Important progress made on reshaping general surgery

Date published: 31 August 2023

The Department of Health has published a progress report on the implementation of the Review of General Surgery.

Review of General Surgery
Review of General Surgery

The Review was published in June 2022, setting out key actions to improve general surgery provision in Northern Ireland.

Despite the many pressures currently facing the health service, significant progress has been made on implementing the actions.

Of the 10 actions in the Review, one action has been fully completed and six actions are on target to be delivered. The remaining three have an amber rating, which means some anticipated delay to delivery.

The Review, led by a group of expert clinicians, sets out evidence-based standards for emergency and elective general surgery. Implementation of the standards will ensure that people across Northern Ireland who require general surgery receive the highest quality care in the most appropriate environment.

Key Review actions include the establishment of Elective Overnight Stay Centres (EOSC). These are centres for intermediate complexity surgery that will sometimes, but not always, require an overnight stay in hospital.  An EOSC will provide a range of specialities including General Surgery, Urology, Gynaecology and ENT with the aim of improving patient outcomes. 

In line with the Review of General Surgery, the Mater Hospital in Belfast was announced in June 2022 as the first Elective Overnight Stay Centre.  Subsequently, EOSCs were announced at Daisy Hill Hospital (DHH) and South West Acute Hospital (SWAH).  These three EOSCs are being taken forward on a phased approach with lists already underway at all sites.

Another key action in the Review is the establishment of Post Anaesthetic Care Units (PACUs). These provide an intermediate level of care where a higher degree of observation, monitoring and interventions can be provided for than in a general ward. PACUs will protect critical care capacity and reduce ‘last minute’ cancellation of inpatient surgery. This will support surgical capacity during times of increased critical care activity, such as during emergency surges or winter pressures.

PACUs at the Belfast City, Royal Victoria, and Ulster Hospitals have been building capacity incrementally since becoming operational. 

Craigavon Area Hospital opened two PACU beds on 7 August 2023 and it is anticipated that the remaining designated sites at Antrim and Altnagelvin Hospitals will be operational before the end of 2023.

Notes to editors: 

  1. General surgery in Northern Ireland has changed over time because of increasing surgical specialisation, new technology, capacity gaps within the current structure and rising demand both in unscheduled and scheduled practice. The overall aim of the Review was to develop a model for general surgery that is equipped to deliver an equitable, sustainable, and high-quality service for patients. 
  2. The progress report can be read here:
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