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Operations at all west Wales hospitals, including Withybush cancelled again today

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THE HEALTH BOARD has confirmed that, in the interest of patient safety, routine planned operations remain cancelled today (Tuesday 7 January 2020) at Bronglais, Glangwili, Prince Philip and Withybush hospitals.

Operations were also cancelled yesterday for the same reason.

The exception to this is emergency surgery and urgent cases wherever possible, as well as most day surgery, with the exception of Bronglais Hospital. All outpatient appointments are continuing as normal.

A spokesman said: “We are contacting patients affected directly so please attend as planned if you do not hear from us. Otherwise, please do not contact our appointments or outpatient teams unless absolutely necessary as they are very busy at this time.

“This situation remains challenging with the Health Board operating in line with our escalation procedures to help manage patient flow and maintain patient safety. This includes commissioning additional areas to accommodate patients who require overnight care and support from senior clinicians, managers and other staff not initially rostered to work over the weekend to support the review and care of patients.

“In collaboration with our Local Authority partners, we continue to implement our broader winter plan which is designed to help reduce demand for hospital admission and prioritise patients for care within their home environment over the wider winter period. Over the next few weeks, a number of staff taking on new and different roles will be coming into post to support patients to receive the most appropriate care for their needs in the most appropriate setting. These are resourced through the winter planning monies supported by Welsh Government, in addition to the money we invested ourselves as a Health Board.”

Health

Withybush woes as new consultation launched

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• Health Board says coronavirus has had a major impact on services • New hospital could be built between St Clears and Narberth
• It’s a similar plan which led to protests involving thousands of locals in 2018

MORE than 18,000 people have signed the petition opposing the decision to downgrade Withybush General Hospital, but that was three years ago, and it seems that the health board may have forgotten the locals’ anger.

The health board is launching a consultation exercise to “deliver on our long-term commitment for a healthier mid and west Wales”

Steve Moore, Chief Executive of Hywel Dda UHB, said: “The global pandemic has had a major impact on all areas of our lives so it’s crucial that the health board considers, reflects and learns from this extraordinary period. This engagement exercise will allow the public to tell us in their own words how COVID-19 has affected their health and care, and access to it.

“I would encourage as many people as possible to participate.” 

Under similar proposals to those first unveiled in 2018 a new district general hospital would be built on the border between Carmarthenshire and Pembrokeshire providing A&E services, while in some of the options Carmarthen’s Glangwili hospital would also lose services, including A&E.

The people of Pembrokeshire protested. They protested outside the hospital, they marched through Town, they took their placards to the Senedd.

There was no one, it seemed, who wanted a new super hospital ‘up the line’.

Save Withybush Hospital protests back in 2018 in Haverfordwest

Ten months ago, the First Minister and Health Minister of Wales were united in their decision not to offer any reassurances to the safeguarding of A&E services at Withybush Hospital.

With the July 2020 u-turn of Cwm Taff health board not to remove services at Royal Glamorgan Hospital, the ministers have come under pressure to offer reassurances to the future of Withybush services.

Mark Drakeford said last summer that the decision was down to local health boards, with Vaughan Gething, Health Minister taking a similar stance.

Withybush has already seen the downgrade to its maternity services, with it now being a mostly daytime service with expectant mums with pregnancy complications or those giving birth after 5pm mostly having to travel across the border into Carmarthenshire to give birth. Other departments have also been shrunk on what locals call “a salami slicing away of local services”

Speaking at a Plenary last year Vaughan Gething, was asked by Pembrokeshire MS Paul Davies, the Welsh Government’s position on the delivery of A&E services at Pembrokeshire and if they would remain at Withybush.

Mr Davies said: “You’ll be aware, there is a strong campaign to retain A&E services at Withybush General Hospital.

“Given the recent news that Cwm Taff health board has decided to retain A&E services at The Royal Glamorgan Hospital, the people of Pembrokeshire are now looking at that decision and, quite rightly, asking for the same safeguards.”

The Health Minister said that the decision to overturn the removal of services at Royal Glamorgan Hospital, was made after they were able to recruit more staff which would help them safely deliver that service. Recruitment problems have often been cited as a key problem at Withybush Hospital in recent years.

Mr Gething said, “The member will also know, over a long period of time, the challenges that have been faced in delivering healthcare across Wales and the plans for the future delivery of healthcare.”

He added “The health board is now planning for the continued provision of essential and key services alongside caring for patients affected by Covid-19.”

However, although the Welsh Government is desperately trying to distance itself from its unpopular decisions on local health provision, the buck stops with it.

In November 2018 hundreds of people took to the streets to oppose the downgrading of Withybush. But now it is clear that the plan of a new hospital further away from Pembrokeshire’s population centres and industrial complexes is still on the cards.

Surprisingly, the exact cost of the new hospital, and its exact location, is yet to be determined but the health board is hoping to finalise a ‘programme business case’ in the coming weeks which will then be submitted to the Welsh Government this summer.

A full business case can be signed off by March 2024, The Pembrokeshire Herald understands.

Protestors outside Withybush at the 2018 protests

The health board has said the plan to reshape the way people receive medical treatment in west Wales is part of the “ongoing process” that is now under way with an engagement exercise running until June 21.

According to a new eight-page document published by Hywel Dda entitled ‘Building a Healthier Future After Covid-19’ the pandemic has been a “big challenge” which created an “extremely difficult” period.

The document, seen by The Pembrokeshire Herald, states: “We are progressing plans for a new hospital in the south of the area, somewhere between and including the towns of St Clears, Carmarthenshire, and Narberth, Pembrokeshire. At this early stage, we would welcome site nominations you may have and your views on how we compare possible sites.”

The health board is inviting people’s opinions on a post-Covid future in general and how healthcare is provided across the region today and in the future – pointing out that health and wellbeing centres have been opened in Aberaeron and Cardigan while plans are in the pipeline for similar facilities in Llanelli and Cross Hands.

While many aspects remain uncertain at this stage one thing that has been decided is that the new hospital is to be built between St Clears and Narberth because “this location is the most central to most of the population in the south of the Hywel Dda area”. The site will also have at least 35 acres of “developable land” with “appropriate transport infrastructure”.

A spokesman for the health board said: “The new hospital will be our main site for the network of all our hospitals, providing both urgent and planned care. It will enable us to have more consultants in permanent posts being available more of the time and specialising in areas of care. Consultant-led services will be available 24-hours a day seven days a week.

“We will provide rapid access to specialist assessment and treatment, discharging people as soon as possible so they can receive rehabilitation closer to home. Emergency and unplanned care will be provided in a different building to planned care therefore avoiding the disruption or delay that can occur from high volumes of emergency cases.”

The public is also being asked to nominate sites for a new hospital based on four criteria: (1) The nominated site must be within the zone between and including St Clears in Carmarthenshire and Narberth in Pembrokeshire. This location is the most central to most of the population in the south of the Hywel Dda area. (2) The nominated site should be a minimum of 35 acres of reasonably developable land. (3) The nominated site should have realistic prospects of obtaining planning permission for a new hospital. (4) There should be appropriate transport infrastructure for a major hospital site.

The health board said: “Anyone can have their say on the plans by emailing the health board at hyweldda.engagement@wales.nhs.uk or by calling 01554 899056.”

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Health

Update on local vaccinations for residents aged 18 to 39

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ALL adults aged 18 to 39 living in Carmarthenshire, Ceredigion and Pembrokeshire will be offered Moderna or Pfizer BioNtech for their first COVID-19 vaccine, Hywel Dda University Health Board can confirm.

Today’s announcement states, as a precaution, unvaccinated adults aged 30 – 39 years who are not in a clinical priority group at higher risk of severe COVID-19 disease, will be offered an alternative to the Oxford AstraZeneca COVID-19 vaccine, where possible.  This is already the case with adults under 30 years.

Fewer than 200 people under 39 are booked to receive a first Oxford AstraZeneca vaccine at the Picton Centre on Saturday 8 May. The health board is making every effort to contact everyone affected to offer a new appointment at a session offering the Moderna or Pfizer BioNtech vaccine.

All mass vaccination centres in Carmarthenshire, Ceredigion and Pembrokeshire will provide the  Moderna, Pfizer BioNtech and Oxford AstraZeneca vaccines. Please attend your appointment as planned as your clinic will have the appropriate vaccine for your age.

Ros Jervis, Director of Public Health for Hywel Dda UHB, said: “We understand that today’s announcement may cause some concern. The Oxford AstraZeneca vaccine is a safe and effective vaccine, cases of blood clots with low platelet counts continues to be extremely rare and is thought to be a reaction to first exposure.  The decision to stop using the Oxford AstraZeneca vaccine in those under 40 who have no clinical risk factors reflects the excellent progress we are making in bringing the pandemic under control and the increased supply of the Pfizer BioNTech vaccine. 

“If you have received a first dose of the Oxford AstraZeneca vaccine without suffering any serious side effects, it is recommended that you should complete the course and receive the second vaccine when invited, irrespective of age, in line with JVCI advice.”

The Oxford AstraZeneca vaccine has already saved thousands of lives and remains safe and effective for the majority of the population with over 1 million people have received the AZ vaccine since January.

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Mark Drakeford in Milford Haven as pub tills ring for first weekend since December

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As part of the easing of lockdown restrictions, hospitality business owners let out a sigh of relief this week after a long winter as it was announced by Mark Drakeford that the sector could open – partially.

On Monday, many of us went for a pint as pubs, cafes, and restaurants can now serve customers outdoors.

First Minister Mark Drakeford visited Milford Haven on Sunday (May 2) in last minute campaigning before the election on Thursday.

It was the first weekend of trade since pubs were forced to shut before Christmas.

Indoor hospitality is still set to return on May 17 he confirmed.

Announcing the changes officially for the first time last week, First Minister said: “The public health context in Wales remains favourable, with cases falling and our vaccination programme continues to go from strength to strength.

“Because meeting outdoors continues to be lower risk than meeting indoors, we are able to bring forward changes to allow any six people to meet outdoors.

“This will provide more opportunities for people, especially young people, to meet outdoors with their friends.

“This will undoubtedly have a significant positive impact on people’s wellbeing. I’m also pleased to confirm outdoor hospitality will be allowed to reopen from Monday 26 April.

“These changes will help the hospitality sector recover after a difficult twelve months. It is thanks to the continuing efforts of people across Wales we are able to introduce this change. Together, we will continue to keep Wales safe.”

Reaction to the changes

Welcoming the announcement Jane Dodds, leader of the Welsh Liberal Democrats, said it was “great news”.

She said: “As a nation we must all work together to ensure the vaccination programme continues and that the lockdowns and closures we’ve been through never need to return.”

Welsh Conservative Senedd leader, Andrew RT Davies, said: “Labour had ample opportunity to bring forward a roadmap out of lockdown, but refused to do so.

“Thanks to the UK’s great vaccination story much more detail could have been announced prior to the election period… but Labour chose to play politics instead of adopting the Welsh Conservative roadmap.”

Mark Reckless, from the Abolish the Welsh Assembly Party, said: “This is getting to the point of testing election rules to breaking point.

“The Labour leader is using his platform as first minister to make political announcements during an election campaign.”

So what do businesses have to do by law?

Welsh Government guidance states: “As an employer or business operator, you have a legal responsibility to protect employees and visitors; and anyone else on the premises, from risks to their health and safety. You also need to assess the risks from COVID-19 and take reasonable measures to minimise exposure to the virus.

“Risk assessments are used to identify and address these risks or minimise them. When undertaking your specific COVID-19 risk assessment you must comply with the Coronavirus Regulations and have regard to the statutory guidance and use this document to inform your decisions and control measures, recognising you cannot eliminate all risks.

“Risk assessments must be reviewed and updated regularly, whenever circumstances change including whenever the coronavirus alert levels change in Wales.

“A risk assessment is not about creating huge amounts of paperwork, but rather about identifying sensible measures to control risks. Your risk assessment will help you decide whether you have done everything you reasonably need to. There are interactive tools available to support you from the Health and Safety Executive (HSE) at Managing risks and risk assessments at work.

“These risk assessments will be the starting point for implementing the reasonable measures that are required to be taken to minimise exposure to the coronavirus on premises open to the public and in workplaces.

“This involves considering issues such as: whether ventilation is adequate; hygiene factors including hand washing and access to hand washing facilities; ensuring physical distancing is taking place and if 2m is achievable; the extent to which the use of screens, PPE and face coverings can mitigate risks, especially where the 2m distance is not achievable.”

Made possible by the vaccine?

As of April 29th, Public Health Wales said a total of 1,816,451 first doses of the Covid-19 vaccine have now been given in Wales.

The agency said 732,643 second doses have also been administered.

Wales is currently in phase two of its vaccination programme, meaning the NHS is now inviting everyone aged 40 to 49 to be vaccinated, after successfully offering the vaccine to everyone in the JCVI priority groups 1-9.

It comes as an estimated six in 10 adults (61 per cent) in private households would have tested positive for Covid-19 antibodies in the week to April 11th, the ONS said on April 28th.

This is up from around one in two adults, or 48.2 per cent, two weeks earlier.

On April 7th, Wales became the first country in Britain to administer the Moderna vaccine.

It was also announced on April 14th that all over 16s who live with an adult with a weakened immune system are to be prioritised for Covid-19 jabs, following advice from the Joint Committee on Vaccination and Immunisation (JCVI).

Adults who are immunosuppressed have a weaker immune system to fight infections naturally and are more likely to have poorer outcomes after contracting coronavirus.

This includes those with blood cancer, HIV or those who are having immunosuppressive treatment.

What about hospitality that can’t operate outdoors?

The First Minister has announced that an extra £200m is available to help businesses which are not yet able to open.

This will help top up the non-domestic rates grants. Mr Drakeford said it means hospitality, tourism, leisure and non-essential retail businesses, which must remain closed will be eligible for a third payment of between £4,000 and £5,000 to help them meet ongoing operating costs while they cannot trade.

“This is in top of the announcement earlier this week extending the business rates holiday for retail, leisure and hospitality businesses for the whole of the next financial year,” Mr Drakeford added.

“We have made well in excess of £2bn available to businesses over the course of the last year to help them through the pandemic, which is over and above the support available from the UK Government’s schemes.

“This is the most generous business support scheme available in the UK. I’m very pleased we’ve been able to safeguard more than 160,000 jobs in these most difficult of times.”

Controlling the crowds

Hospitality catering to households who have effectively been locked down all spring will be a welcome sight to many after large crowds recently descended upon Cardiff Bay.

Police had been given special powers after crowds gathered in Cardiff Bay on April 2nd, despite coronavirus restrictions still being in place.

Cardiff council said a significant amount of rubbish had been left by “large groups of people intent on breaking Covid-19 restrictions”.

South Wales Police has put a dispersal order in place, giving officers the power to exclude people from the area.

Covid rules at that time stated six people from two different households could meet outdoors. It followed similar scenes outside the Senedd earlier that week, when three police officers were injured.

Supt Marc Attwell said: “As restrictions have eased, the need for personal responsibility is critical and it is extremely disappointing that a small minority are willing to put themselves, and others, in harm’s way.

“Cardiff Bay in particular has attracted large crowds over the past few days.

“The behaviour seen over the past three days has placed additional pressure on not only the police but the local authority as well, and meant that officers have been diverted from other parts of the force.”

“We are asking people in groups of six or more who are thinking of attending or organising a gathering at the Senedd over this bank holiday weekend not to do so.”

Officers arrested a 20-year-old man for a public order offence, a 22-year-old woman was arrested for being drunk and disorderly and for possession of a Class A substance and a 35-year-old-man was also arrested for possession of a Class A substance.

The council said the trail of litter left a “huge task” for clean-up staff as “bins were left unused and the ground was littered with rubbish”.

“Despite the preventative measures put in place by the council, in partnership with South Wales Police, the Welsh government’s coronavirus regulations were again broken by a significant number of people illegally gathering in Cardiff Bay,” the authority said.

“The rules are clear, six people, from two households are allowed to meet outdoors, maintaining two metre social distancing.

“Breaking these rules significantly increases the chances of Covid-19 cases rising in the city.”

Now, with places for people to socialise in an organised manner, scenes like this should hopefully be avoided as people safely enjoy themselves.

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