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Badger and the balancing act

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badger knows bestSOME people, readers, who shall for the moment remain shameless, seem to think that newspapers and other media should not report news as it is but news as they would wish it to be. To them, every day is a good news day and every mishap, misstep or disaster is an ‘opportunity’. Well readers, over the last few years, readers, there have been plenty of chances for Badger’s chums at County Hall and Health Board HQ to avail themselves of some pretty catastrophic opportunities. Some believe that there should be more stories about diligent councillors doing their altruistic level best with nary a thought about preening their public image or grabbing an extra allowance or three. To those persons, readers, it’s all about ‘never mind the quality, feel the width’. Still, others believe that they and their organizations are misrepresented or represented unfairly by Badger and his ilk. They complain that negative news affects how the services they deliver are perceived and hamper their efforts at recruitment and improvement.

To those people, readers, there are no cuts there are only ‘efficiency savings’ and staffing problems cannot possibly be the result of crappy staff management and salami-slicing cuts. Apparently, readers, such is Badger’s power over the hearts and minds of the surface world that the merest flick of his claw sends shivers through bureaucrats and petty politicians with nothing better to do than take careful aim at the messenger, rather than act on their own faults and flaws. Nothing could be further from the truth, of course. Badger is a solitary creature tip-tapping away in his sett, pausing only to look up at the outside world and do some reading. However, those who complain the loudest have public servants on hand to prepare their carefully chosen words for them. Those without wordsmiths on tap are handsomely paid from the public purse, presumably on the basis they are able to string two words together and express themselves in a clear and clearly thought out way. Or so you would think. Words are slippery things, readers, and they do not always mean what you and Badger might believe. Badger wants, therefore, to show you, dear readers, the sort of sign posts that one should look for when questioning the pronouncements made by those in public authority. Here readers, Badger will provide three phrases to watch out for when you are trying to ascertain the amount of horse feathers being peddled on each occasion you might hear them.

1. ‘Everyone agrees that no change is not an option’ This phrase is especially beloved of those seeking to ram through a radical programme for which they have no democratic mandate on the basis that we’ve all gone to hell in a handcart and only they can operate the brake. It impliedly asks you to ignore the fact that they got us into this infernal truck in the first place. It is indicative of prejudgement of a substantive issue that precludes the chance of proper debate around alternatives. The meaning of the term ‘everyone’ in this case can vary from ‘the members of the ‘independent’ panel I appointed who have surprisingly agreed with my objectives’, through to ‘a policy think tank populated by people with ideas and no common sense’, ‘my cabinet colleagues and I’, and – as Badger suspects in Leighton Andrews’ and Mark Drakeford’s cases – ‘the voices in my head’.

2. ‘The level of service has fallen far short of the level of service we usually provide and is below expectations we set for ourselves’ Badger’s bugbear, if badgers have bugbears, readers, is the use of the above phrase in the context of the non-admission admission that the service provided has been appalling. Let’s look at the phrase critically for a moment or two. What is actually being said is that the person or body at fault is one which sets itself high standards and that – in this instance ONLY – those standards have not been met. It is asking you, the engaged reader, viewer or listener, to agree that – for example only – Abertawe Bro Morgannwg Health Board could not possibly have known about the level of elderly patient mistreatment and neglect at Princess of Wales Hospital, Bridgend, despite the fact that the course of alleged misconduct covered many years, was the subject of a number of complaints and involved a significant number of health workers, several of whom have now been charged with criminal offences. If they said what they mean in the way that they really feel about it, something like this would be more appropriate: “Our management systems are chaotic and we systematically ignored complaints and warning signs. Sorry.” (Jazz hands).

3. ‘Lessons must be learned; and they will be learned’ Now, readers, this is a phrase that can be deployed in almost any circumstance in which the speaker or writer needs to verbalise contrition while signalling that they want to brush a scandal under the carpet. It is most often deployed by those seeking to demonstrate that, no matter what previous failings there may have been, they are committed to sorting them out and hope that you will not notice that they are the group or individual responsible for the cock up in the first place. A special ‘sad’ voice is used to deliver this phrase, possibly to distract attention from some pretty lumpy carpets about the place. Jamie Adams used to love this one when he rattled on about the failings in our county’s education system that his administration had put right. Did you know, readers, that the administration that piloted Pembrokeshire’s education system into the mire is the same one that seeks your approval for digging it back out of the mire with the help of the Welsh Government? Did you know that Jamie Adams was Deputy Leader of the council for four years and a deputy Cabinet and Cabinet member for three or four years before that? Because if you didn’t, readers, Jamie isn’t about to tell you. Otherwise there is a risk that, unlike some of his Cabinet colleagues and IPPG stooges, you will be able to work out how many beans make five and where the buck must ultimately stop. No wonder it was once said ‘I have seen the future and it smirks’. Looking at Jamie Adams one can see the future is now. Badger is not demonstrating bias here, readers. Badger thinks that statements coming from authority should be forensically examined. After all, readers, policies mean pounds – and pounds mean you and me are going to pay policies’ prices. It is right to approach a statement with an open mind in the hope of judging whether, on balance, one agrees with a policy or not. It is our duty to read and listen critically and to question authority. Sometimes authority will be right, but we must always test it first and judge it. Badger is a sceptic, but that does not mean he is a pessimist. Badger always travels hopefully, readers, when reading a pronouncement, listening to a speech, following a debate. It is hardly Badger’s fault that it is usually better to travel hopefully than to arrive.

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All-Wales charity wins at prestigious national air ambulance awards

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THE LIFE-SAVING air ambulance service in Wales has won two top prizes at the annual Air Ambulance Awards of Excellence.

The Emergency Medical Retrieval and Transfer Service (EMRTS) and its partners the Wales Air Ambulance Charity were nominated in a trio of categories in the event organised by Air Ambulances UK – the national organisation supporting the work of the UK’s 21 air ambulance charities.

At a ceremony held at the home of Reading FC last night, (Thursday, 30 November) the service walked away with gongs for Operations Support Staff of the Year and Special Incident of the Year.

EMRTS National Director David Lockey said: “Once again the talents of our staff and quality of our service has been recognised nationally and both of the prizes are thoroughly deserved.

“They recognise the expertise, professionalism and dedication not only of our highly skilled clinicians, but also the teams that support them, from the Critical Care Hub and the administrative and logistical support to our stakeholders and partners, the Wales Air Ambulance.

“We are proud to have each of them working for EMRTS”.

Sue Barnes, Wales Air Ambulance Chief Executive, added: “We are always incredibly proud of our EMRTS colleagues. Each and every day, the medical and aviation crews deliver exceptional care across the country, supported by the expertise of those who coordinate our service from the Critical Care Hub.

“We are absolutely delighted to see this recognised by the air ambulance community and our congratulations go to all of the award winners. It is a moment to fully appreciate their dedication and to say thank you to our Charity supporters who allow us to deliver such a critical service for Wales.”

The winner of the Operations Support category was EMRTS Critical Care Hub manager Greg Browning, having been nominated by colleagues for his exemplary and outstanding service.

The Hub, based in Cwmbran, is the centre of the Wales Air Ambulance service. Operating 24/7, an allocator/ dispatcher and critical care practitioner monitor every 999 call made to the Welsh Ambulance Service and identify where early critical care intervention is required before dispatching the most appropriate Wales Air Ambulance resource.

Greg is responsible for the complex management of making sure the operation runs smoothly, and since joining the service back in 2015 has been an instrumental member of the team.

Speaking after his win, Greg said: “I am beyond thrilled. This is first time I have been nominated for an award, let alone win one, and it is undoubtedly one of the proudest moments of my entire career. 

“Knowing that my colleagues were behind the scenes nominating me for this award makes me feel hugely honoured and is something I shall cherish. The entire table erupted when I won, which is still surreal. I am grateful every day for the opportunities EMRTS and the Wales Air Ambulance have presented me with, and this is quite simply the icing on the cake.”

EMRTS medics also won the Special Incident of the Year Award for the delivery of extremely premature twins in a home environment.

Two EMRTS crews in Wales Air Ambulance Charity rapid response vehicles were last year dispatched by CCP Tom Archer and Critical Air Support Dispatcher, Katie Manson, to a woman in labour at just 24 weeks.

With the twins being so premature the odds of their survival were extremely low.

Critical Care Practitioners Josh Eason, Elliott Rees, Marc Frowen and Critical Care Consultant Dr Laura Owen, delivered the twins and were able to provide advanced critical care interventions in challenging conditions, with the support of top cover consultant Dr Matt O’Meara.

The emergency included extremely difficult intubations, mechanical ventilation, and the administration of lifesaving medication. Despite the conditions, the twins were stabilised and safely transported to the nearest neonatal unit. Despite challenging odds, their advanced care paved the way for one twin’s miraculous survival.

Speaking on behalf of the team, Critical Care Practitioner Josh Eason said the awards are testament to the work the Wales Air Ambulance does on a daily basis.

He said: “The event was amazing, and the atmosphere was wonderful. It was so nice to celebrate all of our colleagues’ excellence across all air ambulance charities across the UK and come together as one big team. We are all really proud to win our award and we are equally honoured to have been nominated and shortlisted against some amazingly talented and deserving air ambulance charities.

“Everyone is a winner in their own right, and we are shocked but extremely grateful to receive our award. The team are thrilled and so proud. Everyone in our category demonstrated the amazing work the air ambulance teams do and the real life benefit of providing critical care to patients.

“The awards are an opportunity to reflect on the work that the air ambulance charities do and highlight the positives and achievements and are a great example of why we do the work that we do.”       

Operations Director Mark Winter was also shortlisted for Lifetime Achievement award for a long and distinguished career at the hub of EMRTS. He continues to be the operational glue for the organisation and always goes above and beyond to ensure that the organisation functions and all of its members are safe and well looked after.

The Wales Air Ambulance service is consultant-led, taking hospital-standard treatments to the patient and, if required, transferring them directly to the most appropriate hospital for their illness or injury. For the patient, this can mean hours saved when compared to standard care and is proven to greatly improve survival and early recovery. 

This advanced critical care includes the ability to administer anaesthesia, deliver blood transfusions and conduct minor operations, all at the scene of an incident.

The Service is often described as a ‘flying emergency department’, however, it can also deliver the same standard of care by road via its fleet of rapid response vehicles.

This 24/7 service is delivered via a unique Third Sector and Public Sector partnership. The Wales Air Ambulance Charity relies on public donations to raise the £11.2 million required every year to keep the helicopters in the air and rapid response vehicles on the road. The Emergency Medical Retrieval and Transfer Service (EMRTS) supplies highly skilled NHS consultants and critical care practitioners who work on board the Charity’s vehicles.  

As a pan-Wales service, its dedicated crews will travel the length and breadth of the country to deliver emergency lifesaving care.

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Three Dyfed-Powys Police nominations win Wales Safer Communities Awards 

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Dyfed-Powys Police’s Economic Crime Team, INTACT – a multi-agency partnership to combat serious violence and organised crime in Dyfed-Powys, and the Integrated Offender Manageent (IOM) housing project in Dyfed-Powys won awards at the Wales Safer Communities Award in Swansea this week.

The Safer Communities Awards were being held to recognise outstanding contributions to community safety in a multi-agency context. The Awards Ceremony was an opportunity to recognise those who have had a real impact on people’s lives throughout the year.

The Economic Crime Team (Safeguarding Award Winners), INTACT (Serious Violence Award Winners) and the IOM project (Offending and Justice Award) were three of four nominees put forward by Police and Crime Commissioner Dafydd Llywelyn for an award.

Over recent years, staff and officers from Dyfed-Powys Police as well as some key partners who work within all three of these business areas have shown commitment and dedication to safeguarding the communities of Ceredigion, Pembrokeshire, Carmarthenshire and Powys according to PCC Llywelyn, and deserve to be recognised nationally.

In April 2020, Dyfed-Powys’ Economic Crime Team took over the management of all fraud and cybercrime incidents reported to the Force as a call for service – triaging the reports and engaging with victims at the earliest opportunity in order to provide consistent subject matter expert advice, guidance and support and to ensure accurate reporting to Action Fraud.

By taking on the management of all fraud and cybercrime incidents the Economic Crime Team has not only reduced the strain on frontline officers but have gained positive feedback from victims within the community, with many commenting on the quality of service and reassurance they have received.

Formed in 2019, INTACT is a multi-agency partnership to combat serious violence and organised crime in Dyfed-Powys. This partnership was formed in 2019.

The aim is to reduce the harm caused to individuals and communities by serious violence and organised crime (SVOC). It operates under the 4P approach to policing: Prepare; Protect; Prevent; Pursue.  They work closely with partner agencies to provide early intervention & prevention service to protect those most at risk of engaging in SVOC as victims or offenders.  To date, over 600 children, young people and vulnerable adults have been offered a variety of targeted interventions.

The Dyfed-Powys Integrated Offender Management (IOM) housing project in Ceredigion is a Provision of temporary move on accommodation for Integrated Offender Management offenders.

The IOM team in Ceredigion identified accommodation as the key need amongst the cohort to attempt to break the offending cycle. Existing multi-occupancy projects didn’t provide an environment or opportunity for rehabilitation.

The PCC provided set up funding for a dedicated property (single bedroom flat) to stabilise IOM nominals while more long-term accommodation was found.  Since the project was established in 2021, seven nominals have used the property, with main criminogenic needs being accommodation, drugs and mental health. Six nominals have since been de-selected from IOM, with one remaining on the scheme. Reasons for de-selection are that pathways have successfully stabilised, and the individuals no longer require intense multi-agency wraparound support.

In congratulating the three initiatives, Dyfed-Powys Police and Crime Commissioner Dafydd Llywelyn said; “I am immensely proud to congratulate Dyfed-Powys Police and the multi-agency partners, on the well-deserved recognition given to them at the national Wales Safer Communities Award this week.

“The dedication and exceptional efforts of our Economic Crime Team, Serious Violence and Organised Crime Team, and the Integrated Offender Management housing project team have all been acknowledged through these Awards. 

“This accomplishment highlights a commitment to safeguarding our communities by tackling complex challenges. Their achievements are a testament to the collaborative spirit and effectiveness of staff and officers, and I extend my sincere appreciation to all involved and commend them for their exemplary service.”

Also receiving recognition at the Awards was the Dyfed-Powys Community Champion initiative. This initiative is a partnership programme between West Wales Domestic Abuse Services, Calan Domestic Violence Service, Threshold, Montgomery Family Crisis Centre and Carmarthenshire Domestic Abuse Service. The Champions educational programme raises awareness of stalking, harassment and hate crimes, working towards creating safer communities, encouraging participants to become Upstanders and report as appropriate. 

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Withybush paediatric care gone for good in yet another blow for hospital

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OVER seven years after “temporarily” closing Withybush’s 24-hour Paediatric Ambulatory Care Unit (PACU), Hywel Dda UHB decided to close the department permanently on Thursday, November 30.
In January, the Board will meet to receive the plan for its implementation plan to make the change permanent.

A FOREGONE CONCLUSION

Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as Thursday’s meeting chugged along, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.
The Board’s ability to deliver its preferred option, which included returning some outpatient services for children to Withybush, is doubtful.
However, it now needs a plan to implement its plan. That plan to have a plan for its implementation plan will be discussed in January when the Board will discuss the planned plan for a plan.
If the planned plan for a plan doesn’t work out, the Board will go back to the drawing board to draw up another plan for its plan.

A “TEMPORARY” PROBLEM

In three years, the Board moved from a 24/7 service to a promise to return to a 12/7 service to a bold attempt to preserve an 8/7 service.
As our columnist Badger noted five years ago, the next step was bound to be a 0/7 service.
And then Covid came along.
PACU was closed, and its services “temporarily” transferred to Glangwili during the pandemic.
At the end of the pandemic, PACU didn’t return.
Instead, the Board justified its continued cessation because of the risk of a spike in respiratory viruses.
When that spike didn’t happen, the Board consulted on a “permanent solution”.
And that permanent solution – as glaringly obvious for years – was permanent closure.

A DECADE OF WORTHLESS REASSURANCE

In 2014, the Board stopped providing 24-hour paediatric care at
Withybush. At the time, it said that a 12-hour provision was deliverable, and it planned to return 24-hour paediatric care to Withybush once it recruited clinical staff.
By then, there was only ONE advert for a single paediatric consultant at Withybush and NONE for nurses specialising in paediatric care.
At one point at the end of 2015, the Board suspended its recruitment campaign for posts at WithyWithybush’s after claiming to have recruited staff to fill vacancies there. It announced an intention to launch a more focused campaign later.
In November 2016, the Board restated its commitment to maintaining the Paediatric Ambulatory Care Unit’s opening hours at Withybush from 10am-10pm, even though it faced “renewed and significant workforce challenges at the consultant level”.
In 2017, CEO Steve Moore said the Board was clear: “The changes to paediatric services are temporary and in response to us needing to ensure a safe and reliable service for our families with the consultant paediatricians available.”
After ending the 12-hour PACU cover, the Board did not launch an effort to recruit for three months after its closure.
By the end of the same year, the Board said: “Unfortunately, we have not been able to recruit a sufficient number of consultants to support the re-establishment of the 12-hour PACU service, although our recruitment efforts continue.
“In the meantime, the Health Board is working with staff and partners to explore a number of ideas to support a sustainable PACU service for the longer term.”
In 2018, the Community Health Council issued a report.
It said: “The health board needs to do all it can to resolve the current temporary reduced hours arrangements in PACU”.

CONSULT THE PUBLIC, THEN IGNORE THEM

Thursday’s meeting continued to offer mealy-mouthed platitudes instead of health services.

Board members suggested that parents of children in need of paediatric care would be reassured by the clarity the permanent removal of a key service from Pembrokeshire would provide.
Discussing the lack of transport options, Board members said they would publicise the availability of the Designated Ambulance Vehicle and the use of a taxi service to ferry children and parents from Glangwili.
The disconnection between the Pembrokeshire public and the Board over the issues could not be more complete.
Board members said that the main problem with the attitude of Pembrokeshire’s concerned parents was communication.
Pembrokeshire’s respondents to the Board’s conscientious rubber-stamping process were clear the issue was not communication but concern about timely treatment close to home.
70% said PACU should return to Withybush. The Board’s alternative, closing PACU for good, was overwhelmingly rejected.
If communication were the issue, not the provision of treatment at Withybush, the Board could have resolved it by being straightforward and transparent.
It wasn’t.
All the communication in the world, delivered by the best communicators money can buy, cannot circumvent that epic failure of honesty.
Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as the meeting ground on, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.

TOTAL DISCONNECTION

Board members suggested that parents of children in need of paediatric care would be reassured by the clarity the permanent removal of a key service from Pembrokeshire would provide.
Discussing the lack of transport options, Board members said they would publicise the availability of the Designated Ambulance Vehicle and the use of a taxi service to ferry children and parents from Glangwili.
The disconnection between the Pembrokeshire public and the Board over the issues could not be more complete.
Board members said that the main problem with the attitude of Pembrokeshire’s concerned parents was communication.
Pembrokeshire’s respondents to the Board’s conscientious rubber-stamping process were clear the issue was not communication but concern about timely treatment close to home.
If communication was the issue, not the provision of treatment at Withybush, the Board could have resolved issues by being honest and transparent from the outset. It wasn’t. All the communication in the world, delivered by the best communicators money can buy, cannot circumvent that epic failure.

PERMANENT CLOSURE “BETTER”

Six years ago, “temporary” became the status quo.
Then “temporary” became a further “temporary reduction”. During Covid, the whole service was “temporarily” withdrawn.
So intense was Board members’ collective delusion at Thursday’s meeting that the permanent removal of the PACU service and its replacement with a vague promise of some outpatient clinics for children returning to Withybush sometime over the rainbow was represented as an improvement on the current position.
Even this Thursday morning, the current position was “temporary”, not permanent.
The Health Board’s thesaurus must look very peculiar.
Its word games demonstrate the extent to which the Board had long dispensed with the pretence of PACU’s closure temporary nature.
In the meantime, the Board plans to tell more people about its Dedicated Ambulance Vehicle and plans to fund taxis for distressed parents and sick and injured children.
You can bet that’ll make everything better.

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