Healthcare staff at South West Acute Hospital in Enniskillen believe temporary arrangements introduced after the suspension of emergency general surgery are not safe or effective, according to a health watchdog report.

The Regulation and Quality Improvement Authority (RQIA) conducted an unannounced inspection between November 2025 and February 2026. Its findings, published this month, detail widespread concerns among frontline workers over patient transfers, ambulance delays, and tense working relationships with ambulance crews.

An online staff survey carried out as part of the inspection found that every respondent was either dissatisfied or very dissatisfied with the safety of care. All those who answered the question expressed dissatisfaction, the report noted.

Inspectors highlighted ongoing delays in moving patients from Enniskillen to Altnagelvin Area Hospital in Londonderry, a journey that can take up to 90 minutes. They found that no additional resources had been allocated to manage the increased volume of ambulance transfers or to boost surgical bed capacity at Altnagelvin.

Staff told the RQIA they felt constantly in conflict with patients frustrated by long waits and travel far from home. Some reported frequent verbal abuse from relatives. Northern Ireland Ambulance Service personnel described a communication breakdown and warned that emergency transfers were leaving rural communities vulnerable.

Patient experiences varied. Some praised compassionate care, but others recounted long waiting periods, overcrowding, and treatment delivered in corridors. Several patients and relatives said they did not feel safe in Altnagelvin’s emergency department.

The report identified four areas for improvement: application of clinical pathways, staff engagement and communication, patient outcome monitoring, and risk management. While the RQIA acknowledged progress in direct admissions to surgical wards and surgical staff recruitment, it said further measures were necessary.

The campaign group Save Our Acute Services (SOAS) said the findings revealed a disconnect between frontline experience and management assurances. Spokesperson Donal O’Cofaigh said the temporary pathways had been shown to be failing, with staff warning the regulator of risks. He noted that recommendations from a previous RQIA review 18 months ago remained unimplemented.

SOAS will meet with the RQIA and return to Stormont on Monday to press for action, according to another spokesperson, Helen Hamill. She said the campaign would highlight the importance of staff voices, which she felt had not been given enough weight in the inspection summary. The group is awaiting a High Court ruling on July 1 on whether it can proceed with a judicial review. A public meeting is scheduled for July 6 at the Westville Hotel in Enniskillen to update the community, with further fundraising and awareness events planned over the summer.

Karen Hargan, Chief Executive of the Western Trust, said the report recognised significant progress. The trust remained committed to maintaining safe services and would work with staff and partners to implement the recommendations.