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GP shortage ‘caused by Withybush downgrades’

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docsPEMBROKE residents have expressed concerns about reduced opening hours in the town’s doctors surgery as a result of a shortage of doctors. Since September 1, the surgery at St Oswald’s has closed at 1pm on weekdays. Until then, it had been open until 6.30pm on Monday, Wednesday and Friday. The surgery, a member of the Argyle Medical Group which also has practices in Pembroke Dock and Neyland, serves Pembroke, Monkton, and a number of outlying communities in the area. The surgery in Pembroke Dock will remain open from 8am – 6.30pm.

However, concerns have been raised about how the reduction of provision in Pembroke will affect elderly patients, or those with reduced mobility. Speaking to The Herald, Practice Manager for the Argyle Medical Group Juliet Goldsworthy confirmed that the reduction in surgery hours was a deirect result of staff shortages: “We’re two doctors down at the moment – its a common problem across Wales,” she said.

Safety was apparently a major consideration for the shorter opening hours. The practice was unwilling to let one doctor work at the surgery alone. “Its about managing the surgery safely andwe can’t do that at the moment,” Ms Goldsworthy added.

When we asked how long the staff shortage had been a problem for, she said that the staffing shortages were ‘relatively recent,’ though admitted that they had ‘struggled on’ over recent months. However, staff holiday time had meant that they were unable to keep the current provision. “The first doctor left about 18 months ago, and we lost another one 12 months ago,” she added.

“We have been advertising in national publications, but haven’t had any response. Accepting that the situation for patients was ‘far from ideal,’ she said that the problem was an all-Wales issue. Ms Goldsworthy confirmed that the practice had 10.75 FTE (full-time equivalent) doctors.

There are around 25,000 patients registered with the practice, which equates to 2325 patients per GP. Several years ago, the average number of patients per GP in Wales was 1640, and while Ms Goldsworthy said that this had risen to around 1900-2000, she still acknowledged that Argyle Street still did not meet these levels.

“Its not ideal – it puts a lot of pressure on both patients and doctors,” she added. Ms Goldsworthy pointed out that Argyle Street employed full-time nurse practitioners, who worked supporting GPs, as well as a full-time pharmacist who could ease the burden on doctors with work related to medication. “We were one of the first practices to take on a full-time pharmacist,”she added. “The health board seems to be looking more at approaches like this now. I understand that patients hanker for days gone by, but times have changed.”

With regards to the opening hours at St Oswalds, Ms Goldsworthy told us that if two new doctors could be recruited the situation would be reviewed after six months. At present, she said that the practice has been advertising ways for those unable to drive to attend the Argyle Street Surgery to travel there more cheaply.

“Services like country cars, and public transport can save people money on taxis,” she pointed out. Ms Goldsworthy emphasised that the surgery would still be open in mornings, and that hopefully people who would struggle to get to Pembroke Dock would be able to attend then. “We do visit a lot of people at home, if they are unable to get out. Our visiting rates are quite high,” she added. She pointed out that a shortage of GPs could lead to a continuing problem, because constant staff-shortages would lead to an increased workload, and the job becoming less attractive for medical trainees.

“There is talk of a ‘Golden Hello’ in Wales, but I’m not sure what is going to become of that,” she said. Concerningly, Ms Goldsworthy agreed with other commentators, including Simon Hart MP, who has previously said that a reduction in service provision at Withybush will lead to a knock-on effect on the county’s medical community.

“As Withybush downgrades and less doctors come to work there, their partners, who often used to work in surgeries won’t come here either, leading to the health community shrinking. We had a doctor who worked with us who was fantastic, but his wife worked in paediatric care, and when the department in Withybush downsized she had to move to Swansea to find work.

“There may also be issues with GP training at the hospital.” Speaking to The Herald, MP Simon Hart agreed that Issues faced by Withybush Hospital were a definite contributing factor in staffing problems across the medical community in the area: “From what I can discover there is a definite connection between recruitment and uncertainty over Withybush. For once the problem is not entirely about money,” he said.

“For the County to be able to attract Doctors and their families, they need to assure them that the services have a future and that there is certainty as far as their jobs are concerned. The Welsh Labour Government continues to fail in this regard and our county suffers accordingly.” We asked Hywel Dda University Health Board whether this was a fair reflection, and what if anything could be done to attract more GPs to the county.

At the time of going to press The Herald had received no reply. A spokesperson for Hywel Dda UHB said: “We would strongly urge caution when drawing ‘definite’ links between recruitment issues at a hospital and GP level as there is no absolute or clear evidence for this. GP recruitment is challenging across Wales, this is well documented, and we are experiencing this in areas across Carmarthenshire and Ceredigion as well as Pembrokeshire.

“Whilst we are taking clear actions to address recruitment at our hospitals, we have numerous responses to recruitment challenges at a GP level. For example, we are in the process of developing a Primary Care Support Team to offer support to Practices with workforce issues to which we have successfully appointed a GP clinical lead and three Advanced Practitioners, due to start shortly.

“We are also supporting the development of other roles that can provide patient care in General Practice working alongside GPs. For example, Argyle Surgery have employed a practice based pharmacist to support the GPs on a day to basis. This is alongside developing portfolio GP roles to increase the appeal of working in the Hywel Dda area to those wanting diversity within their role.”

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Trains resume between Carmarthen and Pembroke Dock as works end

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TRAIN services resumed this morning (Thursday 28 March) after ten days of essential round-the-clock work to upgrade track and drainage between Carmarthen and Pembroke Dock.

The railway was closed from Monday 18 March to Wednesday 27 March to allow Network Rail teams to replace more than 200 metres of track and 300 tonnes of ballast (track stones) between Pembroke station and Pembroke Dock.

Work to improve the drainage between Narbeth and Kilgetty stations was also completed at the same time.

Nick Millington, Network Rail Wales and Borders route director, said: “This essential work in Pembrokeshire demonstrates our commitment to improving the reliability of the service we provide to passengers along our route.

“We know that replacing the track can be disruptive and very noisy, so I would like to thank the residents of Pembroke for their patience while our team carried out this crucial work.”

Colin Lea, Planning and Performance Director at Transport for Wales said: “We’re pleased that our colleagues in Network Rail have completed this essential work and that Transport for Wales rail services resumed today.

“We’d like to thank passengers for their patience while this work has progressed and look forward to welcoming passengers back in time for the Easter weekend.”

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Welsh Water has increased sewage discharges into waterways ‘by 40%’

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NEW figures released by the Environment Agency have shown that Dwr Cymru discharged sewage into waterways for a staggering 23,354 hours last year, a 40% increase on 2022. 

The Welsh Liberal Democrats are now calling for tougher action against sewage dumping in Welsh waterways.

The party has also called for a halt on bonuses for water company bosses whose firms have dumped sewage into waterways.

Conservative MPs have consistently voted against measures which would have helped to tackle the crisis.

The Leader of the Welsh Liberal Democrats Jane Dodds MS said: “It is a complete scandal that filthy sewage is being pumped into our nation’s rivers and waterways without consequence.

“It’s beggars’ belief that both the UK Conservative Government and the Welsh Labour government are allowing water firms to get away with this environmental vandalism.

“We as a party are calling for tougher action to stop sewage being dumped in local waterways. We have also called for a halt on bonuses for water company fat cats whose firms have pumped filth into our waterways.”

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New bus services announced by Pembrokeshire County Council

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A NUMBER of changes to local bus services will be introduced in the coming weeks as a result of a shake up to bus funding. 

From April 2024, the funding which has been provided directly to bus operators by the Welsh Government to keep services going in the wake of the Covid pandemic will cease. 

Additional funding will instead be provided to Local Authorities to support their local bus network.

In total, Pembrokeshire County Council and the Welsh Government will provide over £3million in support for bus services in Pembrokeshire during the coming year.

As part of this process, all Pembrokeshire’s local bus services have been re-tendered. 

A public consultation, receiving over 300 responses, helped to inform decisions about which services should be prioritised. 

Councillor Rhys Sinnett, Pembrokeshire County Council Cabinet Member for Residents’ Services said: “I am delighted to be able to report that we are able to maintain the whole of Pembrokeshire’s current local bus network in the coming year.

“We have also secured key improvements such as reinstating an hourly service on the 349 route between Haverfordwest and Tenby via Pembroke Dock, and the popular Strumble Shuttle and Puffin Shuttle coastal bus services during the summer.”

The changes will also see two key services, the 302 Haverfordwest to Milford Haven and 349 Haverfordwest to Tenby via Pembroke Dock, brought under Council oversight for the first time. 

This will give the Council greater oversight of service operations and fares.  Pembrokeshire residents will also benefit from a new fare structure on all First Cymru services, due to be introduced from 1 April 2024. 

This will use Tap On Tap Off to allow passengers to pay the cheapest fare depending on the number of journeys they make or distance travelled, and will cap the maximum adult fare at £3 single and £5.40 return. 

More information about these fares can be found on the First Cymru website

A number of additional service changes and improvements are being considered for introduction during the course of the coming year in response to feedback received from the public consultation.  

The following bus service changes have been confirmed:

From 23 March 2024:

  • The Celtic Coaster (403) on the St Davids peninsular will restart for the 2024 season on Saturday 23 March and will run until Sunday 29 September. This is an hourly service, increasing to half-hourly during the whitsun half term and school summer holidays. There will be no service departing Caerfai Road at 13.00 and 13.30.
  • The 351 (Tenby to Pendine via Amroth) will return to its summer timetable.

From 1 April 2024

  • An hourly service will return on the 349 (Haverfordwest to Tenby via Pembroke Dock) service (April to September only).
  • The 356 (Milford Haven to Monkton) service will no longer call at Waterston and Hazelbeach due to operational issues caused by the narrow lanes in this area. The Fflecsi service will still be available.
  • A Saturday service, between 07:30 and 18:30, will be reintroduced in the Fflecsi Mid Pembrokeshire zone (formerly known as Bwcabus). This zone covers the area between Letterston, Crymych, Clunderwen and Wiston.  Passengers can also travel from this zone to Fishguard and Haverfordwest. 
  • The 302 (Haverfordwest to Milford Haven) and 349 (Haverfordwest to Tenby via Pembroke Dock) services operated by First Cymru will come under Pembrokeshire County Council control, giving the Council greater oversight of service operations and fares.
  • The 322 (Haverfordwest to Carmarthen) and 381 (Haverfordwest to Tenby via Narberth) services will be run by First Cymru. The 322 timetable will remain the same. The 381 timetable will remain the same from Haverfordwest to Tenby but journeys from Tenby to Haverfordwest will depart slightly earlier (37 past the hour instead of 45).
  • The X22 and X61 services which provided journeys at the start and end of the day between Pembroke Dock and Kilgetty, and Pembroke Dock and Haverfordwest will be withdrawn.
  • The 410 (Fishguard Town) and T11 (Haverfordwest to Fishguard via St Davids) services will be operated on a commercial (T11 part commercial) basis by Richards Bros. An improved connection with the ferry at Fishguard Harbour will be provided at 12.30.

From 19 May 2024

  • The Tenby Coaster service between Tenby and Saundersfoot will return for the summer season.

From 25 May 2024

  • The 400 Puffin Shuttle and 404 Strumble Shuttle services will return to the coast between Marloes and St Davids, and St Davids and Fishguard. These services will operate 7 days a week until 29 September 2024.  The Fflecsi service is also available in this area throughout the year.
  • The 387/388 Coastal Cruiser service around the Angle Peninsula will also return to its summer timetable, operating 7 days a week until 29th September 2024.

Further information about all Pembrokeshire bus services can be found on the Council’s website.

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