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Health

Leaflet to calm fears over A&E downgrade

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Health board will explain how to get urgent care for children, as local NHS continues to be under extreme pressure

RESIDENTS in Pembrokeshire are being asked to look out for a leaflet about children’s hospital services, which will be delivered to households from next week (Week commencing 25 October 2021).

The leaflet will explain why temporary changes to re-locate the children’s daytime unit (PACU/Puffin Ward) and its specialist staff from Withybush Hospital, Haverfordwest, to Glangwili Hospital, Carmarthen, have been extended into 2022. It will also provide information on how to access the right care for a child when they are unwell.

Medical Director and Deputy Chief Executive of Hywel Dda University Health Board Dr Philip Kloer said: “We hope the leaflet will be a useful, quick guide for parents and carers to keep handy in the home. We know that making decisions when a child is sick or injured can be stressful and we hope this guide will help.

“It includes a QR code which will take you to our dedicated web resource on children’s services, where there are also alternative versions of the leaflet and contact details for people who wish to share their experience of care.”

The temporary move of the service was made in spring 2020 due to the need for space within the hospital to respond to the COVID-19 pandemic. It has been extended due to the continuation of the pandemic and also to ensure that the increasing number of children with respiratory illnesses access specialist care when needed.

It means that Withybush Hospital currently treats only children with minor injuries such as minor wounds, minor burns or scalds, insect bites, potential broken bones if not badly misshaped, minor head or face injuries, or foreign bodies in the nose or ear; and booked outpatient appointments.

Children with serious illnesses or injuries are treated at Glangwili Hospital where there is a co-located Emergency Department and children’s hospital services, including an overnight children’s ward, children’s high dependency unit and children’s daytime (ambulatory) care.

Multi-professional clinicians, including local senior doctors in children’s care (paediatrics), emergency medicine, and anaesthetics, have supported the recommendation and the need for clearer messaging to the public in order to reduce the risk of delays in the treatment of children and young people.

Clinical Director for Women & Children’s services, Dr Prem Kumar Pitchaikani said: “We need to avoid the delay that may be caused when a child is brought to Withybush Emergency Department only to need a transfer to Glangwili Hospital. The continuation of this temporary service change, will ensure that very ill children, including the increasing number of children likely to have respiratory viruses this winter, will get access to their definitive treatment more quickly. They can also be monitored and treated quickly by specialists in the event that they deteriorate.”

Clinical Director for Emergency Medicine, and senior consultant at Withybush Hospital Emergency and Urgent Care Centre Dr Nicola Drake said: “It is critically important that sick children have the support of specialist paediatricians at the earliest opportunity. They also need early access to specialised equipment that is provided and monitored by paediatricians.”

The intention is to continue with the temporary position and commence a review in March 2022, with a report back to the Health Board in autumn 2022. The review will be scrutinised by the Health Board and Hywel Dda Community Heath Council and will include measuring outcomes for children and young people, as well as patient experiences and the views of communities.

More information on how and when the access children’s healthcare services locally is available on our website if you search ‘children’s services’.

If you have an experience of children’s services you wish to share with us, please search the website for ‘patient survey’ or ‘complaints’; email: hdhb.patientsupportservices@wales.nhs.uk; or telephone: 0300 0200 159.

We will engage with our communities about the future of children’s services in 2022, but if you want to share your views at this point please; email: hyweldda.engagement@wales.nhs.uk; write to: FREEPOST HYWEL DDA HEALTH BOARD (you will not need a stamp); call: 01554 899 056 (this telephone number is not staffed, but messages will be recorded).

*Please note these changes affect children’s services at Withybush Hospital only and adult services at the hospital remain the same. Paediatric services at Bronglais Hospital, Aberystwyth, remain the same. There is no change to Prince Philip Hospital, Llanelli.

  •  Where to get help if my child is unwell?

Call 999 if your child has serious injuries or a life-threatening illness, including severe difficulty or irregular breathing, blueness around the lips, is pale, mottled and abnormally cold, has a fit or seizure, is extremely distressed, is very lethargic or unresponsive, develops a rash that does not disappear with pressure, or has testicular pain.

Go to a Minor Injury Unit (24/7 at Withybush Hospital; weekdays, daytime only and for children over 12-months at Tenby Hospital and Cardigan Integrated Care Centre) if your child has minor wounds, minor burns or scalds, insect bites, potential broken bones if not badly misshaped, minor head or face injuries, or foreign bodies in the nose or ear.

Contact your GP today if your child has an illness that won’t go away, indicated for example by a high temperature, shivering, muscle pain, cough, wheezing, increased effort to breath,  persistent vomiting/diarrhoea/severe tummy pain, blood in their poo or wee, or dehydration. Call NHS 111 Wales (24/7) for urgent advice if you are unsure what to do. Call 111 for urgent help when your usual GP surgery, or other primary care service, is closed.

*You may be asked to take your child to Glangwili Hospital Emergency Department if input from specialist children’s doctors is required.

Treat at home or contact your pharmacist if your child has a minor illness or ailment such as a sore throat, cough, skin irritation, or if a young person needs emergency contraception. You can get help online by searching ‘NHS 111 Wales symptom checker’. Some pharmacies offer treatment without appointment for low level injuries.

If you are deaf or speech-impaired you can access 999 services using the Relay UK app and dialling 999, or NHS 111 by dialling 18001 111. 

Health

Welsh Government announces additional funding for hospices

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HOSPICSE across Wales are set to receive a further £5.5 million in funding to help continue delivering essential palliative and end-of-life care services.

The cash boost is in addition to the £3 million uplift in recurrent funding confirmed in the Welsh Government’s 2025–26 budget. The new funding will support Wales’ twelve NHS-commissioned hospices — including the country’s two children’s hospices — in managing financial pressures and ensuring fair pay for staff.

Hospices in Wales play a vital role in supporting patients, families and carers during the most challenging times, and are committed to providing dignified and personalised care outside of hospital settings.

Health Secretary Jeremy Miles said: “Hospices play a vital role in supporting families at some of the most difficult times.
We are committed to strengthening and improving palliative and end-of-life care to ensure everyone who needs hospice support receives dignified and personalised care, outside of hospital.”

Liz Booyse, Chair of Hospices Cymru, welcomed the announcement: “We welcome the Welsh Government’s commitment of funding. It is a testament to the importance of the hospice sector within our healthcare system, and we are immensely grateful. Our services provide vital care and support to over 20,000 children and adults affected by terminal illnesses each year.
This funding is a significant step forward, and we will continue working in partnership with the Welsh Government to achieve a sustainable funding settlement that will bring greater stability to the Welsh hospice sector.”

Matthew Brindley, Policy and Advocacy Manager for Wales at Hospice UK, added: “Recent years have been very tough for Wales’s hospices, amid a combination of rapidly rising costs and ever-growing need for end-of-life care.
We’re grateful to the Welsh Government for recognising both the pressure hospices are under, and the immense value they bring to Wales’ health and social care system.
It’s vital we continue to work together toward a more sustainable approach to hospice funding in Wales. Our population is ageing, with increasingly complex health needs. We need a strong, robust palliative and end-of-life care system — and hospices in Wales are ready to play their part.”

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Health

Mind, Body and Spirit Awareness Day at North Pembrokeshire venue

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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.

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Health

‘Nobody taking responsibility’ for paying care workers the real living wage

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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.”

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