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Health

Chair’s reflections and focus on recovery one year on

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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.

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Health

Tavernspite School the ‘healthiest of schools despite the pandemic’

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THE STAFF, governors, parents, and of course, the children of Tavernspite Community Primary School are delighted to gain the Welsh Network of Healthy School Schemes National Quality Award for an incredible 5th time after a recent and very rigorous assessment.

The school is already well known and highly regarded for its outstanding work in developing the health and wellbeing of all members of its school community. To achieve this prestigious recognition in the midst of a pandemic is all the more impressive. 

Health and Wellbeing at the school is led by teacher, Lauren Arthur, who has done an incredible job preparing for this re-assessment and raising the profile of the Healthy Schools scheme.

The assessor Mrs Lynne Perry, enjoyed a virtual tour and presentation by Year 3 pupils who took great pleasure in proudly showing Mrs Perry all the wonderful work the school has done to ensure its children are safe, happy with high levels of emotional and physical wellbeing.

In her report, Mrs Perry wrote, ‘Tavernspite School continues to be an outstanding health promoting school. The health promoting school ethos is evident across the whole school population and it runs seamlessly throughout everything that the school does. Tavernspite School continues to give high priority to promoting and enhancing the health and well-being of the whole school community.’

The school received fantastic support from Mrs Liz Western, Senior Public Health Officer and Lead for Healthy Schools and Pre-schools, Pembrokeshire, to whom they are very grateful.

Head teacher Kevin Phelps said, ‘We were delighted to receive this award for the fifth time, particularly considering the experiences we have all been through these past twelve months. Health and wellbeing has never been so important and we are proud to be leading the way like this.’

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Health

New Covid vaccine arrives first in West Wales

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THE FIRST person in the UK to receive the Moderna vaccine against Covid-19 got their jab at 8:30 in the morning of Wednesday, April 7, at West Wales General Hospital.
The recipient was Elle Taylor, aged 24. Ms Taylor is an unpaid carer from Ammanford.
Speaking after receiving the vaccine, the 24-year-old, who works at a further education college, said: “I’m very excited and very happy.
“I’m an unpaid carer for my grandmother, so it is very important to me that I get it, so I can care for her properly and safely.
“My grandmother has had her first dose and she is going for her second dose on Saturday.”
Miss Taylor said she only found out on Tuesday evening that she was to be the first in the UK to receive the jab by Moderna, an American company.

HEALTH BOARD ‘DELIGHTED’

The Medicines and Healthcare Products Regulatory Agency (MHRA) authorised the Moderna vaccine as safe and effective in January 2021 following rigorous clinical trials.
Moderna is the third Covid-19 vaccine distributed in the UK.
Two other vaccines, the Pfizer vaccine and the Astra Zeneca vaccine, are already in use across the UK. 31 million people across the UK have received their first shot of one of those vaccines since the inoculation programme began in December last year.
Supplies arrived in Wales on Tuesday, April 6.
5,000 doses were delivered to vaccination centres in the Hywel Dda University Health Board area.
The Moderna vaccine is a two-dose vaccine given at an interval of between four and twelve weeks.
Ros Jervis, Director of Public Health for Hywel Dda University Health Board, added: “We’re delighted to be able to use the Moderna vaccine for deployment across west Wales.
“We will be using this new vaccine, alongside Oxford Astra-Zeneca, to continue the immunisation’s roll out to our communities in Carmarthenshire, Ceredigion and Pembrokeshire.
“We are incredibly lucky to have a third vaccine in Wales, with a long shelf life and the ability to be easily transported, to help deliver the vaccination programme to small clinics across our rural communities.”

THE MODERNA VACCINE EXPLAINED

The Moderna vaccine does not contain the virus to produce immunity.
It cannot give you COVID-19.
The injection stimulates the body’s natural defences (immune system). It works by making the body produce its own protection (antibodies) against the virus that causes the COVID-19 infection.
The vaccine delivers the ‘instructions’ that cells in the body can use to make antibodies to fight the virus that causes COVID-19.
As with any vaccine, Moderna may not fully protect all those who receive it. Those who get it may not be fully protected until two weeks after the vaccine’s second dose.
In trials, the vaccine was 94.1% effective in preventing Covid-19 infection in patients with no prior history of the disease. It was 100% effective in preventing patients from developing the severe Covid-19 symptoms that lead to hospitalisation.
Although the Moderna vaccine is the priciest of the vaccines yet rolled out, it has an advantage over the Pfizer vaccine. It can be stored in a regular fridge for up to fourteen days after its delivery to a vaccination centre.
It contains no ingredient derived from animals.

A KEY MILESTONE

Health Minister Vaughan Gething said: “This is another key milestone in our fight against the COVID-19 pandemic. The third vaccine for use in Wales significantly adds to our defences in the face of coronavirus. It will help to protect our most vulnerable.
“Every vaccine given to someone in Wales is a small victory against the virus, and we would encourage everyone to go for their vaccine when invited.
“If people cannot attend their appointment, we ask them to let the health board know via the contact details provided in their invitation as this vaccination slot can be offered to someone else rather than be wasted.
“Once you have been vaccinated, you should continue to follow guidance, staying two metres apart, washing your hands and wearing a face covering to protect those around you.
“I want to thank all those who have been working tirelessly to deliver the vaccine across Wales and help us meet our second milestone of offering a vaccine to all phase one priority groups. I also want to thank the 1.5 million people in Wales that have already come forward for their vaccine and done their bit in this national effort.”
Welsh Conservative deputy health spokesperson and candidate for Ceredigion and Mid and West Wales, Amanda Jenner, said: “The Conservative UK Government’s decision to go it alone has been fully vindicated with the phenomenal results of the British vaccination programme.
“The roll-out of the Moderna vaccine, administered by our outstanding NHS and volunteers, will boost our ability to protect Welsh people and restore our freedoms.”

VACCINE SUPPLIES

Starting from the middle of last year, the UK Government secured a deliberate oversupply of vaccine to ensure continuity of supply.
As part of that strategy, the Department of Health placed provisional orders – pending approval by the medicines’ regulator – of seven different vaccines in different stages of development.
The UK has ordered 40 million doses of Pfizer’s vaccine, 100 million doses of the Oxford vaccine, and 17 million doses from Moderna.
A further four vaccines are either in clinical trials or awaiting MHRA approval:  Novavax (60 million doses, Janssen (30 million doses), Valneva (60 million doses),  GlaskoSmithKline (60 million doses).
The number of Covid-19 vaccine doses on order is enough to fully inoculate the UK’s entire population twice.

BOARD STATEMENT ON VACCINATION PROGRAMME
194,057 people in our three counties have now received their first dose of the vaccine, and 47,087 people are fully vaccinated having received both doses.
We will have offered a first dose of the vaccine to all those in priority groups 5-9 by Sunday 18 April.
To ensure no one is left behind, this week the health board has launched an appeal asking people in groups 1 to 9 who have not been contacted to get in touch to arrange their first vaccine dose.
If one or more of the following applies to you and you have not received your first vaccine appointment, please contact the health board on 0300 303 8322 or by email COVIDenquiries.hdd@wales.nhs.uk by Friday 16 April:

  • are aged 50 or over
  • are aged 16 to 64 and have underlying health conditions that put you at increased risk of COVID-19 mortality
  • work in a care home or in health and social care in Carmarthenshire, Ceredigion or Pembrokeshire
  • are the primary unpaid carer of an elderly or disabled adult who is at increased risk of COVID-19 mortality, or a child with severe neuro-disabilities
Please be patient if you haven’t been contacted about your vaccine yet and we politely ask that you do not contact the health board or your GP to ask about your vaccine. You will be contacted when it is your turn.

THE SECOND DOSE

Second doses are essential for longer-term protection, so it’s important that everyone comes forward for their full course when called.
When you will be contacted for your second vaccine dose depends on which vaccine you have received.
We are asking anyone who received the Pfizer vaccine and has not received a second vaccine appointment yet, to get in touch as soon as possible on 0300 303 8322. Please note our phone lines get very busy at times and you may have to wait for the call to be answered. You can also contact us by emailing your name and contact phone number to COVIDenquiries.hdd@wales.nhs.uk
The health board aims to complete all second Pfizer vaccine doses by week commencing Monday 12 April.
To check which vaccine you received, look at the card given to you when you received your first vaccine. It will say if you received either the Pfizer BioNtech vaccine or the Oxford AstraZeneca vaccine.
If you received a first vaccine dose of the Oxford AstraZeneca vaccine, we politely ask that you do not contact your GP practice or health board at this time to ask about a second vaccine appointment. You will be contacted when it is your turn for a second dose – we are calling those who received a Pfizer first dose at this time.
Care home residents, people aged over 80 and all other priority groups who have received the Oxford AstraZeneca vaccine at the GP surgery will be contacted between 11 to 12 weeks following their first vaccine with an appointment time.
Confidence is building around the effectiveness of the vaccines.

Emerging evidence is clear on the impact of the vaccine in preventing severe disease and hospitalisation. That is now playing out in admissions to our hospitals, and thankfully, numbers of deaths from coronavirus being reported.
UK and EU regulators have also been very clear about the safety of the vaccines. The benefits of vaccination far outweigh any possible risks.
All three vaccines are safe and effective.

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Health

Police and drugs advice service issue warning over ‘deadly batch’ of heroin

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POLICE have asked the media to issue a warning over a batch of heroin.

The drug circulating in west Wales, first detected in Llanelli, is particularly dangerous, it has been confirmed.

“We are warning drug users to take extra care following reports of a particularly harmful batch of heroin circulating in the Llanelli area” said a Dyfed-Powys Police spokesperson.

“We have reasons to believe some drugs being distributed and used in the Carmarthenshire area at present have been contaminated with other substances and could be extremely dangerous for anyone taking them.

“We would also appeal to drug users to seek medical attention immediately if they become unwell.

“Please share this information with anyone you believe could come into contact with these drugs.

”In an emergency or if you think someone’s life is at risk always dial 999.”

Earlier this week Barod, the drug and alcohol abuse service reported a dangerous and toxic heroin circulating in Pembroke Dock which a spokesperson described as being ‘potentially deadly’.

To comes as Public Health England issued a formal alert about the risks of heroin containing fentanyl or carfentanyl.

The warning reads: “There is significant evidence from a small number of post-mortem results of recent drug user deaths and from police seizures that some heroin may contain fentanyl or carfentanyl added by dealers.

“These are highly potent synthetic opioids and very small amounts can cause severe or even fatal toxicity.

“Those of you in contact with heroin users should be alert to the increased possibility of overdose arising from heroin cut with these synthetic opioids, be able to recognise possible symptoms of overdose and respond appropriately.”

The fentanyls are a group of synthetic opioids; some have legitimate uses while others are illicit drugs.

Fentanyl is about 100 times more potent than morphine and is a licensed medicine used to treat severe and terminal pain. Carfentanyl is 4,000 – 10,000 times more potent than morphine and principally used as an animal tranquilliser.

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