Health
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: https://hduhb.nhs.wales/healthcare/covid-19-information/restarting-services/
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: https://hduhb.nhs.wales/healthcare/covid-19-information/preparing-for-treatment-lifestyle-advice/
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.
Health
Mind, Body and Spirit Awareness Day at North Pembrokeshire venue

This Saturday, April 12, thoughts will be turning to the mind, body and spirit, thanks to the ever-popular Awareness Day that takes place at Canolfan Hermon in North Pembrokeshire.
This is the fourth event of its kind at the village hall and each year the event continues to grow from strength to strength.
This year, there will be a total of eight therapists in attendance as well as two mediums, a card reader and ten stall holders selling spiritual, mind and body items including crystals, jewellery, honey and cosmetics. There will also be a stall from the Jig-So Children’s Centre in Cardigan while hot food and refreshments will also be served throughout the day by Fusion Kitchen.
As with previous events, the Mind, Body and Spirit Awareness Day will be raising funds for Breast Cancer and Thrombosis UK. As a result, there will be a £1 entry fee as well as optional raffle tickets and a Memory Tree for additional donations. A light language healing demonstration will take place at 1 pm.
People near and far are invited to experience the different therapies, while event organiser Lynda Barnes says there is guaranteed to be something here for everyone. The event starts at 11 am and will continue until 3 pm.
For further information, contact Lynda Barnes on 07920249194.
Health
‘Nobody taking responsibility’ for paying care workers the real living wage

CARE HOME providers urged the Welsh Government to follow through on a key commitment to ensure care workers are paid the real living wage.
Giving evidence in the Senedd, Care Forum Wales, which represents more than 450 care homes, warned funding did not reach all parts of the sector in 2024/25.
The non-profit organisation said funding for the real living wage (RLW) was not ringfenced, so some councils chose to spend the money on libraries and teachers’ salaries instead.
Care Forum Wales raised concerns about “nobody taking responsibility”, with the Welsh Government claiming to have provided the money and councils saying it was insufficient.
Labour’s manifesto for the 2021 election contained a pledge to “ensure care workers are paid the real living wage during the next Senedd term”.
But Sanjiv Joshi, Care Forum Wales’ treasurer, warned the Welsh Government’s push for care workers to receive the real living wage has become an aspiration rather than a reality.
He told the local government committee: “The first year when it was announced … providers had to give an undertaking to commissioners that we were paying the real living wage.
“Since then, that’s now become aspirational as commissioners have not had the funds – or so we are told – to follow through and maintain those real living wages.”
Giving evidence on April 3, Melanie Minty, policy adviser at Care Forum Wales, said: “The real living wage, as Sanjiv said, isn’t reaching the sector necessarily.”
But, describing the RLW as a drop in the ocean, she warned care homes cannot compete with councils and the NHS which pay a higher rate than used in costing commissioned care.
Under the Welsh Government’s 2025/26 budget, funding for the real living wage is allocated to councils within the revenue support grant, meaning it can be spent on other areas.
Ms Minty also voiced concerns about an increasing number of councils receiving grants to build care homes that “will never recover their costs”.
She pointed to the example of Carmarthenshire Council building a £19.5m residential home despite free capacity in the county’s independent sector.
Cautioning that commissioning too often focuses on cost over outcomes, she said: “I’ve heard of commissioners going into homes and saying ‘you’re spending too much on food’.
“Things like holidays have been drastically cut back for younger people.”
Mr Joshi, who runs the Caron group of care homes in mid and south Wales – which includes Valley View Care Home in Hengoed – warned of a £9,000-a-year difference in nursing fees between neighbouring councils.
He said: “We’re talking about Cardiff and RCT … imagine the pressure that puts on and it’s not driven by the needs, the needs would not be that different.”
Pressed about the minimum level of profits required to make services feasible, Mr Joshi replied that he targets an 11% return which is unachievable in parts of Wales.
Warning of an “irrational” policy direction, he said: “We have the private sector delivering incredible value for money [yet] being eroded by underfunding. Then we have the public sector spending four or five times that amount, it doesn’t make sense.”
Mr Joshi told the committee families are increasingly having to make up a difference in costs that should be provided by councils and health boards.
Warning charity providers are exiting the market, Ms Minty said: “Most of our third-sector members have sold their care homes because they are not viable.”
Ms Minty called for a fee methodology that can be applied consistently across Wales, with some councils far more transparent and understanding of the costs than others.
“Cardiff, while giving a really good increase this year, has been very honest in admitting they know it’s not going to meet all the changes,” she said. “Whereas other local authorities … have been known to make an offer and say this will cover all sorts of things.”
She said the sector has stabilised since the pandemic and Brexit but increasing employer national insurance contributions have added to the pressure.
She told the committee: “I think we’ll see an unintended consequence will be that employers are forced to suppress pay increases … and some will be forced to make redundancies.”
Health
New patient deal aims to cut NHS waiting times across Wales

A NEW deal between the NHS and the public is at the centre of a plan to drive down the longest waiting times for healthcare in Wales.
Health Secretary Jeremy Miles is expected to unveil a strategy this week aimed at reducing the overall waiting list by 200,000 patients by March 2026. The plan also sets targets to eliminate two-year waits for planned treatments and restore a maximum eight-week wait for diagnostic tests.
A key part of the announcement is the introduction of a new “patient deal”, which aims to improve transparency, reduce missed appointments and ensure better preparation for surgery. This deal will be incorporated into updated referral-to-treatment guidelines due later this month.
What the new deal includes:
- Faster access to planned care with patients told how long they can expect to wait once added to the list.
- Waiting time tracking through the NHS Wales App, with updates available from June.
- Only fit and well patients will be added to surgical waiting lists, in line with evidence showing they recover more quickly and have better outcomes.
- Support to get surgery-ready, with help to improve health before treatment.
- Appointment changes, where patients will be offered two dates. If they miss both without good reason, they will be removed from the waiting list.
- Alternatives and risks explained, so patients are fully informed before deciding on surgery.
Each year, around 700,000 outpatient appointments in Wales are either missed by patients or cancelled. Health boards will now be under stricter obligations to reduce these disruptions, and to minimise the number of cancellations made by the NHS itself.
Mr Miles said: “The NHS will do all it can to prioritise faster access to treatment. In return, we are asking the public to prioritise and keep their appointments so that, together, we make the best possible use of scarce NHS resources.
“We cannot continue losing one in seven appointments due to no-shows or other avoidable reasons. These missed slots delay care for everyone and waste vital resources.
“Evidence shows people in better health recover more quickly and require shorter hospital stays. By preparing patients properly and ensuring they understand all treatment options, we can deliver better outcomes and greater efficiency.”
The Welsh Government hopes the new plan will bring waiting lists closer to pre-pandemic levels. As well as reducing overall waiting list size by 200,000 by March 2026, the government has pledged to ensure no one waits more than two years for planned treatment and to restore the eight-week target for diagnostic testing.
Health boards will be expected to continue transforming how they deliver planned care over the next 12 months. This includes adopting more regional working models and implementing recommendations from the Ministerial Advisory Group on NHS Performance and Productivity, due to report later this month.
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