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Neyland: Health Board want solution in place before closure

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Chat: Neyland Town Council members chatted with Health Board officials before the meeting

THE HYWEL DDA HEALTH BOARD hopes to have a solution in place by September for residents of Neyland affected by the closure of the St Clements Surgery.

The Health Board confirmed that they are speaking to a number of other providers about services being kept in Neyland but added that if they created a level of anxiety or concern in the area it could work negatively against them.

The Argyle Medical Group’s application to close the Surgery was accepted by the Health Board and will be closing on September 1.

The Group had originally applied for the surgery to close in April but that was rejected by the Health Board.

Argyle Medical Group currently has its main practice in Pembroke Dock and another in Pembroke called St Oswalds.

The decision to close the surgery prompted anger amongst Neyland residents and a public meeting was held with representatives of the Argyle Medical Group in January and over 200 people attended.

The Town Council also called for a second public meeting with the Health Board but they refused and instead offered to meet with the council to discuss the issues.

That meeting took place on Tuesday, June 5, where Town Councillors posed a number of questions to the five Health Board members in attendance.

Prior to the meeting a Town Council spokesperson told the Herald they were ‘very worried’ and ‘concerned’ for the people of Neyland about how they would access services in Pembroke Dock.
The spokesperson added: “We feel it is totally unacceptable for residents of Neyland and we need to find some way of easing the burden on the residents.”

At Tuesday’s meeting, Health Board officials assured the Town Council that they were working towards a solution and that they hoped to have that solution in place before the closure of the St Clements Surgery.

Health Board Director of Primary Community and Long Term Care, Jill Paterson said they were talking to other practitioners about a solution but did not want to confirm who they were.
Jill said: “Whenever we get a situation around a change in practices it is very difficult for patients that might be affected by that so I want to assure you that we have heard the views and one of the issues is the issue around travel. The contract for this practice rests with the Argyle practice, the Health Board isn’t taking over a contract at this point and the practice is not returning to us.

“At this point, what the practice is saying, they have got sustainability issues but they are advising that they will continue to provide the care for patients who were previously being seen at St Clements, but clearly, on the other side of the water.

“We know it is the wish of the St Clements practice that the majority of them still want their patient care being provided in this site.

“The reason we are not taking over the practice is that we don’t have the contract coming back to us to allow us to take over.

“Access to services was very much considered by the Primary Care Applications Committee at the time which the decision had to be made and on the other hand we were weighing up the sustainability issues the practice was facing with the significant reduction in their medical manpower.

“What we also needed to do, and we’re still in that discussion, is recognise that whilst in the interim, the practice will continue to offer that service to St Clements patients, it’s incumbent on the Health Board to think about the other options that might be available.

“I think the difficulty, at this point, is we are still in the process of those discussions with other providers of services in the local area, but we’re not at a point in which anything can be confirmed.”

Cllr Bill McGarvie asked if the closure of the Surgery could be delayed until an option was in place.

Jill responded: “We are still a few months from that closure and I’m hoping that we would be able to be at a point where we’re able to be more confident in articulating a more local option for St Clements, we’re in lots of discussions at the moment, there are things that other providers are putting forward that we need to work through.

“I’m hopeful that by the time we are coming towards the closure point there will be a level of confidence that we can give around that future option.”

Councillors also asked if transport would be provided to take patients to Pembroke Dock and Health Board Vice Chair Judith Hardisty said they were currently exploring all of the options.
Cllr Gareth Lawlor asked why St Clements was the one chosen for closure instead of St Oswalds in Pembroke.

Judith Hardisty said: “That was the question we put to them, why St Clements and not St Oswalds? Their argument was, in using the resources they’ve got they felt they could better provide the services they’ve got by concentrating that in Pembroke Dock.”

Cllr Lawlor also asked about staffing levels in St Oswalds and it was revealed that it was currently staffed at the same level as Neyland.

Cllr McGarvie asked if there could be a nurse-led service in Neyland and he was told that was one option that had been considered.

Vice-chair Judith Hardisty later went on to say that Argyle Medical Group had admitted that when they merged they didn’t do enough to properly merge their services and added that they do understand the strength of feeling at the decision they have made.

She also said that as soon as they had anything definite they would share it with them and that they would make sure Argyle Medical Group will meet the conditions that had been laid down.

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Health board statement on ’20-year journey’ in full

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THIS is the full statement from Chief Executive Steve Moore of  Hywel Dda University Health Board following the extraordinary meeting on Wednesday (Sept 26) at County Hall, Carmarthen:

 

HEALTH BOARD STATEMENT

Hywel Dda University Health Board will embark on an ambitious 20-year journey to transform the way we receive health care and support in Carmarthenshire, Ceredigion, Pembrokeshire and borders, it was decided at a public board meeting.

Twelve recommendations from clinicians (doctors, nurses and a range of healthcare professionals such as health scientists and therapists) were approved and can be read in full here https://bit.ly/2NJxft5.

Headline decisions included:

  • more investment will be made in the integration of social care with health and well-being across the seven localities (north and south Ceredigion, north and south Pembrokeshire, Taf/Tywi, Amman/Gwendraeth and Llanelli)
  • a hospital model, will be adopted and includes:
    • a business case to be made for a new hospital in the south of Hywel Dda (somewhere between Narberth and St Clears) to provide specialist urgent and emergency care services and planned care
    • hospital services to be retained and developed at Bronglais Hospital, Aberystwyth, in-line with the Mid Wales Joint Health & Social Care Committee recognising importance of hospital in delivery of services to populations of Ceredigion, Powys and South Gwynedd
    • acute medicine (hospital services that need medical input) to be retained at Prince Philip Hospital, Llanelli, following recent modernisation of services developed with the local community and serving a densely populated area
    • re-purposing Glangwili (Carmarthen) and Withybush (Haverfordwest) hospitals to support community health needs including overnight beds, day case procedures, out-patient and walk-in services such as minor injuries and much more

This follows one of the largest local NHS consultations in the UK (Hywel Dda Our Big NHS Change), which was held between April and July, and which saw a huge and passionate response from the local population. Responses included more than 5,400 questionnaires, 4,000 attendees at events and workshops, hundreds of written submissions, five petitions and extensive social media debate.

Board members considered all they heard from patients, staff, the general public and interested organisations, not just during the consultation, but also in the pre-consultation engagement and option development period.

They also considered recommendations made by Hywel Dda Community Health Council, the clinical viewpoint following consultation, and other matters including safety standards the NHS has to meet and the ability to provide services in the future.

Whilst some key decisions were made, the health board received really insightful feedback from people during the consultation and wants to investigate further, and demonstrate, some developments, including:

  • commitment to work with people and organisations to develop integrated networks (as opposed to hubs) which are unique to the needs of their community and to consider the geographical areas highlighted in the consultation as gaps in current provision
  • work with the community on an early model of the above in Pembrokeshire, focusing on the ability to provide more community based care 24/7 and to demonstrate how it could work and the impact it could have
  • work with local people to explore potential for a range of different types of beds within the local community – whether in existing community hospitals, at home or another setting review, test and challenge the model for acute medicine to be responsive to demand and changes in patient flows associated with the whole system change
  • work closely with Abertawe Bro Morgannwg University Health Board on services where patients could benefit from a regional approach
  • examine the opportunities a new hospital and community model could offer maternity and child health services to ensure doctor and midwifery led care, and care for children (paediatrics) and sick babies (neonatal) are maintained within the boundaries of the Hywel Dda area
  • align with the transformation work in mental health services to ensure mental health and learning disability assessment and treatment units are provided at the new urgent and planned care hospital
  • investigate the practicalities and impacts (through a feasibility study and options appraisal) of locations between Narberth and St Clears for the new hospital
  • work with people living and working in the areas furthest from a new hospital to provide additional support for emergency and urgent care (potential to look at things like placing paramedics within in a community as opposed to within a vehicle)
  • respond to public anxiety over the ability to manage emergency conditions that are time sensitive (e.g. ST Elevation Myocardial Infarction STEMI, stroke and sepsis) consider the opportunities a new hospital in the south would provide Bronglais Hospital
  • work closely with other organisations, including county councils and the third sector, to develop Glangwili and Withybush hospitals
  • develop a detailed plan to address concern heard in consultation regarding access, travel, transport and infrastructure, working with the Regional Transport Group, communities (including those with protected characteristics in response to the difficulties we heard about from people and the equality impact assessment) and Welsh Ambulance Services NHS Trust
  • formally state the Health Board’s support for building a case for provision of a 24/7 service to bring medics to the scene of an accident (e.g. the Emergency Medical Retrieval Transport Service, which operates 12 hours a day and CHANTS (Neonatal Retrieval Service))
  • develop a plan to maximise use of technology in health and care, backed up by secure IT so patient data is safe and joined up between services in the hospital and community
  • put in place a staff plan to deliver future models and provide opportunities for staff
  • work with education and university partners to train a workforce with the skills and expertise to work in the new service model, and drive research, innovation and evaluation into our service development
  • continue to talk the public, staff and interested organisation about all that we do, especially focusing on people with protected characteristics

Chief Executive Steve Moore said: “Today is a hugely momentous day as we confirm we will take a new direction to providing much more preventative and community based healthcare to our population. We’ve heard the concern people have with current healthcare provision and our ability to deliver this sea-change in the years to come but our clinicians have led this work and we believe what has been put before us today offers us the best chance to deal with the fragility our NHS faces and to provide the population with safe, effective care that meets their needs.”

Chair Bernardine Rees added: “We are really grateful to everyone who got involved in our consultation as it has given us really rich feedback. Our ambition is to continue that conversation and input so that we can grow services in our seven localities, using schemes we have already delivered, such as the front of house project at Prince Philip Hospital and Tenby walk-in, as the basis of what can be achieved.”

The next step will be for clinicians and staff to work with the public and other organisations to bring the additional detail together into a draft Health Strategy to put before public Health Board at the end of November.

Medical Director and Director of Clinical Strategy Dr Philip Kloer said: “We’re aware that some people, particularly those who live furthest from the new hospital zone between Narberth and St Clears may be anxious about these changes. They will not happen overnight and we are committed to working with those communities and our partners to demonstrate and test what additional provision can be made, particularly for time-sensitive emergency conditions.

“For example we are working with partners to build the case for the Emergency Medical Retrieval Team (doctors who are brought to the scene to treat and then transfer) and CHANTS (the Neonatal Retrieval Team) to be a 24-hour service, and also investigating the potential to place advanced paramedics in communities so they are available solely to that community.

“Another important factor in providing life-saving treatment is getting people quickly to the definitive hospital which will provide their care. At the moment, people in our coastal areas of Pembrokeshire have to travel to Glangwili for some treatment, which in the future, we will be able to offer at a more equitable location, for the south of Hywel Dda, in the new hospital zone.”

The new hospital will be dependent also on a full business case, which will be made to the Welsh Government.

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Pembroke Dock: Future uncertain for Catholic primary school

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THE HERALD understands that the governing body of St Mary’s Catholic Primary School, Pembroke Dock, is commencing a period of consultation on the future of the school. It has consulted with the trustees of the Diocese of Menevia on the governing body’s proposal to close the school permanently from April 2019 and has received their agreement to take the next steps in this process.

Parents were outside the school gates on Wednesday to demand answers, and say they are organising a meeting at the school on Friday (Sep 28)

The governers released a statement which reads: “As the school is a voluntary aided school, the proposal to consider it for closure has to be agreed by the GB and the trustees of the Diocese. However, the governing body has asked the Local Authority to provide support from officers to ensure that the requirements of the statutory consultation process are met and this will be discussed at the next meeting of Pembrokeshire County Council on October 11.

“The next stage of the process is the publishing of a consultation document with detailed information on the school which will be widely available and comments will be invited from members of the public and organisations including the Diocese and Local Authority. These comments will be considered by the GB prior to it making a final decision on the school’s future.”

A spokesperson commented “The decision has been made with great sadness, but it was felt to be the only one left to governors for a variety of reasons.

“There has been a dramatic fall in the school’s roll in recent years and we now have only 32 full time pupils at the school.

“There has been a significant drop in Catholic baptisms in the local area, reducing demand for places and the low numbers have called into question the financial viability of the school.”

A spokesperson for the Diocesan Director of Education commented “The Trustees of the Diocese of Menevia have accepted the GB’s decision with a heavy heart, and has urged all parties to work together to ensure continuity of access to Catholic education for any child whose parent desires it.

“The governing body will work towards this with the Diocese and Local Authority and to safeguard so far as possible, the employment of all those members of staff affected.”

The GB has been assured that there is sufficient capacity in other local schools to secure alternative places for the school’s pupils.

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Withybush downgrade ‘is a kick in the teeth’ for Pembrokeshire

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NEWS that Withybush General Hospital is to be downgraded has already started to attract criticism from politicians.

One of the first to react was  Stephen Crabb MP, who told The Pembrokeshire Herald: “Today’s announcement makes a mockery of consulting the public, but it is hardly surprising. It is another kick in the teeth for the people of Pembrokeshire. We have been through these consultations before and at every turn the views of local people get ignored. The biggest response to the West Wales consultation came from here in Pembrokeshire precisely because it is the area that loses out the most from all the options the Health Board put forward.

“The decision to keep a full hospital at Llanelli looks very political. It fits with the big plan that Welsh Government in Cardiff have been pushing for the last ten years which is to reduce and centralise services further east.

“If the long-term plan is to build a new hospital then we need some cast iron commitments from Welsh Government over funding and location and a promise not to reduce any more services at Withybush until that new facility is open and functioning.”

Paul Davies AM added: “I’m extremely angry and disappointed that following an extensive public consultation, Hywel Dda University Health Board has simply ignored the views of the people of Pembrokeshire. It is unacceptable that Withybush hospital will be downgraded and that patients will have to travel further for essential treatments and services.

“This is a very dark day for the people of Pembrokeshire, who have seen health services constantly centralised away in recent years. The Welsh Government has a duty to ensure all parts of Wales have access to essential health services and so it must take a stand against Hywel Dda University Health Board and act now – before it’s too late.”

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