General Surgery Review: major plan to transform services in Northern Ireland
Last updated 30th Jun 2022
A new wide-ranging plan to shake up general surgery services across Northern Ireland was launched today (Thursday).
Health Minister Robin Swann said they were looking at ways to “to produce better, safer and more consistent care for patients”.
Unveiling a Review setting out new standards for hospitals in the provision of emergency and elective (planned) general surgery, he said:
“The case for reshaping general surgery services is unanswerable. As this report underlines, we are not currently providing the best possible care for all our patients. Whilst our surgeons and wider multi-disciplinary teams do outstanding work, current arrangements do them a disservice.”
The Review recommends:
• A new future for general surgy involving changing to the current pattern of services
• Establishing Elective Overnight Stay Centres
• These units will involve planned procedures for high volume ‘intermediate’ complexity cases
The Mater Hospital in Belfast will house the first of these new centres – with additional locations drawn up later.
The Review emphasises the “pressing need for change, given current issues of sustainability and keeping pace with the development of the specialty.”
The Department of Health said there have been major changes in general surgery over the last two decades with surgeons now more sub-specialised and focused on specific areas such as colorectal surgery, upper gastrointestinal surgery etc.
But in a statement it added: “This means larger staffing teams are required, which can lead to recruitment issues and an increased reliance on locum cover. In addition, access to interventional radiology and endoscopy facilities is not consistent across the hospital network.
“Across Northern Ireland, there is wide variation in performance across surgical specialties both with regard to time spent in hospital and the levels of surgery carried out as daycase.
“A further challenge involves cancellation of planned general surgery procedures due to emergency surgery cases requiring staff and theatre space. This can be addressed by greater separation of elective and emergency surgery provision.”
Professor Mark Taylor, the Review chair, is a Consultant in General and Hepatobiliary Surgery.
He said: “The changing nature of surgical speciality means delivering emergency general surgery across multiple smaller sites with a lower patient turnover is becoming increasingly difficult in terms of rotas, staff recruitment and retention, skill mix, and maintaining quality care.
“If we don’t secure change in a planned way, it will happen anyway in an unplanned and piecemeal fashion as services in a number of locations increasingly struggle to keep going.”