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Health board releases advice as staff absences start to impact on care provision

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The health board have today released a statement regarding staff absences due to Covid-19, and how to access care. We publish their press release, as requested, in full:

Our staff are working tirelessly each day in the face of unparalleled pressures and challenge. They continue to go above and beyond to prioritise the care and treatment of urgent and emergency patients. We are immensely proud of the collective effort that our whole workforce continues to make. Unfortunately, we can confirm that the current wave of Covid-19 infections is beginning to have a serious negative impact, with significantly higher than usual staff absences across hospitals, community services and primary care, including GP surgeries. This means you may have to wait longer than usual, but all services continue to prioritise according to clinical need. We are asking our communities, patients, visitors and members of the public to follow the guidance below:

  • Our community pharmacists can provide some walk-in care, and treatments for common ailments, find your nearest service here: https://hduhb.nhs.wales/healthcare/services-and-teams/pharmacy/; as well as our minor injury units: https://hduhb.nhs.wales/healthcare/hospitals-and-centres/minor-injuries-units/
  • If you have a serious, life threatening emergency please continue to call 999.
  • If it’s urgent (but not an emergency), visit the NHS111 Wales symptom checker, dial 111, or seek urgent care through your GP.
  • If you have a relative or loved one in hospital who is medically fit but is waiting to be discharged, you may be able to help us by providing short term care or considering interim placements in care homes.
  • Our vaccination programmes for both COVID-19 and flu continue at an unprecedented scale and remain a key part of our defence against these viruses.  All our mass vaccination centres are now offering drop-ins for COVID-19 first, second, third and booster vaccines for those eligible – please attend for yours if you have not already. For information on eligibility and opening times, visit https://hduhb.nhs.wales/healthcare/covid-19-information/covid-19-vaccination-programme/
  • Follow Welsh Government and local guidance.
  • Work from home whenever you can if appropriate.
  • Be vigilant with good hygiene practices to avoid spreading infection in our communities.
  • Good ventilation is important if indoors and remember outdoors is safer where possible.
  • Keep a safe distance.
  • Carry out LFD self-tests particularly before going into higher risk situations, such as spending time in crowded or enclosed spaces; visiting people who are at a higher risk of severe illness from COVID-19, or travelling to other areas of Wales or the UK.
  • Lateral flow self-test kits can be obtained by ordering online for home delivery https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests or by collecting locally from most community pharmacies: Check here for participating pharmacies near you https://maps.test-and-trace.nhs.uk/ Please remember to report your test results, negative or positive, on the UK Government portal here https://www.gov.uk/report-covid19-result/ If it’s positive, don’t go out. Self-isolate and arrange for a PCR test – book here https://gov.wales/get-tested-coronavirus-covid-19 or call 119NB we are aware there is national unprecedented demand for PCR and LFT tests. At times to support distribution and remain within the capacity at the laboratories, there may be temporary pauses in ordering and you may not be able to access the tests you need from gov.uk. The Government is advising you keep checking every few hours as more PCR and LFD tests become available every day.

If you need to come into our hospitals at any time, you 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.
  • Wear a mask before entering the hospital;
  • Ensure you maintain a two metres distance from others;
  • Wash your hands regularly;

If you need to visit someone in hospital, please remember this must be pre-booked with the charge nurse or ward sister. More information about hospital visiting is available on our website though please note this is subject to change at short notice.

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Health

Omicron ‘challenging all parts of healthcare provision’

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THE INCREASING challenge on healthcare from the Omicron variant is currently affecting all parts of healthcare, including GP, dental, pharmacy and optometry provision, Hywel Dda health board has said in its latest press release.

GP Practices across Carmarthenshire, Ceredigion and Pembrokeshire remain under considerable pressure and as a result, more appointments may be offered over the telephone or online.

The board is giving the following advice to service users: “If you are asked to attend the surgery in person, please do so alone unless you need assistance, and remember to wear a face mask.

“Most Practices have online systems, such as E-Consult or Ask My GP, to allow patients to ask a non-urgent question about their health. Please see your Practice’s website for more information.

“My Health Online remains an online 24/7 option for ordering repeat medication; designed for patient convenience and especially useful for those who are self-isolating or shielding. Patients can register for this through their GP practice. Please allow extra time when ordering prescriptions.

“Telephone triage systems are in place in the majority of surgeries to ensure that a patient speaks to a clinical member of staff about their health.

“If a patient needs to be seen in person, the surgery will make an appointment with the most appropriate healthcare professional for their needs.

“Due to staffing issues we have also seen in recent weeks an impact on service pressures in community pharmacies, dentists and optometrists. We continue to work with all of our Primary Care services to make sure that we are able to provide timely and appropriate care but ask that patience and kindness is shown to staff as they are working very hard to try to deliver the services that patients can normally expect to receive from them. 

“Services may vary depending on individual dental practice circumstances, please ensure that you contact your practice who will be able to advise appropriately.

“You may find that you have to wait a little longer than normal to receive your prescribed medication and we would ask that you allow seven days for any repeat medication.”

Jill Paterson, Director of Primary Care, Community and Long Term Care for Hywel Dda University Health Board said: “We wish to reassure patients that GP services are still available to you. When you contact your practice, you will speak to the most appropriate person for your condition and if you need to be seen in person, you will be given an appointment at the practice.

“It may take longer than normal to get through on the phone and you may wish to contact your doctor’s surgery online, if possible.

“We have had reports of verbal abuse targeted at Primary Care staff and this will not be tolerated; please remember they are working very hard to help their patients and we thank you for your patience at this time.

“Many conditions can be treated over the phone with advice and if required, a prescription can be issued to your nominated pharmacy. Please do not put off seeking treatment.

“Pharmacies offer a wide range of services including treatment for minor ailments. Please be aware that pharmacies are also operating at capacity and you may have to wait longer than usual.”

Responding to the latest Welsh Government press conference and the announcement of additional funding towards easing winter pressures, Darren Hughes, director of the Welsh NHS Confederation, said:

“We welcome the announcement of further funding to support health and care organisations during a time of unprecedented pressures.

“The issues in social care have not gone away but have been exacerbated by the latest wave of the virus. Health and care services continue to work together in innovative ways to both help prevent hospital admissions and support the discharge of as many medically fit patients as is possible, given the constraints.

“It’s important we recognise that all parts of the system are experiencing extreme levels of demand at a time of record high staff absences: not just in our hospitals but in GP surgeries, pharmacies and the community, too. Although Covid hospitalisations aren’t at the highest they’ve been throughout the pandemic, in part thanks to the vaccination programme, GPs are absorbing much of this demand as many patients turn to them for support with Covid symptoms.

“The coming weeks will be some of the most challenging in the NHS’ history as it seeks to absorb the pressure of the Omicron wave amid huge demand and the challenge of significant staff absences.

“This is why the NHS needs you to access services in the right place at the right time, to make sure emergency health services are available for those who need life-saving care.”

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Health

Omicron peak could come in ‘the next 10 to 14 days’ in Wales

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THE FIRST MINISTER Mark Drakeford has said he is ‘hopeful’ figures in Wales could start to reduce from around two weeks’ time.

The comments came during the live briefing held yesterday lunchtime in Cardiff, with the First Minister referring to modelling several times and comparing it to what has been recorded in firm figures.

The First Minister said of the above slide, “It shows you how the modelling that we’ve had done for us here in Wales shows how the Omicron wave wave is expected to behave. The blue line shows how cases are predicted to grow over the coming weeks. The black line shows the actual confirmed cases.

“As you can see, the actual cases are following very closely the predicted wave, and what the wave shows is the speed at which the Omicron wave will break over us and then how cases decline at a relatively rapid rate as well.

“Now we haven’t reached the peak of that wave yet, it could be within the next 10 to 14 days. But we will get to the top of the wave and then hopefully we will see the numbers reducing again here in Wales.

“The latest figures show that there are more than 2300 cases per 100,000 people across Wales. Cases are highest amongst 20- to 39-year-olds but we are also now seeing rises in older age groups. As community transmission increases rapidly, while the figures are clearly concerning, they are in line with what the modelling forecasts told us.”

“Every close contact is an opportunity for it to spread.”

Data was also released on the number of people to being admitted to hospital with coronavirus, “The latest figures show that there are now a total of 994, just under 1000, COVID-19 patients in our hospitals in Wales and that is a 43% increase on a single week and that number is the highest we have seen in Welsh hospitals since March of last year”.

“There are now around 40 people are so ill in hospital that they have to receive critical care and the majority of those people are people who have not been vaccinated. Very sadly since just the start of this year, public health Wales has reported 38 New deaths from coronavirus.”

When asked about reversing restrictions, and what timeframes could be involved, the First Minister said, “As people will have seen from the model that we showed earlier, the position over the next 10 days to two weeks is not going to be one that is easing.

“The numbers are likely to continue to rise. So it will not be until we have past the peak of infections and we are sure that we can see the pressures on the spread of this virus in the community are beginning to reduce, and will then take a while as it always does to feed through into reducing pressure on health services, hospital services, critical care services.

“So I don’t anticipate that over the next fortnight we will be in a position to move away from the level of restrictions we currently have in place. But, we will track it every day. We will review it every week. And when we see that corner being turned and we can see the number as we hope coming down reasonably rapidly. That will be the point at which we will be able to assess when it is safe to begin to lift the extra restrictions and protections we put in place so far.”

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Health

Most stupid and inappropriate calls to the Welsh Ambulance Service revealed

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THE WELSH AMBULANCE SERVICE has revealed the most inappropriate calls made to 999 in the past year.

Among them was someone who had eaten a mouldy tomato and someone who had got their plaster cast wet.

One person with an earring lodged inside their ear asked for a “lift” to the Emergency Department, while another dialled 999 for a papercut.

Of the 470,653 incidents recorded by the service in the last 12 months, nearly a quarter were non-essential, including someone with diarrhoea and someone enquiring about their medication.

In the face of unprecedented demand, the ambulance service is reminding people only to call 999 in a serious or life-threatening emergency.

Chief Executive Jason Killens said: “Our ambulance service exists to help people who are seriously ill or injured, or where there is an immediate threat to their life.

“That’s people who’ve stopped breathing, people with chest pain or breathing difficulties, loss of consciousness, choking, severe allergic reactions, catastrophic bleeding or someone who is having a stroke.

“People with something stuck in their ear still have a clinical need, but calling 999 for that is ill-judged when there are so many other ways to access more appropriate help.

“Non-essential calls represent nearly a quarter of our total 999 calls, and time spent dealing with these could be time spent helping someone in a life or death situation.”

As Covid-19 tightens is grip, the Trust is asking the public to think about the many alternatives to 999.

Director of Operations Lee Brooks said: “Winter is traditionally our busiest period, and we also have a global pandemic to contend with.

“It’s easy to make fun of the people who call 999 foolishly, but actually, these people do have a legitimate clinical need – they just don’t know where to turn for it.

“We’re asking the public to educate themselves on the NHS services available in their area, of which there are many.

“The symptom checkers on the NHS 111 Wales website are a good place to start for advice and information, or you could phone 111 to speak to a nurse or health information advisor.

“Also think about your local pharmacist, dentist and optician, as well as your minor injuries unit and GP.

“Also ensure you have a well-stocked medicine cabinet for things which can be treated at home, like coughs and colds, sore throats and grazed knees.

“Every single one of us has a responsibility to use NHS services wisely and protect them for those who need them most.

“Help us to help you, and think twice before you call 999.”

Examples
The following are real 999 calls made to the Welsh Ambulance Service in the past year –

Call 1
Caller: Basically, I had a piercing a few weeks ago in my ear. Everything’s been fine but last night I woke up and the piercing had gone. I can’t find the piercing and it feels like it might be in my ear drum.
Operator: Right, OK.
Caller: Normally I would go to A&E myself but I don’t actually have any money. A lift to A&E would be amazing.

Call 2
Caller: My neighbour came here and she gave me a sandwich, cheese and tomato. Anyway, I feel quite sick now. I looked at the tomatoes and there’s mildew on them.
Operator: OK, is that why you’re requiring an ambulance?

Call 3
Caller: I was mucking about with my plaster cast and it’s coming apart. I don’t know whether to get a taxi or an ambulance.
Operator: From the information you’ve given, you require a more detailed assessment by a nurse. An ambulance will not be sent at this time.
Caller: Oh, you’re joking. Are you being serious?
Operator: We’re extremely busy at the moment.
Caller: I’ll get a taxi.

Call 4
Caller: I cut my arm, my arm’s cut.
Operator: How did you do that?
Caller: I sliced it on a piece of paper.
Operator: When did this happen?
Caller: About half an hour ago.
Operator: Is there any serious bleeding?
Caller: No.

Call 5
Operator: Tell me exactly what’s happened.
Caller: Basically, my mum drank apple vinegar but mixed it with water and lemon. Now she has diarrhoea.

Call 6
Caller: Oh, hi there. Basically, I’ve got my hand in a cast. It’s been in there for three weeks and I’ve got it wet.
Operator: OK.
Caller: It’s not an actual emergency, I just need to get to hospital.

Call 7
Caller: What it is, right, I’ve got different medication and I don’t know whether I can take these or not now.
Operator: What’s your telephone number?
Caller: I don’t want an ambulance, I just don’t know if I can take my meds or not.

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