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Withybush: Health chief speaks to The Herald

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health chiefFOLLOWING loud public protests about the Local Health Board’s plans for the future of Withybush Hospital, local media were invited to meet with Health Board Chair Trevor Purt for interviews in the Board’s offices at Merlin’s Court, Winch Lane, Haverfordwest.

The Herald put questions to the Health Board chief which our readers and correspondents raised with us about the decision to close the Special Care Baby Unit at Withybush and transfer services elsewhere and about the future of health care at the Haverfordwest site.

Polite but firm, Trevor Purt did not allow much of the exasperation he must undoubtedly feel spill over into his answers. When it did, he was clear and forthright. To be sure, he was eager to get his message across and – in terms – that message was that changes to service provision in Pembrokeshire have not been driven by a determination to cut costs but in order to ensure quality of care.

We asked him first about the announcement of the “safety net” made by Health Minister Mark Drakeford in the Senedd on January 21. Did the announcement of the “safety net” mean that the arrangements announced in September were incomplete?

“We had put a safety net in place. It was never going to be the case that we would shut the provision at Withybush down on one day and shift it over to Carmarthen the next. That would be impractical and illogical. There are twelve months while we examine the progress of the service change and that will be done by a panel drawn from the Community Health Council and other stakeholders.

“Not even our sternest critics suggest that the model we propose is wrong: the dispute is about the location of the unit at which we will deliver centralized services for complex births. As a board we have to look beyond parochial concerns and deliver the best possible outcomes for the whole of the population the Board serves.”

But why Glangwili?

“We chose Glangwili ahead of Withybush because it has better links to Morriston Hospital and the wider Health Board area. I have heard the suggestion that we have not discussed our plans with Abertawe Bro Morgannwg Health Board. We have considered developments at Morriston very carefully indeed and been in close communication with our counterparts there. People should not let rhetoric get in the way of the facts.

“Plans are not made in isolation, we have a range of considerations to take into account. If we had chosen Withybush, we would be facing the same protests in Carmarthen as we are in Haverfordwest. I understand people are angry and frustrated but I believe that is because there has been a lot of misunderstanding and misinformation.

“I want to make a couple of things very clear: the Royal College of Midwives has told us that in order for a junior doctor to get sufficient expertise in obstetrics they need to be exposed to a range of types of case. They have said that the range required means that a unit has to have 2,500 births annually. That is the position of the professional bodies as well. The Deanery and the GMC require doctors to be fully accredited and to maintain that accreditation. If we have insufficient accredited doctors, all complex births would be taken to Morriston and none would take place in the Health Board area.

“This is not about money. This is about delivering a safe and sustainable future for obstetric provision across the Health Board’s area. In many respects, we are suffering from a long term structural problem. It is a numbers game, but the number is not money: it is about attracting, training and retaining staff.

“Secondly, we announced our plans last January. The CHC did not raise any issue about switching to a midwifery led obstetric service. Its objection only related to SCBU. The idea that this is a sudden change or shock announcement is wrong. We made our plans clear last year.

“The experience in Powys, where there has been a midwife-led obstetric service since 2001, has been that that service has been effective and safe. We anticipate that the majority of expectant mums will be able to choose where to give birth and most births will take place where they are planned to take place. It will be mum’s choice in the overwhelming majority of cases.

“In addition, the Emergency Medical Response Service – which is being planned for the whole of Wales – will ensure very quick access to emergency care. When there is an emergency, patients will be stabilized locally, where possible, and then taken to the appropriate unit for specialist care, whether that is at Glangwili or Morriston.”

But what about the decision on paediatric care? Is the health board “salami-slicing” services as critics have claimed?

“No. I want to make it as clear as possible. Our plans for obstetrics were announced last year at the end of the consultation. This is not new and, again, our plans for paediatric care were not criticised by the Community Health Council. They did not form part of the referral to the Minister and were not considered by the expert panel on the future of the Special Care Baby Unit.”

What about A & E at Withybush? Part of the rationale in closing the Minor Injury Units at Tenby and Pembroke Dock was that this would preserve services at Withybush. Is A & E safe?

“I want to make this as clear as I can: I do not foresee that we will not continue to provide an emergency 24/7 service at Withybush.“That service configuration might be with middle grade staff or a GP service, but we will maintain a 24/7 A & E service at Withybush.”

Our interview ends. Our friends at Radio Pembrokeshire are waiting with a large microphone outside. We will be meeting again with Trevor Purt in March. Let us know what questions you want to put to him and we will do our best to work them into our meeting.

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Proposed locations for new hospital site to be reviewed

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HYWEL DDA UNIVERSITY HEALTH BOARD (UHB) will this week undertake a review of potential sites as part of the ongoing process to identify a suitable location for a new hospital.

Eleven sites will be assessed on Friday 22 October, including those identified by members of the public during the six-week engagement exercise, which took place earlier this year.

This stage of the process is intended to lead to the creation of a shortlist of sites. This will be subject to further detailed appraisal with significant public and wider stakeholder involvement. The final decision about the chosen site will be made by the health board, in agreement with Welsh Government.

Steve Moore, Chief Executive of Hywel Dda UHB, said: “The building of a new hospital is a major long-term project, which is why we place great emphasis on being open and transparent about the process involved.

“The process we are following includes developing a programme business case to support our strategy for community and hospital-based health and care. As part of the process to apply for funding from the Welsh Government, we will submit the programme business case, and then individual outline business cases, then the final business cases for the new infrastructure we will need. The health board will therefore engage with the public on a regular basis between now and the submission of the final business cases to ensure your views are fully considered.

“I understand and recognise there are passionate feelings about a new hospital, but we strongly believe a new facility is essential for urgent and planned care in the south of the Hywel Dda area. It will provide trauma care and be the main emergency department for the south of our area.

“I can also reassure the public that we have no plans or intention to close either Glangwili or Withybush hospitals. We will engage further on how these hospitals could work alongside the proposed new hospital.”

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Unprecedented demand on health and social care services in local area

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Joint statement by Hywel Dda University Health Board, the Welsh Ambulance Service NHS Trust, Pembrokeshire County Council, Carmarthenshire County Council and Ceredigion County Council

The urgent statement we have asked to publish is as follows:

THERE is currently an unprecedented demand on health and social care services across Carmarthenshire, Ceredigion and Pembrokeshire, which is leading to significant delays in care provision. Put simply, the difficulty in discharging medically-fit patients from hospital – many of whom have complex personal circumstances and needs – is leading to significant bed shortages, and consequently, lengthy ambulance waits at the ‘front door’ of A&E departments, which mean that paramedics are unable to respond to other 999 calls in the community.Social care and Health teams are doing everything possible to support people who are well enough to leave hospital but need ongoing care. Priority is being given to the most vulnerable, and alternative health and care packages are being offered as a short-term measure. More carers and health staff are also being recruited to support people in need.

If you have a relative or loved one in hospital who is well enough to go home, but is waiting to be discharged with homecare and community health support, you may be able to help them to get home more quickly if you and your family are in a position to support them at home. If your relative is waiting for a formal package of care, you may be able to offer support and care on a short term, temporary arrangement or you might want to consider whether your loved one could be supported in a temporary residential or nursing care setting. If you feel that this is an option that you could consider, please speak to the ward manager or your social worker to explore further.

Spending as little time in hospital is better for patients and means that NHS beds can be freed up for others with urgent care needs. Supporting older patients to get home from hospital efficiently is an important part of their recovery and it also protects them from negative consequences of hospital admission, such as hospital acquired infection, falls and a loss of independence.  You can find out more about the hospital discharge process and guidance here: Inpatient information – Hywel Dda University Health Board (nhs.wales)

Your support not only helps your loved one, but it is a huge support to the NHS and social care services as well.

Thank you.

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Child taken to hospital following collision with car outside school

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AN EARLY morning collision outside Ysgol Harri Tudor school, Pembroke, has seen a child taken to hospital.

The collision happened between a child and a car on Pembroke Road, Pembroke, at approximately 9am this morning.

A secondary school pupil has been taken to hospital via ambulance for what is said to be minor injuries.

Police and ambulance service were on the scene and were helped by school staff to manage the incident.

A police spokesperson said: “Dyfed-Powys Police attended a road traffic collision involving a car and a secondary school pupil this morning, 21st October 2021. The collision occurred on Pembroke Road, Pembroke at approximately 9:00am.

“The Ambulance Service also attended and escorted the teenage boy to hospital with what are believed to be minor injuries.”

A Pembrokeshire County Council spokesperson said: “We can confirm that there has been an incident outside Ysgol Harri Tudur in Pembroke this morning where a pupil came into contact with a car. 

“The police and ambulance have been on the scene and were assisted by school staff. We are not able to release any further details at present.”

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