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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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Strong winds close Cleddau Bridge, other traffic problems reported

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THE CLEDDAU BRIDGE closed to all traffic this evening due to high winds, but there are other problems on the roads.

Here is the latest.

Between Cresselly and Lawrenny a large tree has been uprooted with the council reporting that a nearby bridge may have been damaged.

The council is reporting that there is flooding on the following roads (as at 17:00 HRS):

  • Rosemarket to Honeyborough
  • Road between Sutton and Nolton

A large tree has been been blown down between Lawrenny and Cresselly and has possibly damaged a bridge, meaning that the road will need to remain closed until Monday.

Reports of flooded roads:

  • Trewent – Freshwater East
  • Targate Raod between Freystrop and Johnston
  • Old Hakin Road, Haverfordwest as leaving Merlns Bridge
  • Druidston – Nolton Haven Road
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Home office is ‘misleading the public’ over police funding, says Police and Crime Commissioner

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THE POLICE AND CRIME COMMISSIONER has told The Herald that he believes that the Home Office is ‘misleading the public’ that his force will have an increase in funding in 2019/2020.

On the face of it, it appears that Dyfed-Powys Police will have an increase in funding of £8.1 million in 2019/20. However this figure is based upon the presumption that PCC Dafydd Llywelyn will increase the current Band D property precept level by £24 annually.
After what he describes as a frustrating delay, the Government’s provisional grant funding settlement has been announced, which sets out the position for Dyfed-Powys Police for the 2019/20 financial year. On the face of it, it appears that Dyfed-Powys Police will have an increase in funding of £8.1 million in 2019/20. However this figure is based upon the presumption that PCC Dafydd Llywelyn will increase the current Band D property precept level by £24 annually.
PCC Dafydd Llywelyn said: “The way in which the Home Office and Central Government are misleading the public is disgraceful and I am very disappointed in the way this settlement once again shifts the burden onto local tax payers. I continue to try and do the right thing to protect our communities but I feel we are being let down by the Government in London as their actions are likely to impact on our local services.”
“I am currently consulting with the residents of Dyfed-Powys; asking if they would be willing to pay additional police precept to continue to safeguard our communities. Within the survey I have outlined the impact of for Dyfed-Powys Police and its communities. My decision will be made by listening to local communities and the professional advice of the Chief Constable.”
“I am working closely with the Chief Constable to critically review all aspects of the budget requirement. Given the scale of financial challenges that are faced, a precept increase will be unavoidable, but how much this is increased by should not be dictated by Government.”

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Police issue warning over sheep attacks in Pembrokeshire

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DYFED-POWYS POLICE has issued advice to pet owners following a spate of livestock worrying incidents in the Saundersfoot, Narberth and Crescelly areas.

There have been six reports of dog attacks on sheep in the past three weeks, one of which caused a dog to be shot after it was caught attacking sheep in Solva.

PC Gerwyn Davies of the Pembrokeshire Rural Crime Team, told The Herald: “It is important dogs are always kept on leads near livestock, but especially so at this time of year. Sheep are heavily in lamb and their numbers have increased because they come from high grounds in mid Wales for the winter.

“Sheep worrying can have a long term effect on ewes as they can lose pregnancies as a result of stress. This obviously has a negative impact on farmers who not only lose out financially, but it is also very upsetting.

“Sadly, three ewes have been killed and several more injured in the past few weeks. One family dog was shot in Solva after it attacked sheep, which is a sad situation for the dog’s owner and upsetting for the farmer.”

Farmers can legally shoot any dog if they believe it is the only reasonable way of stopping it worrying livestock. If your dog chases or attacks livestock you should make arrangements to contact the landowner/livestock owner.

Anyone who has information about, or wants to make a report of livestock worrying, can contact the Pembrokeshire Rural Crime Team by calling 101.

Dog owners are reminded of this advice when walking in the countryside:

  • Do not allow your dog to enter a field on its own and keep it under your control at all times.
  • Keep your dog on a lead when crossing through fields that contain livestock.
  • Stick to public right of ways.

When at home:

  • Make sure you know where your dog is at all times.
  • Ensure that your property is secure and that your dog cannot escape day or night.
  • If you know your dog has previously chased or attacked sheep then take responsible measures to prevent it happening again.
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