The Western Trust has been criticised after a Fermanagh patient was forced to wait in Altnagelvin Hospital’s emergency department for three days in the months before his death.
With the Health Committee hosting its weekly meeting in the South West Acute Hospital, members of the Save Our Acute Services (SOAS) group told MLAs about the experience of 61-year-old Mark McGuigan.
The group were giving evidence about the impact of a decision to suspend emergency general surgery at the SWAH in December 2022, with patients transferred over 50 miles away to Altnagelvin Hosptial in Derry.
It has been the subject of a major campaign from SOAS, who say the pathways for transferring patients are not effective and causing harm.
Helen Hamill from SOAS: “The messages that we want you to remember is it’s not (just) about if people live or die, it is also about how they experience health.
“The waits, the traumatic journeys. It’s the uncertainty, it’s about long-term harm. It’s about delays in EDs, delays in ambulance transfers and how people recover.”
Helen Hamill from the SOAS campaign group addresses the Stormont Health Committee.
She also accused the Western Trust of playing down the experiences of patients, and said that clinical data showing reduced deaths did not present the full picture.
“Mark McGuigan was 61-years-old when on March 1 this year, he developed gallstone problems at home at Roslea,” she said.
“As he was over 55-years-old, the surgical pathway the Western Trust put in place bypassed SWAH.
“It went straight to Altnagelvin ED where he sat for three days, developed sepsis, developed pancreatitis and eventually developed necrotising fasciitis.
“Mark died on November 17, the third-year anniversary from when the Western Trust stated the surgical services were being stood down at SWAH.”
She added: “Mark was a friend of our campaign, attended many of our meetings. But he’s much more than a statistic. He is a sign of how dangerous these pathways are to the health of our population.
“Mark’s story will not be reflected in any stats because he never actually made it to surgery. He still had his gallstones when he died.”
A family notice said that Mr McGuigan passed away peacefully in Belfast City Hospital on November 17 and would be sadly missed by his two daughters, son and wider family.
Ms Hamill continued: “Our message is clear, rural communities deserve equity in healthcare. We needed a funded plan to restore emergency surgery at SWAH, commission its spare capacity and create an integrated surgical network.
Dr Tom Frawley, chairperson of the Western Trust at the Health Committee.
Dr Tom Frawley, chairperson of the Western Trust, acknowledged the concern caused by the changed pathways for emergency general surgery.
“We could no longer sustain that service with no substantive consultants to staff the rota, however today many patients continue to have their surgery on this site and there are more patients being treated across more specialities than in previous years,” he said.
He said the geography of the western trust and a failure to invest in the road network had created serious operational difficulties.
Another factor was the difficulty in keeping staff from crossing the border for better terms and conditions.
Neil Guckian, Chief Executive of the Western Trust, said surgery outcomes had improved in recent years.
The Trust’s Chief Executive, Neil Guckian, spoke of “unprecedented” pressures in the Western Trust due to deprivation, an older population as well as underfunded mental health services.
Other pressures included a severe shortage of nursing home places in the Western Trust making it more difficult to discharge hospital patients.
On emergency general surgery, he said there was a drive to carry out more surgeries as day cases in both the SWAH and Altnagelvin.
On complaints of a double ED journey, where patients presenting at the SWAH then faced a second wait at Altnagelvin, he admitted “for the first 18 months we struggled getting patients direct to a bed”.
With only 26% of transferred patients from SWAH going straight to a bed in Altnagelvin, he said this increased to 92% in May this year.
“We all accept that delays in EDs are too long across Northern Ireland, I apologise to the public at every trust board public meeting every month.”
He said this was “clearly linked” to the shortage of social care capacity in the Western Trust.
On revised pathways, he said the Western Trust was now “fully compliant” with the standards for emergency general surgery.
He said years of analysis showed that mortality level had reduced by 14%, meaning that surgical patients now had a better chance of survival with a 21% reduction in complications and a 22% reduction in readmission rates for general surgery patients.
On a roadmap document on how to improve services from SOAS, Mr McGuckian said he was “disappointed” not to have a further conversation with the group last week.
“There are recommendations that we would support, there are recommendations that are for other partners and other organisations to take forward,” he said.
“And there are recommendations that we cannot support, either because SOAS do not have the full facts that we have or because there are patient safety concerns with what they are suggesting.”
Recognising that a consultation process over the summer “was not good enough,” he said the Western Trust was committed to putting this right and that it was now time to rebuild trust and reset relationships.
Altnagelvin Hospital in Derry.