Neonatal unit at SWAH ‘acutely under threat’

LOCAL councillors have claimed the current staffing pressures could be used as a pretext to axe the SWAH neonatal unit.

The issue was discussed at last week’s meeting of Fermanagh and Omagh Council, in which members were responding to correspondence from the Western Trust.

Writing to the council, the Trust’s chief executive, Neil Guckian, said, “Over the last few years, several experienced neonatal trained nurses have either retired or left, with the result that the unit has struggled for some time to provide the appropriate level of nurse staffing.

“In November 2021, the Trust recognised that patient safety was a concern, and moved to providing an emergency stabilisation and transfer out service for babies born in SWAH that require a higher level of neonatal care.”

The SWAH is commissioned to provide six special care cots, but this has been cut to two in order to provide the emergency stabilisation service as only one specialist neonatal nurse has been ‘successfully’ employed to replace the ‘several’ that have left in the last few years. The situation has been exacerbated by Covid absences.”

Currently, any baby that requires ‘short term care’ can remain on the unit with those who require a ‘higher level of care’ being transferred to other neonatal units, a Trust spokesperson confirmed. On occasion, this has been as far away as Dublin due to capacity issues across the North.

“A total of six babies were transferred to other neonatal units during the period 1/10/21–31/12/21. All of these babies required a higher level of care and would always have been transferred accordingly, regardless of the current situation,” the spokesperson added.

Two further nurses are set to retire in March, Mr Guckian confirmed, putting the viability of the service into further doubt.

Cllr Donal O’Cofaigh told the meeting, “There is a managed approach to the situation at Altnagelvin to protect services at the expense, potentially, of services in SWAH.

“This is genuinely concerning. Babies are carrying the brunt of this; babies who are premature, sick, neonates are being transported as a result of the failure both recruit and support the retention of staff.”

Cllr Adam Gannon questioned why better ‘workplace planning’ has not been adopted by the Trust with recruitment, retention, and preparing for staff retirement.

Cllr Josephine Deehan, who is a doctor at the Strule Medical Practice in Omagh, described the current state of the neonatal unit as the ‘thin end of the wedge’.

She said, “As a council, we need to be very concerned regarding the sustainability of acute services delivered in the SWAH because if we cannot provide neonatal services then it will definitely influence the choice that parents have in where they deliver their child.”

If not enough mothers-to-be choose use the SWAH, it is feared maternity services could be withdrawn altogether.

“Our acute services are acutely threatened,” Cllr Deehan added.

Cllr Eamon Keenan claimed the staffing issues were ‘excuses’, and that it has always been the Trust’s plan to cut the neonatal services as they had proposed to do in 2017.

Fermanagh councillor Sheamus Greene said rural health services in rural areas are ‘under hostile attack’. “The Fermanagh and Omagh area just seems to be an easy target,” he added.

Emmet McAleer said, “We need to fight this tooth and nail because we in Omagh have lost health services before and it’s a massive loss to the community.”

Councillors backed Cllr O’Cofaigh’s proposal to write to the health minister to highlight the need to maintain neonatal services in the region and to establish a group within the council to campaign on the issue. “We as a council need to be standing up,” he said.

In his letter, Mr Guckian concluded, “We will continue to strive to provide safe neonatal services at SWAH, and will continue a proactive approach to recruitment and retention of neonatal nursing staff.”