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Children’s unit at Withybush set to have reduced hours

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withybush (2)MEMBERS of Hywel Dda University Health Board will discuss temporary changes to the opening hours of the Paediatric Ambulatory Care Unit at Withybush Hospital whilst there are fewer consultant paediatricians available, at a full health board meeting on Thursday (Nov 24).

The issue has emerged due to a combination of long standing difficulties in recruiting paediatric consultants across the UK and an exacerbation locally due to the coinciding retirement of one Pembrokeshire paediatric consultant, along with maternity leave of another.

The Health Board said: “Doctors, nurses, hospital managers and the Executive Team have been in discussion about how to best serve children and families in Pembrokeshire by doing all that is possible to maintain the Paediatric Ambulatory Care Unit (PACU) at Withybush Hospital whilst there are fewer consultant paediatricians available. To do nothing is a risk. The health board’s prolonged attempts at substantive and locum recruitment have been unsuccessful and agency consultants are only sometimes available which creates the risk of an unsafe, unreliable and fragile service.

“The recommendation to full health board is to get agreement in principle to progress towards continuation of a 12 hour, seven day PACU at Withybush Hospital, with remote paediatric consultant support. However, the consultant recruitment difficulties mean we must consider how we can do this temporarily in a safe way until we have developed this method of working for our locality. One option for providing paediatric consultant cover, whilst minimising the number of families affected, is to reduce opening hours for PACU by four hours a day. This means PACU would be open from 10am until 6pm.

“There is also a recommendation, in line with original service change plans and advice from the Royal College of Paediatrics and Child Health, to merge the overnight on-call rota with the one operating in Carmarthenshire. This would mean that if there was a paediatric emergency out-of-hours at Withybush Hospital, the on-call paediatric consultants would offer remote advice.”

Chief Executive Steve Moore said: “We share the desire of our Pembrokeshire community to retain community and hospital services for sick children as close to home as possible and within the county whenever we can. We are committed to keeping the Paediatric Ambulatory Care Unit at Withybush Hospital open seven days a week and we think there is an option to allow us to safely do this, even with the renewed and significant workforce challenges.

“However, to do this safely, the recommendation from our staff is to temporarily reduce the opening hours of Withybush PACU by four hours a day.

“It is our duty to be realistic about the availability of our consultants and to plan care around this so that it is safe, consistent and to avoid public confusion. Otherwise, we risk the event of having insufficient staff and having to close the unit in an unplanned and uncoordinated way, risking patient safety and public confidence.

“Our recruitment efforts continue and we are pleased to have successfully appointed one agency consultant until the end of the month. We will review hours when the staffing situation improves and we want to work with our staff, partners and community to look at how we can strengthen services in Pembrokeshire, and across our whole area, in the long term.”

PACU is due to move closer to the Emergency Department at the end of the year and there are plans to strengthen links between the two departments, including development of Advanced Paediatric Nurse Practitioners. The health board also wants to improve telehealth links with the acute paediatric team based at Glangwili Hospital and provide more protected clinic time and community service capacity.

Clinical lead for Child and Adolecent Health Dr Simon Fountain-Polley said: “Families generally look after their own children for the majority of acute illnesses. If they need advice they can still access NHS Direct, community pharmacists, or their local GP. Most children, thankfully, don’t need to see the hospital paediatric team for acute illnesses. For that relatively small proportion of children who do, their GP can refer them into hospital services.

“Up until 6pm, Withybush Hospital PACU will still be open. After 6pm, the Withybush Hospital emergency department team will seek advice from Glangwili Hospital paediatric team, and if a child needs admitting they will be referred to the children’s ward at Glangwili Hospital, as is the case currently after 10pm.”

The health board will make a decision on Thursday and whatever the outcome will keep the situation under close monitoring.

In the meantime, the health board continues to reduce the impact on families as much as possible. This includes provision of the dedicated ambulance vehicle for transfers between Withybush and Glangwili hospitals, provision of funded transport schemes such as that provided by Action for Children, help under the NHS Travel Costs scheme and, in exceptional circumstances where no alternatives are available, vulnerable families will be provided with a paid for taxi to return home.

Paediatric consultant vacancies continue to be advertised with one applicant scheduled to be interviewed in January and the health board is speaking to potential recruits to demonstrate the benefits of working in Withybush Hospital and the wider paediatric team.

To support the intention to provide longer term continuation of the 12 hour PACU service at Withybush Hospital, with consultant support provided remotely by the acute paediatric team based at Glangwili Hospital, the health board plans to hold a patient, staff, public and stakeholder engagement process to co-design the future service for children in the area.

Pembrokeshire Assembly Members Paul Davies and Angela Burns have expressed their anger and frustration at the news.

Preseli Pembrokeshire Assembly Member Paul Davies said: “I’m extremely angry that the local Health Board are making plans to reduce the number of hours that the paediatric ambulatory care unit will be open at Withybush Hospital. Only a few weeks ago the Cabinet Secretary for Health made it clear in the Assembly Chamber that local families are being assured that they can continue to access services as they do now and do not need to make changes in how they access care.

“Well clearly the Welsh Government needs a much more robust dialogue with the Hywel Dda health board because that’s not the message that’s being heard in Pembrokeshire. Any further changes to this service would be catastrophic and the Welsh Government should urgently intervene to address this matter once and for all.”

He added: “Local people in Pembrokeshire will know that I’ve been campaigning to see our paediatric services re-established on a full-time basis and I’m extremely disappointed that some politicians are playing party politics with this very important issue, rather than standing up for families across Pembrokeshire.”

Assembly Member for Carmarthen West and South Pembrokeshire Angela Burns said: “This is a deeply concerning turn of events and goes against recent promises by the Welsh Government.”

“We’ve all fought long and hard to keep a broad level of services at Withybush and for services to be reinstated, this kind of situation dents public confidence and sends out the wrong message to potential and current staff.”

“I will be monitoring the service delivery to ensure this “temporary situation” really is just that.”

The Health Board have also released an FAQ which covers what they believe will be the most common questions from the public. These questions can be found below.

What would this mean for Pembrokeshire families?

If Hywel Dda University Heath Board accepts the recommendations, it would mean in the short term, that the Paediatric Ambulatory Care Unit (PACU) at Withybush Hospital would be open daily, but would close at 6pm instead of the current 10pm.

What is PACU?

Withybush Hospital’s Emergency and Urgent Care Centres (EUCC) and PACU provide the vast majority of hospital care required for children in Pembrokeshire. About 75% of those children who are referred into Withybush Hospital PACU, are treated there and do not need to be transferred to another hospital. It provides care for children with sudden onset of pain, high temperatures, sickness, infections, or requirements for dressings, blood tests, x-rays or scans.

What about children who need to stay in hospital overnight?

Currently any Pembrokeshire children who need an overnight, inpatient stay in hospital, are transferred to Glangwili Hospital, in Carmarthen. This will remain the case under the recommendations. There is a dedicated ambulance vehicle for women and children’s transfers between Withybush and Glangwili and a parent or carer can remain with their child on transfer and on the wards.

What about sick children who need assessment after 6pm?

At the moment, children who require paediatric assessment after 10pm are referred or transferred by ambulance to the PACU at Glangwili Hospital. If recommendations are accepted, this will happen from the earlier time of 6pm.

What about hospital appointments for children?

Scheduled care including procedures, tests and outpatient clinics will continue at Withybush Hospital during the daytime. In addition, the PACU service described above will also be available 10am-6pm.

What do you do if your child is unexpectedly sick at night?

Parents should continue to access care for their children as they do now.

If your child is unwell, you can do a number of things:

  • Call NHS Direct Wales – 0845 46 47 – they can advise you if you are unsure what to do, as well as provide health information on a wide range of conditions, treatment and local health services
  • Use your community pharmacy if open
  • Make an appointment with your GP as usual, including out-of- hours GP services, which are contacted through your normal GP telephone number
  • For a paediatric minor injury, go to Withybush Emergency and Urgent Care Centre (EUCC) 24 hours a day
  • In an emergency, if your child is very sick, you should dial 999 for assistance. Children who present at Withybush Hospital out-of-hours will usually be transferred to Glanwgili Hospital for paediatric input. In the exceptional circumstance where emergency resuscitation is required, emergency and anaesthetic staff will resuscitate, stabilise, and arrange transfer onto another hospital.

What about families with open access?
The advice already in place after 10pm, will come into action from the earlier time of 6pm temporarily. Families will retain open access to both WGH and GGH PACU as they do now.

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Launch of Haverfordwest Castle Conservation Management Plan

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MEMBERS of the public are being asked to help shape the future of Haverfordwest Castle as a draft Conservation Management Plan (CMP) is launched.

One of Pembrokeshire’s most important historical assets, the Castle is owned by Pembrokeshire County Council, which has produced the CMP.

The plan:

▪ sets out the significance of the castle and describes how the building will be protected with any new use, alteration, repair or management; 

▪ will help with the planning of maintenance, conservation and repair work and adaptation of the site to meet new or changing uses; 

▪ will help promote understanding of the site and look at improving public access and activities for local people and visitors; 

▪ will support proposals to conserve the castle and adaptations of the site in response to climate change; 

▪ and underpin funding applications to support improvements

An engagement exercise has been launched alongside the Plan, giving members of the public with an interest in the historic and/or environmental significance of the castle an opportunity to comment on the document and share their views.

To take part in the engagement exercise, please click on the following link: 

https://haveyoursay.pembrokeshire.gov.uk/regeneration-communities

The deadline for responses is Sunday, March 28, 2021.

 

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Natural Resources Wales approves Ireland-UK interconnector licence

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GREENLINK INTERCONNECTOR LIMITED says it welcomes the decision by Natural Resources Wales (NRW) to approve its application for a Marine Licence for the Greenlink electricity interconnector project, which will link the power markets of Great Britain and Ireland.

An important project for Pembrokeshire, and the UK as a whole, NRW’s go-ahead is one of several consents required for the construction of the project and covers installation of the marine cable in UK waters.

The approval is a major milestone for Greenlink and joins the onshore planning consents granted unanimously in July last year by Pembrokeshire County Council and Pembrokeshire Coast National Park Authority.

Greenlink’s proposed 190km subsea and underground electricity cable will run beneath the Irish Sea to connect National Grid’s Pembroke Power Station in Wales and EirGrid’s Great Island substation in County Wexford, Ireland. It will have a nominal capacity of 500 MW.

The Wales-Ireland link is just one of four interconnectors being installed

Nigel Beresford, CEO for Greenlink Interconnector Limited, said: “We are delighted by Natural Resources Wales’s decision to grant this licence. This marks a significant milestone for Greenlink and another important step towards project construction, which we expect to commence later this year.

“The Greenlink team has worked constructively with Natural Resources Wales and Welsh marine stakeholders to find workable solutions to the many technical and environmental challenges facing a large infrastructure project like this, and this has been reflected in the quality of the final proposal.

“The thorough environmental and technical assessments we have undertaken, supported by the practical and value-adding feedback we have received from key marine stakeholders, have ensured that we move forward confident that we are delivering a well-designed project with the interests of the Welsh marine habitat at its core.”

The subsea section of the cable will be approximately 160km in length and uses high voltage direct current (HVDC) technology. The preferred route and installation methods were chosen following the conclusion of subsea surveys and consultation with key stakeholders.

In Ireland, a Foreshore Licence application was submitted to the Department of Housing, Planning and Local Government (Foreshore Unit) in 2019 and the onshore planning application was submitted to An Bord Pleanála in December 2020.

Greenlink is one of Europe’s most important energy infrastructure projects and brings benefits on both sides of the Irish Sea for energy security, regional investment, jobs and the cost-effective integration of low carbon energy. The project will offer important local supply chain opportunities and plans are being drawn up for ‘meet-the-buyer’ events in the local area prior to construction.

Once fully consented, Greenlink is expected to have a three-year construction programme, with commissioning planned by the end of 2023.

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Appeal from Fire and Rescue Service to install working smoke alarms

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AT 01:17am this morning, Tuesday, March 2, 2021, crews from Milford Haven were called to a property fire in the Hakin area of Milford Haven.

The fire was confined to a pan on a stove in the kitchen area and extinguished by firefighters using two breathing apparatus, a hose reel jet and a thermal imaging camera.

Crews also ventilated the property and fitted smoke alarms within the property.

The Fire Service left the incident at 02:00am.

Watch Manager Alun Griffiths, Mid and West Wales Fire and Rescue Service, said “This fire was the result of cooking left unattended. It is so important to remove all pots and pans from a heat source when you are called away from the cooker.

“Thankfully, the occupiers of the property managed to exit the property before our firefighters arrived, but it could have ended very differently as there were no smoke alarms fitted in the property.
“I cannot stress enough the importance of installing working smoke alarms in your homes and testing them regularly. In the dreadful event of a fire, they can alert you to the danger sooner and could mean the difference between life and death.

“As a Fire and Rescue Service, we provide Home Fire Safety advice which is free of charge. We also offer Safe and Well Visits which you can arrange by phoning us on 0800 169 1234 or by visiting the Mid and West Wales Fire and Rescue Service website.”

For further Home Fire Safety advice or to talk about the possibility of a Safe and Well Visit by Fire and Rescue Service personnel, please phone us on 0800 169 1234.​​​ Alternatively please complete an online Request a Safe and Well Visit​ form on the Mid and West Wales Fire and Rescue Service website: https://www.mawwfire.gov.uk/eng/your-safety/in-your-home/

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