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Views on the emergency general surgery options

Option A 

1.80 In many staff discussions and across the three residents’ workshops, Option A was the preferred model. It was seen as the more viable, less confusing, and clinically sustainable approach. Concentrating emergency general surgery on fewer sites was viewed by many as offering clearer pathways, better potential for consultant recruitment, and improved patient outcomes due to strengthened specialist availability. 

1.81 There were, however, concerns about:  

  • infrastructure limitations at Glangwili – many consultees questioned whether Glangwili has the physical capacity, theatre space, and diagnostic resilience to support a centralised emergency surgery model; and some also noted the building’s general condition as a concern. 
  • staff de-skilling at Withybush, and the viability of interdependent services such as anaesthetics, critical care, acute medicine, and A&E if emergency general surgery were no longer to be undertaken there.  

Option B 

1.82 Some questionnaire respondents who stated a preference for Option B argued that if emergency general surgery is removed from Withybush entirely, the need to travel further in emergencies could pose additional risks to patient safety.  

1.83 On the other hand, workforce issues were a prominent concern, especially among staff, with current surgical rotas considered fragile and recruitment challenges persistent. Considering these concerns, Option B was frequently viewed as unworkable as it would be unlikely to fix underlying workforce pressures. It was also widely considered to be confusing for patients and teams, disruptive to continuity of care and decision-making, and more costly in view of the need to maintain two sites. 

1.84 If Option B were to be adopted, staff at Withybush identified wide-ranging infrastructure needs - including diagnostics, ward space, sterile services, laboratories, and equipment (including X-ray) - necessary for safe and effective delivery of emergency general surgery at the hospital. 

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