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‘Once in a lifetime’ reorganisation planned by Health Board

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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.”

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Man from Pembrokeshire killed in M40 caravan crash

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Stuart Richards, 32: Killed by a car travelling in the wrong direction

A FORMER Pembrokeshire died in a collision on the M40 last week (Oct 15) when a car towing a caravan was travelling in the wrong direction and crashed into his vehicle.

32-year-old Stuart Richards, a former Sir Thomas Picton pupil, was travelling northbound in his Ford Mondeo when he was hit by the Subaru Forester.

He had served as an Army Officer in Iraq, Afghanistan and Jordan.

The driver and passenger of the Forester also died in the crash.

Terrifying dashcam footage of the car travelling down the M40 in the wrong direction has been posted to social media, showing the car failing to slow down just moments before the crash.

A Thames Valley Police spokesperson said: “Shortly before 4pm on Monday, the Force received reports that a Subaru Forester towing a caravan was travelling in the wrong direction on the northbound carriageway of the M40.

“A few minutes later, the vehicle was subsequently in a collision with two other cars, a Ford Mondeo and a Ford Focus, near junction 6.

“The driver and a passenger of the Subaru, both aged in their eighties, died. They are yet to be formally identified at this time.

“The driver of the Ford Mondeo also died. He was formally identified yesterday, October 17, as Stuart Richards, aged 32, from Stockport, Cheshire.”

The crash has been referred to the Independent Office for Police Conduct (IOPC) after it was revealed police officers had contact with the occupants of the Subaru days prior to the crash.

A report of a damage-only collision involving the Forester was made to the police force on October 10.

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Can Pembrokeshire still afford Wales’ lowest council tax?

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PEMBOKESHIRE COUNTY COUNCIL’S Finance Director, Jon Haswell said council tax would need to rise significantly to meet service needs in the wake of a 0.4% cut in Welsh Government funding.

Although its the smallest cut out of all the councils in Wales, the cut puts the authority £600,000 out of pocket

He was effectively saying that the councils coffers will be empty and that something has to change, and change fast.

Last year Pembrokeshire’s council tax went up by 12.5% – the first double-digit increase in Wales since 2004 – but Pembrokeshire’s Council Tax bills are still the lowest in Wales.

At the Audit Committee meeting on Thursday (Oct 18), Mr Haswell warned that on current predictions, based on the Welsh Government’s standard spending assessment of what it thinks the council needs, council tax would need to rise by 28% or more unless services were cut.

That is 2% less than Plaid Cymru councillor Mike Williams’ said it would be at Full Council the week before (Oct 11), but it’s pretty close.

As we reported on Friday in our print edition, Cllr Williams turned his own fire on the previous administration for placing Pembrokeshire into its current financial position, pointing out that the actual rise in Council Tax needed to address the funding gap in March this year was in excess of 30%.

He said: ‘It’s about time some members had a wake-up call’ as to the current state of the Council’s finances and the previous administration’s totemic policy of having the lowest Council Tax in Wales. Firmly pointing the finger at Cllrs Adams and Davies following their earlier questions, he suggested they needed to look to themselves to find the origins of the authority’s current difficulties.

RECAP – WHAT WE REPORTED LAST WEEK

A 0.5% cut in funding to Pembrokeshire County Council will result in significant and potentially devastating cuts to public services.
As we previously reported, the Welsh Government announced its budget settlement for Welsh local government last week.
While that settlement shows ‘only’ a 0.5% cut in the Pembrokeshire’s Revenue Support Grant, the reality behind that headline figure is grim.
And there is little comfort to be taken in the news that Pembrokeshire’s cut is smaller than that inflicted on neighbouring Carmarthenshire. Pembrokeshire’s budget is far smaller in proportion to Carmarthenshire’s. Our County’s resources are stretched to breaking point following years of the folly of the ‘lowest Council Tax in Wales’ policy in twenty-two years of rule by the ‘Independent’ group, most lately under Jamie Adams.
While money was washing around local government that policy was sustainable. However, once systemic cuts came in 2008 – and persisted for ten years and rising – there was no fat to trim and cuts are now deep into the bone of frontline services.
The Welsh Government funding takes little or no account of the Council’s obligation to pay wage increases negotiated centrally which far outstrips the money provided to meet them, changes in National Insurance, changes to teachers’ pensions, the effects of inflation, and the impact of regulations affecting buildings’ maintenance.
Hit seven ways from Sunday by a barrage of deep cuts to its budget delivered year-on-year for the last decade and in the teeth of the fallout of a Council Tax policy which has left the Council’s cupboard bare, there is no way for the Council to resolve its financial position without making even deeper cuts than those already contemplated and revealed exclusively in this newspaper last week.
The social care budget’s ‘protection’ by the Welsh Government has left all Councils floundering; because Pembrokeshire has a high proportion of older residents, it has been hit hard. The Council has even less money to spend on other services as the proportion of a smaller revenue ‘pie’ is taken up by protected budgets.
The devastation being wreaked by cuts is unsurprising. In 2014 dire warnings were given about the cumulative effects of continuing cuts before that year’s budget. Almost five years’ on, the situation is even worse than predicted.
With the Cabinet unwilling to ask for a further large Council Tax increase for next year, real savings will be hard to find. Something somewhere has to give.
The only hope is that the UK Government actually delivers real relief from austerity instead of tinkering at the edges.

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Man who assaulted Tenby barmaid avoids jail

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A MAN who touched a barmaid’s bottom and then offered her money for sex has been made the subject of a suspended prison sentence.

Mark Adams, aged 55, had denied sexual assault but was convicted by a jury after a trial at Swansea Crown Court.
Today, Adams was jailed for six months, suspended for two years, and ordered to complete 20 days of rehabilitation.
He must also pay £3,230 in prosecution costs.
The jury heard how Adams did not dispute that he asked the barmaid in a Tenby pub for a “selfie” as a pretext to get close to her and touch her bottom.
He then offered her £300, and then £400, to spend time with him but agreed that really meant having sex with him.
Adams, of Tintagel Way, Portsmouth, told the jury the approach had worked in the past with other women.
Judge Keith Thomas told Adams he had followed up with sexual assault with a humiliating offer of money for sex.
His behaviour, said the judge, came from an inflated sense of his own importance.
The court heard that his victim no longer felt safe in her place of work or in her home town of Tenby.
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