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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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Coastal car parks at beauty spots remain closed

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THE RECENT changes in regulations reinforce that movement is restricted to your local area.

This has been identified by the Welsh Government as an approximation of a five mile radius from your home.

Members of two separate households from the same local area (not travelling more than five miles) can now meet outdoors, as long as they maintain social distancing.

You should aim to meet another local household as close to your home as possible. Always take care to maintain social distancing and hand hygiene.

Pembrokeshire County Council car parks at attractions and beauty spots (including public toilets) currently remain closed so you should check before travelling.

They remain closed as a clear message that travel remains restricted, and associated tourism amenities remain closed.

A critical point for all to note is that lifeguards are not currently patrolling beaches and toilets and other facilities are not open.

Full details of the car parking facilities which remain open for the local community can be found on the Council’s website:
https://www.pembrokeshire.gov.uk/emergency-planning/service-changes

Councillor Phil Baker, Cabinet Member for Infrastructure said: “The emphasis is on careful, structured unlocking, and not to put in danger any of the recovery measures that relate to public health and not to undo the safeguarding that lockdown has delivered.

“We will continue to review and monitor this carefully and take cautious, measured steps only to provide the benefits of the eased regulations without putting our residents at risk.”

Motorists are reminded not to contravene parking restrictions – such as yellow lines – where they exist as parking enforcement is still being undertaken.

As with other service areas, car parks will be reviewed in line with current advice.

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Pembrokeshire County Council Leaders coronavirus update

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PEMBROKESHIRE County Council Leader, Councillor David Simpson, has provided a further coronavirus update for Tuesday, 2nd June, as follows:

‘I want to thank everyone for the continued support to myself, Elected Members and officers of the Authority.

‘We have all experienced many challenges over the years but this continued struggle is very testing for all. We continue collectively to work together to ensure we, in Pembrokeshire, remain safe and avoid catching Covid-19

‘It is clear that we still have to remain “local”. There is no remit for travelling outside our local community. You will have read and heard clear guidance on only travelling five miles from home.

‘As always and where you can, please exercise from your home. The more we can do to reduce the spread of the virus, the better we will all fare in the long term.

‘I want to highlight that today marks the 50 th anniversary of the collapse of the Cleddau Bridge. This was indeed a tragedy as lives were lost and it is a sad chapter in Pembrokeshire’s history.

‘As in any incident, people can, and do, rebuild and also learn lessons. After Covid-19 the new “normality” will look different from what we were used to. But we will all move forward and regain Confidence.

‘I’m sure, like you, I question how I should be tackling this issue. Should I be doing more? The answer is simple and direct – we need to ensure social distancing is maintained; wash our hands regularly and listen to the advice given by experts.

‘Remember: ‘Stay Strong and Stay Local.’

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‘Check in, Catch up and Prepare’ All school’s in Wales prepare to enter next phase

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ALL children will have the opportunity to “Check in, Catch Up, Prepare for summer and September”, the Education Minister Kirsty Williams announced today as she published details of the next phase for schools in Wales.

It is proposed that all schools will start the next phase on 29 June, with the term extended by a week, therefore ending on 27 July.

In the next academic year, beginning in September, the intention is that the autumn half-term break will be expanded to two weeks.

In each school there will be a phased approach. Year groups will be split into cohorts with staggered starts, lessons and breaks. It is expected that this will mean, at most, a third of pupils present at any one time, though schools may need time to reach this level of operation.

There will be much smaller classes, providing secure dedicated time with teachers and classmates. This time will include online and personalised classroom experience, getting children and teachers ready for a similar experience in September.

Next week, the Welsh Government will publish guidance to support schools, as well as further and higher education institutions. This will include information on managing their facilities and logistical arrangements, including buildings, resources, cleaning and transport.

The Government is also today publishing a paper from its COVID-19 Technical Advisory Group, representing the latest understanding of the virus with respect to children and education.

Further Education colleges are ensuring that appropriate measures are being taken to re-open for face-to-face learning from 15 June. They will prioritise those students requiring licence to practice assessments and vulnerable learners. This follows close working with Government and the joint trade unions.

Guidance for childcare providers will also be published in the next week, supporting them to increase the numbers of children in attendance alongside schools.

Kirsty Williams said:

“My announcement today gives schools three and a half weeks to continue preparing for the next phase.

“We will use the last weeks of the summer term to make sure pupils, staff and parents are prepared – mentally, emotionally and practically – for the new normal in September.

“29 June means there will have been one full month of test, trace and protect, which will continue to expand. I can also announce that teachers will be a priority group in our new antibody-testing programme. As we continue to keep Wales safe, this approach will be critical.

“The evolving science suggests that warm weather and sunlight gives us the best opportunity to ensure more time in school. Waiting until September would mean almost half a year without schooling. That would be to the detriment to the wellbeing, learning progress and mental health of our young people.

“This is and has been a worrying period for us all. I know that many will feel apprehensive. We have not rushed this work and this decision.

“The three and a half week period before the next phase also gives us time to keep watch on developments elsewhere and provides further check-points to review evidence and the roll-out of testing.

“This is the best practical option that meets my five principles which underpin my decision making.

“I am also convinced that it is only by returning to their own school that we will see increased attendance from our more vulnerable and disadvantaged children.

“Working together we will secure equity and excellence for pupils as they check in, catch up, and prepare for summer and September.”

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