THE LOCAL Health Board is embarking on a ‘once in a lifetime’ reorganisational plan which is looking at all potential options to ‘change the status quo and focus on improving health’ of locals.

This will involve, a press release has revealed, transferring more hospital services into the community where appropriate.

This is part of a strategy that the Health Board is looking into, to help solve an acute recruitment problem which is putting a great deal of pressure on the way that the Heath Board operates – and is leading to an untenable level of use of costly temporary staff to plug gaps and services.

In the summer of 2017, the Health Board embarked in an engagement with the public called ‘The Big Conversation’ which involved public workshops and drop-ins being held across the three counties of Pembrokeshire, Carmarthenshire and Ceredigion.

The Health Board now says the it has independently analysed opinions of the general public and has been using that data to explore, challenge and test different scenarios.

It is yet to be seen what these changes will mean for end service users.

The Herald understands it is likely to mean hospital services being reduced or cut, and replaced with community alternatives.

The Health Board has said it will not make any changes, unless it can guarantee the safety of the people which it serves.

The Health Board has insisted that no preferred option for change has yet been determined, and nothing has been signed off or agreed at this stage.

Medical Director Dr Philip Kloer said: “This is a once in a lifetime opportunity for our health service and community to work together to design an NHS which is fit for our generation and beyond. It has been acknowledged for some time across the UK that healthcare services are challenged like never before and we need significant change. Indeed this has been recognised in the recently published ‘Parliamentary Review of Health & Social Care’ here in Wales.

“We need to develop more proactive, resilient and better resourced local community services to support and improve people’s health and wellbeing, and avoid deterioration where possible. This will involve closer working with our partners, particularly colleagues in social care. We are also looking at ways of providing the most modern clinical practice, using the latest digital, technological, and new scientific developments, in fit for purpose facilities to provide better patient outcomes and experience.

“A number of our services are fragile and dependent on significant numbers of temporary staff, which can lead to poorer quality care. For us specifically in Hywel Dda, the geography we cover is large, with many scattered communities that are getting older, needing more holistic health and social care treatment and support. Because of this, we need to better resource our community based care, which is where most of our patient contact is, and help people manage their health conditions. We also need to evolve traditional ways of working and provide a more proactive approach. This should give patients – young, older and frail and everyone in between – the services they need when the need it, so people do not have to wait too long.

“This will mean changing hospital-based care, as well as community care, and we appreciate the attachment local people and our own staff have for their local hospitals. They have been cared for in them, or work in them, and they also play an important role in our wider communities. The options may propose change to a local hospital; however this is about more than the buildings. This is about investing in our communities, attracting doctors, nurses and therapists by operating a modern healthcare system and keeping hospitals for those who really need hospital care.

“We will not put in place any change that isn’t safe for our patients and population. And we will look at all the impacts from ensuring services are safer with better patient outcomes, to considering the wider impact on people, including the most vulnerable.”

Dr Kloer added: “The potential options are evolving, with changes to them on almost a daily basis. Many will never even reach public consultation, for a variety of reasons including safety, accessibility and affordability, or will change significantly as they are tested against population needs and healthcare standards.

“We will be coming back to the public in the spring with fewer options that have been more rigorously tested and we will open and honest about what we think our preferred option is and why. We would not, and cannot, propose something that would not be safe for our population.

“We live in this community, use our NHS and work for our NHS and we want to work with our patients, staff, partners and public to ensure it is the best it can be.”

Meanwhile, Elin Jones, Ceredigion’s Assembly Member, has called for urgency in the implementation of electronic records for NHS patients in Wales, following the publication of a report by the Wales Audit Office, ‘Informatics systems in NHS Wales’.

The report outlines several of the opportunities that electronic patient records can bring to patients and health boards, as well as the current obstacles to achieving this goal.

Elin Jones, who has long-called for a paperless NHS has welcomed the report, saying: “This is an important step in the development of health services in Wales, which is long-overdue. It would make our NHS more sustainable and more flexible to every patient’s needs.

“I have heard of many instances where patients have turned up to appointments in Llanelli, Swansea or Cardiff, only to find that their medical records have not arrived. These are people who have, in some cases, had to wait a long time for a specialist appointment, and have had to travel long distances, sometimes leaving very early in the morning or have arranged overnight accommodation in order to get to a 9 am appointment.

“Being turned away because their paper record has not arrived is a failure in the current system, and would be addressed directly by electronic records.

“The technology is available, it’s just a case of putting the funding in place.

“With the proper investment into the Welsh NHS by the Welsh Government, electronic patient records can help the NHS to deliver better outcomes for patients and to make more efficient and effective use of scarce financial and human resources.”