1. Emergency Surgery and The South Wales Plan
TJ Havard MD FRCS(Eng) FRCS(Ed)
Director of Professional Affairs for Wales
Royal College of Surgeons of England

2. South Wales Plan Consultant led Maternity care Neonatal care
Inpatient Paediatrics
Emergency Medicine (A&E)

3. Emergency Surgery Considerable number of Emergency admissions
‘Permissive’ role
A+E
Unfiltered General Medical Admissions
Level III Critical Care
Full Range of Elective Surgery
Therapeutic Endoscopy

4. Emergency Surgery Considerable number of Emergency admissions
‘Permissive’ role
A+E
Unfiltered General Medical Admissions
Level III Critical Care
Full Range of Elective Surgery
Therapeutic Endoscopy

5. Key Drivers for Change QUALITY & SAFETY Meeting core standards
Improving patient outcomes (NELA)
SUSTAINABILITY – Medical Workforce
Compliant rotas (all levels – v difficult at Core trainee)
Acceptable training standards (Deanery & GMC)
Recruitment and retention

6. Surgical Clinical Reference Group
Tertiary Services not included
3 Sub-groups
Head & Neck
General Surgery, Vascular, Gynae and Urology
T&O
GIRFT Project supplementing T&O sub-group

7. March 2014

8. Population 3,063,000
13 Acute Surgical Intakes
2014

10. Emergency Surgery (FCEs)

11. General Surgery (FCEs)

12. Emergency General Surgery (FCEs) (By Age Group)

13. Emergency Surgery – 4 levels of hospital

14. Example – General Surgery

15. Example – General Surgery

16. Sustainability - Workforce
Recruitment and retention difficult at all levels
Core Trainees (SHO) most difficult
157 CT in surgery in Wales reduced to 94 in 2012
Fill rates currently 100% but
Of 37 appointed started
25% dropout
20 posts in North Wales, 17 currently vacant
Possible reduction to 70 in the future
Higher training
Shape of Training imminent
SCP/ANP development required

17. Sustainability
How many acute sites for Emergency surgery in South Wales?

18. Sustainability
How many acute sites for Emergency surgery in South Wales?
3 or 4

21. Healthier Together –
Manchester

22. Clinical conferences (All Nations Church)
South Wales Health Collaborative Surgery Steering Group
General Surgery/Urology/Gynaecology/Vascular Surgery Clinical Reference Group
Acute Medicine/Surgery – Joint Clinical Reference Group
South Wales Health Collaborative Board
South Central Wales Acute Care Alliance
Cwm Taf Clinical Conference USW
Cwm Taf Strategic Planning Group
Cwm Taf Surgical Workshops
Also –
Ad Hoc meetings with Alun Tompkinson, Geoff Clarke, Richard Johnson,
Hamish Laing, CEO’s
Also also –
Directorate/consultant meetings, “corridor meetings”

24. How far have we got?

25. Population 3,063,000
13 Acute Surgical Intakes
2016