent years over waiting and handover times – were relying on staff overtime to fill gaps in the Western Trust, something which was creating a vulnerability in providing the service.
Trust board minutes have now revealed the Department are only willing to provide additional funding to alleviate the problem if the removal of emergency surgery at SWAH is made permanent.
The RQIA report was presented to the board on Feb 6 2025, with minutes from the meeting detailing an update on funding from Chief Executive Neil Guckian.
“Mr Guckian referring to the Review Report’s recommendations said there were a number of themes,” said the minutes.
“Referring to ED to ED transfer and capacity within the NIAS, Mr Guckian said in the meetings of the All Party Group and the Strategic Development Group, the DoH and Prof Mark Taylor were in attendance and it was very interesting to hear that in relation to the issue of additional funding for the Ambulance Service, the DoH will not give additional funding until the temporary change is made permanent.
“Mr Guckian reminded members that the Western Trust has the “shortest” NIAS hand over times in Northern Ireland.”
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Later in the meeting, board member Dr Aideen McGinley said the public had a right to know about the situation.
“Dr McGinley welcomed Mr Guckian’s acknowledgement on the oversight and accountability issues,” said the minutes.
“She said the Trust was in a crisis situation admittedly but there is a strong criticism about the amount of information that was coming to Trust Board for members to fulfil the oversight role.
“Dr McGinley said looking at what is reported, and again in respect of communication, the recommendation for additional funding for NIAS, and that the change needs to be permanent for this to happen, she felt the public has a right to know that this is the case.
“She said if we move into further consultation without this openness, honesty and transparency the public will be critical of us.”
Campaign group Save Our Acute Services (SOAS) said the detail in the minutes was a “matter of huge concern”.
“People are asking whether our community is now being held to ransom,” said a spokesperson.
“Any move to make permanent the withdrawal of life-saving emergency surgery from the South West would set in stone our community’s second class status.
“It would also cut across the commitment by public representatives of all five main political parties that they seek the restoration of emergency surgery at SWAH.
“SOAS is calling on Minister Nesbitt to intervene to ensure patient safety now in Fermanagh and Tyrone – that means implementing the RQIA recommendations as well as committing his Department to work towards the full and sustainable restoration of emergency general surgery at SWAH.”
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Sinn Féin MLA Jemma Dolan said the party supports the reinstatement of emergency general surgery at SWAH.
“Unplanned service collapse is not transformation,” she said.
“Transformation must be evidenced based and developed in partnership with those who rely on these services and the health workers who deliver them.”
DoH said additional funding arrangements related to the change were “in line with normal processes”.
“The Department recognises the pressure on NIAS resulting from the temporary change to emergency general surgery services in the Western Trust area,” said a spokesperson.
“We welcome the focus placed on the issue within the previous RQIA review. The Department also notes that the Trust has daily engagement with NIAS to minimise any impact on capacity, including the best use of private ambulance provision.
“Additional funding for NIAS during the temporary change of emergency general surgery would be considered in line with normal processes.
“It is not the case that any additional funding is dependent on the temporary change being made permanent. Instead, any such funding would be non-recurrent, reflecting the temporary arrangements currently in place.
“It is accepted that any permanent change to emergency general surgery services may require recurrent funding arrangements.”
