THE WESTERN Trust has been warned by a concerned group of local consultants that women and babies could die here if the SWAH emergency surgery service is cut.
In a jointly-signed letter seen and quoted on the front page of the Sunday Independent at the weekend, the group of obstetric and gynaecological consultants warned, “Harm will come to patients, and the reality of this needs to be made clear to the public.”
The doctors also revealed they had been told the cut to the service at the hospital was now “inevitable” and they had been asked to come up with contingency measures.
In recent weeks and months, as the threat to the emergency surgery service at the Enniskillen hospital has grown, and with the Trust last week confirming it will have to cut the service if new staff are not recruited soon, there have been fears that the removal of the service would have a knock-on affect on other services.
Privately local doctors had already expressed concern to the Herald that the emergency department service, and obstetrics and gynae, in particular, could be jeopardised by cutting the emergency surgery service.
There are fears everything from simple elective gynae procedures to complicated births that require an emergency c-section would not be able to take place at the hospital safely without an acute surgeon present.
The Trust had stressed the removal of the service would have a “minimal to no impact to other existing services at SWAH.”
However, this latest letter from the consultants stresses otherwise. Indeed, they state the current plan would be “unsafe” to patients and leave staff “vulnerable.” They also state expecting patients, such as pregnant women, to travel to other hospitals “could increase women’s mobidity/mortality risk and risk to their babies.”
For example, they said they as doctors could not mitigate for the risk of an inadvertent bowl injury during routine abdominal or gynae procedures, which every patient has consented for.
The doctors also questioned what would happen in the case of an unstable patient with a ruptured ectopic pregnancy that requires out-of-hours intervention.
“Is it really being implied such a patient is transferred from SWAH theatre in an ambulance to another hospital one-and-a-half hours away by an already overstretched ambulance service?” they asked.
The doctors said this was “not an acceptable standard.”
The consultants’ letter acknowledged that the Trust was facing “extremely challenging” issues with the recruitment and retention of staff, but said they were extremely frustrated by the current plan.
They said last week’s Trust announcement had been “a bombshell” and that they had been “told this was an inevitable change in service and that we needed to produce a contingency plan in an attempt to optimise patient safety given the future lack of surgical expertise.”
Noting the poor road network in the Fermanagh area to neighbouring hospitals, the doctors said, “The situation that we will still be able to deliver uninterrupted obstetric and gynaecological services with absolutely no access to a surgeon while in a rural district general hospital such as ours, is frankly inconceivable.
“We cannot be in a situation where we are in theatre with a major surgeon that cannot be mobilised to assist within a timely fashion.”
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