More than a year after the Regulation and Quality Improvement Authority published its review, two urgent recommendations on emergency general surgery pathways linked to South West Acute Hospital remain unimplemented.

The RQIA report, commissioned by the Department of Health in 2024 and released in January 2025, called for patients assessed at SWAH and accepted for admission at Altnagelvin to be admitted directly to a surgical ward. It also recommended increased ambulance capacity to support the changed service model.

The Western Trust stated that between May 2025 and February 2026, 97% of patients moved directly to a bed. The Trust said 100% direct admission is not always achievable due to system pressures and that patients with the greatest clinical need are prioritised.

Save Our Acute Services said neither recommendation has been fully delivered. The group stated that responsibility now rests with the Department of Health and called for ministerial intervention to restore emergency surgery at SWAH on a sustainable basis.

The Department of Health said it continues to work with the Western Trust on implementation. It reported that the Release to Rescue element of the Regional Ambulance Handover Protocol, introduced in April 2026, has helped release ambulances more quickly, and that recruitment by the Northern Ireland Ambulance Service has reduced vacancies in the West Division.

The Department added that regular updates on progress are being provided to the Health Committee.