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Chair’s reflections and focus on recovery one year on



MARIA BATTLE, Chair of Hywel Dda University Health Board, which plans and delivers the majority of NHS care in Carmarthenshire, Ceredigion and Pembrokeshire, is reflecting on the last year as we reach the anniversary of the first UK stay-at-home instruction in response to the COVID-19 pandemic:

“The day of reflection planned across the UK on Tuesday March 23 2021 will be a poignant day.

Families who have suffered the loss of a loved one either directly from COVID-19, or during the pandemic, are living every day with their personal grief and loss. In Hywel Dda University Health Board alone, 474* people have died from COVID-19 since the start of the pandemic.

Loved ones lost before their time.

Our thoughts and sympathies are first and foremost with people who are grieving at this time. The hope is that this day of national reflection will demonstrate that their loved ones were seen and are remembered. Our thoughts are also with our staff who cared for those lost so lovingly at the end of their lives.

In Hywel Dda University Health Board, we will join others across the UK in a one minute’s silence at 12noon on Tuesday, to remember those lost. Care will continue to be provided, but what can be paused will be paused. We will take those moments privately, or collectively with our colleagues, to remember in peace and to pay tribute.

An online remembrance service has been organised for our staff on this day, so those who wish to come together have a place to do so, although not physically but in the spirit of togetherness.

As always, staff can attend our hospital chapels if they need a place for rest or recuperation, and are invited to light battery operated candles, funded by Hywel Dda Health Charites, and distributed across our sites and community services.

As we know, the simple act of lighting a candle can help the emotions we may experience from continued pain, suffering and anxiety become a tribute to hope and thankfulness for the heroic response by many people in our communities.

We are also invited to shine a beacon into the night sky at 8pm by using our phones, candles or torches; and we thank our partners in local authorities in Carmarthenshire, Ceredigion and Pembrokeshire who will light up landmark buildings in our area for this day of reflection.

But alongside remembrance and reflection, in Hywel Dda University Health Board, we have also turned our attentions to the recovery and learning that is necessary as we start to emerge out of the pandemic.

I am so very proud of the sacrifices made by our staff (frontline and support), their families, our partners and our communities during the past year.

I have been awed by how our communities have rolled up their sleeves. Whether that has been other key workers, people staying at home, those shielding, home schooling, or in support of neighbours by volunteering and carrying out heart- warming acts of human kindness.

The hope and the light that came when we received the first batch of vaccines on December 8 2020 grows daily and shines more brightly. Our staff, volunteers and partners have worked so hard together in recent months to deliver vaccines to those most at risk, to save lives and protect us all.

And people have come forward for their vaccinations in numbers we daren’t imagine were possible, to protect themselves and their loved ones and their communities.

As of March 17 2021, we have given 175,893 vaccinations in total, representing 39.5% of our population (more than 50% of eligible adult population) having received their first dose and 5.9% receiving the full course (2nd dose).

We are on target to offer vaccination to all adults in West Wales by the end of July, subject to supplies being received as planned.

This extraordinary achievement opens up hope for the future as we continue to work towards our vision for a healthier mid and west Wales. But we have a lot of work to do to re-build and a lot of learning to take stock of.

We are all acutely aware of the detrimental impact on people waiting for planned operations far longer than we would like. We have written to all patients who have waited more than 52 weeks to say how sorry we are, to explain why and to ensure our waiting lists are correct to help clinical decisions as we re-start non-urgent care. You can keep up-to-date on the re-starting and expansion of planned care services here:

We are about to offer a single point of contact and additional support to some patients. We are starting with a group of orthopaedic patients, so they are supported to look after themselves and be ready for surgery, and are able to recognise and report any significant changes to their clinical condition. We want to eventually roll this out to everyone on the waiting list.

General advice to people on how to remain well whilst awaiting surgery, which can improve outcomes after surgery, is available here:

Without the pandemic however, we would unlikely have seen the speed of the digital roll out and community based care that we have been able to provide in people’s own homes, or closer to them.

For example, in March last year only 1% of outpatient appointments were carried out online, but as of January this year, 28% of outpatient appointments were carried out in this manner, with really good feedback from patients.

We are also continuing to support staff with their own health and wellbeing with a range of psychological and wellbeing services. Many are exhausted and they and their families have made great personal sacrifices. It has been humbling and inspirational to listen to their experiences and see how they have looked after each other as well as their patients. They need some time to rest and recover before the full resumption of all services.

I have recently set up a group of experts, including the Military, to advise on how we best support staff coming out of the pandemic. To rebuild stronger, we need a solid foundation and that is our staff who deliver or enable the care we provide

Following the Senedd elections, we will also ‘check in’ with our communities and open up a conversation about the pandemic and what it has meant for you and your experience and access to health and care. We want to consider any new information you have that we need to take into account when planning your health services for the future.

So next week is for reflection and remembrance. But it is a not a one day event for us in Hywel Dda UHB. We will use what we have learnt and all our experiences to inform what we do and how we do things moving forward to hopefully, make things better for our communities, our staff and our patients.

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Police and drugs advice service issue warning over ‘deadly batch’ of heroin



POLICE have asked the media to issue a warning over a batch of heroin.

The drug circulating in west Wales, first detected in Llanelli, is particularly dangerous, it has been confirmed.

“We are warning drug users to take extra care following reports of a particularly harmful batch of heroin circulating in the Llanelli area” said a Dyfed-Powys Police spokesperson.

“We have reasons to believe some drugs being distributed and used in the Carmarthenshire area at present have been contaminated with other substances and could be extremely dangerous for anyone taking them.

“We would also appeal to drug users to seek medical attention immediately if they become unwell.

“Please share this information with anyone you believe could come into contact with these drugs.

”In an emergency or if you think someone’s life is at risk always dial 999.”

Earlier this week Barod, the drug and alcohol abuse service reported a dangerous and toxic heroin circulating in Pembroke Dock which a spokesperson described as being ‘potentially deadly’.

To comes as Public Health England issued a formal alert about the risks of heroin containing fentanyl or carfentanyl.

The warning reads: “There is significant evidence from a small number of post-mortem results of recent drug user deaths and from police seizures that some heroin may contain fentanyl or carfentanyl added by dealers.

“These are highly potent synthetic opioids and very small amounts can cause severe or even fatal toxicity.

“Those of you in contact with heroin users should be alert to the increased possibility of overdose arising from heroin cut with these synthetic opioids, be able to recognise possible symptoms of overdose and respond appropriately.”

The fentanyls are a group of synthetic opioids; some have legitimate uses while others are illicit drugs.

Fentanyl is about 100 times more potent than morphine and is a licensed medicine used to treat severe and terminal pain. Carfentanyl is 4,000 – 10,000 times more potent than morphine and principally used as an animal tranquilliser.

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Covid-19 restriction relaxations in Wales brought forward



THE WELSH GOVERNMENT will be accelerating elements of its programme to relax Covid-19 restrictions as cases of new infections continue to fall across Wales, the First Minister today announced.

People will be able to form an extended household, visit the gym or take part in organised outdoor activities a week earlier than planned, as the public health situation – and vaccination rates – continue to improve.

The First Minister last week set out a detailed timetable for moving Wales firmly into alert level three. But some of these measures will now be introduced sooner than planned as cases have fallen markedly from 37 cases per 100,000 people to fewer than 21 per 100,000 this week.

The pressure on hospitals also continues to ease. Confirmed cases in hospital beds continue to reduce, and now stands at 89. This is 26% lower than last Thursday and is the lowest position since 22 September 2020.

The planned opening date for organised outdoor activities and outdoor wedding receptions will be moved forward to Monday 26 April from 3 May.

And, from Monday 3 May, a week earlier than previously signalled, gyms, leisure centres and fitness facilities will be able to reopen for individual or one-to-one training. Extended households will also be allowed again, enabling two households to meet and have contact indoors.

First Minister, Mark Drakeford said:

“The public health situation in Wales continues to improve thanks to everything you are doing to help us control this awful virus. Cases of the virus are falling and our incredible vaccination programme continues to go from strength to strength.

“Last week, we set out our programme to further re-open the economy and relax the restrictions we have lived with for so long, as part of our careful, step-by-step approach to keeping everyone safe. This week, because of the improvements we continue to see, we can bring forward some of our plans.

“This is only possible because of the efforts everyone is making to protect themselves and their loved ones.”

From Monday 12 April, the following relaxations will go ahead:

  • The full return of children to schools for face-to-face education, all post-16 learners will return to further education and training centres, and university campus’ will be able to open for blended face-to-face/online learning for all students;
  • All remaining shops will reopen, completing the phased reopening of non-essential retail;
  • All remaining close contact services will open, including mobile services;
  • Travel restrictions on traveling into and out of Wales will be lifted. However, restrictions on travel to countries outside the Common Travel Area without a reasonable excuse, remain in place. The Common Travel Area means the United Kingdom, the Channel Islands, the Isle of Man and the Republic of Ireland;
  • Wedding ‘show-arounds’ by appointment are allowed;
  • Restrictions on political canvassing are removed, subject to canvassers doing so safely.
  • Further easements to restrictions in the coming weeks will be subject to the public health situation remaining favourable. These will be confirmed at the next three-weekly review of the coronavirus regulations on 22 April.

On Monday 26 April:

  • Outdoor attractions, including funfairs and theme parks, would be allowed to reopen;
  • Outdoor hospitality can resume, including at cafes, pubs and restaurants. Indoor hospitality will remain closed except for takeaways;
  • Organised outdoor activities for up to 30 people can again take place (previously Monday 3 May);
  • Weddings receptions can take place outdoors for up to 30 people (previously Monday 3 May).

On Monday 3 May (previously Monday 10 May):

  • Gyms, leisure centres and fitness facilities can reopen. This will include individual or one-to-one training but not exercise classes;
    Extended household will again allow two households to meet and have contact indoors.
  • As set out in the revised Coronavirus Control Plan, a small number of outdoor pilot events of between 200 and 1,000 people are also being planned.
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Third COVID-19 vaccine arrives in Wales following Moderna approval



THIS WEEK marked another key milestone in our fight against the COVID-19 pandemic with the arrival of supplies of the Moderna vaccine.

A third vaccine for use in Wales significantly adds to our defences in the face of coronavirus and will help to protect our most vulnerable.

Elle Taylor, an unpaid carer from Ammanford, became the first person in the UK to receive the vaccine Glangwili Hospital in Carmarthen.

Speaking after receiving the vaccine, the 24-year-old, who works at a further education college, said: “I’m extremely excited and happy.

“I’m an unpaid carer for my grandmother so it is especially important to me that I get it, so I can care for her properly and safely.

“My grandmother has had her first dose and she is going for her second dose on Saturday.”

Ros Jervis, Director of Public Health for Hywel Dda University Health Board, added: “We’re delighted to be able to use the Moderna vaccine for deployment across west Wales.

“We will be using this new vaccine, alongside Oxford Astra-Zeneca, to continue the vaccine roll out to our communities in Carmarthenshire, Ceredigion and Pembrokeshire.

“We are incredibly lucky to have a third vaccine in Wales, with a long shelf life and the ability to be easily transported, to help deliver the vaccination programme to small clinics across our rural communities.”

194,057 people in our three counties have now received their first dose of the vaccine, and 47,087 people are fully vaccinated having received both doses.

The Health Board has offered a first dose of the vaccine to all those in priority groups 5-9 by Sunday 18 April.

Hywel Dda said that to ensure no one is left behind, this week the health board has launched an appeal asking people in groups 1 to 9 who have not been contacted to get in touch to arrange their first vaccine dose.

Second doses are essential for longer term protection, so it’s important that everyone comes forward for their full course when called.

When you will be contacted for your second vaccine dose depends on which vaccine you have received.

A Health Board spokesperson said: “We are asking anyone who received the Pfizer vaccine and has not received a second vaccine appointment yet, to get in touch as soon as possible on 0300 303 8322. Please note our phone lines get terribly busy at times and you may have to wait for the call to be answered.

“We aim to complete all second Pfizer vaccine doses by week commencing Monday 12 April.

“To check which vaccine you received, look at the card given to you when you received your first vaccine. It will say if you received either the Pfizer BioNtech
vaccine, or the Oxford AstraZeneca vaccine.

“If you received a first vaccine dose of the Oxford AstraZeneca vaccine, we politely ask that you do not contact your GP practice or health board at this time to ask about a second vaccine appointment. You will be contacted when it is your turn for a second dose – we are calling those who received a Pfizer first dose at this time.

“Care home residents, people aged over 80 and all other priority groups who have received the Oxford AstraZeneca vaccine at the GP surgery will be contacted between 11 to 12 weeks following their first vaccine with an appointment time.”

The Health Board says that confidence is building around the effectiveness of the vaccines. Emerging evidence is clear on the impact of the vaccine in preventing severe disease and hospitalisation. That is now playing out in admissions to our hospitals, and thankfully, numbers of deaths from coronavirus being reported.

UK and EU regulators have also been clear about the safety of the vaccines. The benefits of vaccination outweigh any possible risks. All three vaccines are both safe and effective.

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