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Health

Ombudsman slates Health Board

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HYWEL DDA UHB failed a mother and son when it abruptly ended support services for individuals with long-term needs.

The Public Services Ombudsman, Nicholas Bennet, published a report in the public interest this week about the Board’s failings.

The report was scathing about the Board’s failure to discharge its duty of care towards individuals with complex needs.

In the decision, in which both mother’s and son’s names are anonymised, the Ombudsman upheld a complaint made by the mother (Ms B) about the failure of service provision to her son (Mr C).

Ms B complained that the Health Board failed to provide appropriate care to her son, Mr C.

Specifically, Ms B complained that the Health Board failed to provide Mr C with appropriate psychology services and as a result failed to meet his clinical needs.

Mr Bennett found the Health Board failed to take prompt steps and arrange to meet the clinical needs of Mr C following the closure of a psychology service. 

Despite the Health Board identifying that Mr C’s needs were not being met, it failed to put any plan in place to meet them. 

He found that Ms B, as Mr C’s main carer, was left without sufficient support to manage his challenging behaviours. 

The closure of the psychology service happened when Mr C’s challenging behaviours were further complicated by the impact of the restrictions due to the COVID-19 lockdown. 

The Ombudsman found no evidence of contingency planning should the psychology service come to an end, meaning that the Health Board and the patients receiving the psychology service were unprepared for the abrupt end.

Mr Bennett found that the Health Board’s communication with Ms B was inadequate which left her uninformed at the time of the COVID-19 lockdown when she was struggling to cope with Mr C’s challenging behaviours. 

He also found that the Health Board’s complaint responses to Ms B were inadequate and were not in line with the relevant regulation.

After ordering the Board to make a full apology to Ms B, the Ombudsman told the Board it must take further steps to avoid any future repetition of its failings.

Mr Bennett said the Board must undertake a review to identify any other patients with unmet clinical needs as a result of the closure of the Specialist Service and ensure steps are taken to meet those needs either by the Health Board or other agencies.

He also ordered the Board to commission and complete its planned review of the Health Board’s child psychology services and report the findings back to his office.

Commenting on the report, Nick Bennett said it was a “highly concerning case where a mother felt as if her family had been destroyed”.

He said: “The ending of the specialist service left a huge gap for Ms B and all families with children with learning disabilities in the health board’s area.”

Hywel Dda’s chief executive Steve Moore said the health board was “very sorry for the failings identified” and has written an apology to the family.

“This was a very challenging period for the health board’s learning disability team and the psychology service in particular, due to high levels of staff absence, vacancies and unsuccessful recruitment initiatives,” he said.
Mr Moore also said that measures have been introduced to “ensure appropriate communication is in place to respond to complaints”.

However, the ball is now firmly back in the Board’s court to satisfy the Ombudsman that it has taken the further steps he has ordered to address the failure to provide a service to those who are particularly vulnerable.

Health

Hospital visiting restrictions relaxed in Carmarthenshire, Ceredigion and Pembrokehire

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FAMILY and friends can now attend hospitals in Carmarthenshire, Ceredigion and Pembrokeshire to visit patients on a limited basis with prior agreement with hospital staff in line with Welsh Government guidance.

While the prevalence of COVID-19 has reduced within our hospitals and in the community, the virus has not gone away. Like some other areas across Wales and the UK we are continuing to deal with cases of COVID-19 and other respiratory infections in our hospitals. As a result, visiting arrangements to all hospitals in Hywel Dda UHB are being reviewed regularly and remain subject to change at short notice.

With effect from Monday 29 November, all visits must be pre-arranged with the ward sister or charge nurse to enable us to maintain social distancing in our wards and across our sites. This means that a pre-booked visit for one person daily can be supported, provided your visit has a clear purpose and is in the best interest of the patient, in line with the following guidance:

‘Visiting with a purpose’:

  • End of life – last days of life
  • Carer – you are the carer or the nominated representative
  • Parent/Guardian – children and young people can be supported in an inpatient environment by the identified parent/guardian
  • Learning disabilities (LD) – a patient with learning disabilities may need you as their carer/next of kin to share information about their individual needs and virtual visiting may not be appropriate
  • Dementia – to support a person with Dementia as part of the ongoing support/plan of care
  • Other – for example where it is felt a visit from you may help the patient with rehabilitation, understanding of care/condition, help with dietary concerns. The ward sister may agree visiting outside of this guidance in certain circumstances.

The current visiting arrangements within our maternity services remain unchanged at this time.

Please note that visitors who do not meet the criteria will be asked to use a virtual visiting option instead which is available within the hospital, such as using a tablet or mobile phone. Family Liaison Officers will be available on wards to support access to virtual visiting.

All visitors must carry out a lateral flow device (LFD) test at home and have a negative result from that test prior to travelling to the hospital. Lateral flow self-test kits can be obtained by:

It is recommended that test results – negative or positive – are recorded on the UK Government portal (www.gov.uk/report-covid19-result)

When visiting our hospitals please remember to wear a face covering, this will be replaced by a surgical face mask at reception or ward entrance. Please remember to maintain social distancing and to clean your hands on entering the building and as often as possible using soap and water or hand sanitiser.

Mandy Rayani, Executive Director of Nursing, Quality and Patient Experience, said: “On behalf of the health board I want to express our deepest gratitude to our patients, their families and our communities for their continued understanding and adherence to the very strict hospital visiting rules that we have had to impose throughout this pandemic. 

“We appreciate that it is a difficult time for everyone. We will continue to support the wellbeing of our patients/service users, their families and loved ones in the best way we can, while keeping everyone as safe as possible.

“Our patient support team and family liaison officers can help to deliver essential items to patients from their family and facilitate communication through digital options/telephone; if you need their assistance please call them on and 0300 0200 159 and they will do their best to help you.”

Please do not visit any of our hospital sites if you:

  1. are unwell, have flu like symptoms, currently have or had diarrhoea and vomiting in past 48 hours, have been in contact with anyone with the above symptoms in the last 48 hours have an existing medical condition or are on medication that puts you at risk of infection. Infection control advice – Hywel Dda University Health Board (nhs.wales)
  2. have been asked to isolate by the contact tracing team or if you have any of the three main symptoms of COVID-19 – a new continuous cough, temperature or loss or change of taste or smell. If you experience any of these symptoms please book a COVID-19 PCR test via the UK portal or by ringing 119. You should also book a test if you have mild cold or flu-like symptoms, including runny or blocked nose, sore throat, muscle ache or pain, excessive tiredness; persistent headache, persistent sneezing and/or hoarseness, shortness of breath or wheezing. When booking your PCR test, you will also be asked about your symptoms: if you have mild cold or flu-like symptoms, rather than the classic three symptoms, choose ‘None of these symptoms’ and then choose one of the following options to enable you to complete the booking:
  • My local council or health protection team has asked me to get a test, even though I do not have symptoms or
  • A GP or other healthcare professional has asked me to get a test.
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Health

New Covid-19 variant classed ‘of concern’ and named Omicron

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THE UK GOVERNMENT has temporarily halted flights from six southern African countries: South Africa, Botswana, Namibia, Zimbabwe, Eswatini and Lesotho

The European Centre for Disease Control (CDC) says that it has classified the new Omnicron coronavirus variant as being “of concern”.

Officials say that the level of risk associated with the variant is “very high” and that it is extremely likely that the variant will spread across the EU.

Omicron is a word you will be hearing a lot about in the weeks and months to come, most analysts are saying.
The agency added that it feared the profile of the variant may mean that the effectiveness of vaccines could be reduced and that natural immunity may be decreased.

On Friday, Eluned Morgan MS, Minister for Health and Social Services said that the Welsh government in Cardiff was taking immediate action to move the eight south African countries onto the red list for travel as the variant may be capable of evading the protection provided by vaccines.

The Minister said: “The variant has been linked to Botswana, Eswatini, Lesotho, Namibia, South Africa and Zimbabwe.

These countries have moved onto the red list from 12pm today. Two additional countries, Mozambique and Malawi, will also move onto the list from 8pm (20:00) today.
“This means travellers from these destinations will not be permitted to enter Wales but must enter through a port of entry in England or Scotland and go into a managed quarantine facility for 10 days. They must also take post-arrival PCR tests on day 2 and day 8.

South Africa’s Health Minister Joe Phaahla told reporters that the flight bans were “unjustified”.

“The reaction of some of the countries, in terms of imposing travel bans, and such measures, are completely against the norms and standards as guided by the World Health Organization,” he said.

CONCERNED: WHO (PIC FILE)

Stock markets across the world also fell sharply on Friday, reflecting the fears of investors over the potential economic impact.

UK Health Secretary Sajid Javid says there is “huge international concern” over the variant.

MULTIPLE CONCERNING MUTATIONS

Professor Anne von Gottberg of the National Institute for Communicable Diseases (NICD) in Johannesburg said that most strains of the virus have about five to 10 spike mutations, but the Omicron has around 25 to 32.
“So it really was immediately noticeable that something unusual had happened,” she said.
“There are a lot of mutations that are new and that we haven’t seen before,” she said.

She said it was as yet unclear what can be determined from the multiple mutations.
But she said it was precisely because they couldn’t fully understand its characteristics that merited further study and a cautious approach to the new strain.

Prof John Edmunds, a member of the UK’s Scientific Advisory Group for Emergencies (Sage) which advises the government, says the new variant, B.1.1.529, is a “huge worry” and could escape current Covid vaccines.
“The molecular data is extremely worrying – it would point to that perhaps this thing might be able to evade the immune response” he said on a BBC radio programme.

Asked if the new variant could be resistant to current vaccines, Edmunds – an infectious diseases expert at the London School of Hygiene and Tropical Medicine – confirms this is scientists’ “great fear” but it is not yet known to what extent the variant might be able to do so.

“Our fears are it would do so to a large extent” The UK is “still fighting a Delta wave” and does not want to be “fighting both at the same time” as it could create a “very, very, very difficult situation”.

A technician uses a single channel pipette dropper, Johannesburg, South Africa (Pic PA)
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Please protect yourself and others from Covid-19 this Christmas, says Council Leader

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THE LEADER of Pembrokeshire County Council has issued a detailed update regards the Covid-19 situation in Pembrokeshire.

Cllr David Simpson said that we had seen a reduction in positive cases over the last couple of weeks but, unfortunately, numbers have started to rise again.

As of today the positive rate locally was 551.6 per 100,000 people he confirmed.

CLLR DAVID SIMPSON (Pic PCC)

Cllr Simpson said: “I must repeat that Covid-19 has not gone away and the wave of positive cases sweeping across Europe is a concern.
“People continue to catch this awful virus every day. Unfortunately, people are still dying from Covid-19.
“It is human nature to want to forget about Covid as the festive season approaches, I totally understand that.
“Like everyone, I was so disappointed when the tighter restrictions had to be brought in just before Christmas last year.
“And like everyone I’m thinking about buying gifts, planning festive events and looking forward to the celebrations.
“But I would please ask that you also keep in mind the simple things we can all do to give ourselves the best protection against Covid-19 and slow down the spread.”

Cllr Simpson said that People in Pembrokeshire should continue to work from home where you can, take up vaccination including the booster when offered, keep your distance where possible, use face coverings where required, maintain hand hygiene, meet outdoors when the weather allows and let fresh air in if you are meeting indoors.

He said that Christmas parties is one particular area where I would ask people to take extra care.

Cllr Simpson said: “Please consider smaller group numbers than you might ordinarily and try to avoid mixing with too many other people.”

“Remember that Covid-19 loves busy indoor spaces.

“Please do what you can to protect yourself and others.

“I would also take this opportunity to remind everyone that the Welsh Government has now extended the use of the NHS Covid Pass for further settings.

“As well as nightclubs and similar venues, you must also now show your NHS Covid Pass to prove that you are either fully vaccinated or have tested negative at cinemas, theatres and concert halls.

“This applies if you are aged 18 or over and also relates to unseated indoor venues with more than 500 people in the audience, any outdoor or indoor unseated venues with a capacity of over 4,000 and any event, of any nature, which has more than 10,000 people in attendance. To get a NHS Pass and for more information, see: https://gov.wales/get-your-nhs-covid-pass

“At the last three-week review the First Minister did not introduce the NHS Pass for use in hospitality settings but that remains a possibility for the next review on Friday December 10th.

“Our officers will, of course, keep a close eye on announcements from the Welsh Government as we move closer to Christmas and provide further information as it becomes available.

“Continuing the Christmas theme, I would urge everyone to do their shopping locally wherever possible.

“We have some incredible businesses across our County – including the much-loved markets – and our support will be extremely important to businesses and traders after what has been a tough period.

“All Council car parks will be free on Saturdays and Sundays in December to aid popping into the local shops and picking up some gifts.

“I plan to update you all once again just before Christmas so until then please enjoy the build up to the festive season safely.”

Further information:
I would like to highlight that the My Account redevelopment survey ends 30th November, so please get involved so you can have your say. It can be accessed via:  https://haveyoursay.pembrokeshire.gov.uk/my-account-re-development-feedback
Also, our ‘Christmas in Pembrokeshire’ section goes live 1st Dec and contains key information on opening times, waste and recycling collections, Christmas Parking (Free parking days), winter driving and salting routes and Christmas Markets.
For further information visit: www.pembrokeshire.gov.uk/christmas
www.sir-benfro.gov.uk/nadolig
Additionally, there are a number of engagement and consultation applications from across the county – they include:
▪ Narberth Library: (closes 30th Nov)
▪ Eco Park Pre-Application Consultation: (closes 9th Dec)
▪ Net Zero Carbon Plan: (open-ended)
▪ Have Your Say on Council Budget 2022 – 23 (closes 5th Jan). As part of this engagement on Council Budget 2022–23 Cllr Kilmister and Jon Haswell will also be hosting a
Teams Live Stream Event on Wednesday 1st December between 7–8pm.
All are available at: https://haveyoursay.pembrokeshire.gov.uk/

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