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Health

West Wales care homes on “war footing” because of Covid crisis

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Pendine Academy of Social Care. Mario Kreft MBE at the launch in Wrexham.

CARE HOMES in West Wales are on a “war footing” because of desperate staff shortages caused by the skyrocketing Covid infection rate.

According to Mario Kreft MBE, the chair of Care Forum Wales, the sector is facing its worst ever crisis with reports that 75 percent of staff were off work in some homes, either because they had contracted Coronavirus or they were self-isolating.

The situation is so bad that as a last resort homes were introducing “firebreaks” to temporarily restrict visiting as the highly infectious Omicron variant tore across Wales.

Domiciliary care companies were also struggling badly and were often unable to provide the usual level of care.

Mr Kreft warned that the situation was only going to get worse before things got better.

So much so, that some care homes were likely to be forced to declare an NHS-style “critical incident” because they were unable to cope.

But he feared reinforcements might not be available because statutory organisations like local health boards and councils were also short of staff.

Mr Kreft said: “The scale of the challenge is one we have never faced before. It’s really, really tough out there.

“The First Minister reminded us in 2020 that the social care sector was in a fragile state before the pandemic because of its precarious finances and the shortage of staff.

“After two  year of this, the pressures  have been building up and now we’re facing a completely different challenge because the Omicron strain of Covid is so prevalent and so transmissible.

“As a result, we’re seeing problems we’ve not encountered before.

“Care Forum Wales members have been reporting being down by up to 75 per cent in terms of staffing shifts. We’re on a war footing.

“The social care workforce has been heroic right through this pandemic. It’s taken a pandemic for people to realise how essential these workers are – just in the same way as the NHS and other services.

“They are rising to the challenge but it’s incredibly difficult and it’s probably going to get much worse before it gets better.

“It’s quite possible that some care homes will have to call on the statutory services. There are plans in place and we have been working with Welsh Government and our colleagues  in health boards and local government.

“We may have to declare what the NHS would call a critical incident and in that case the only place you can go is the statutory agencies.

“The trouble is that we all know they are suffering like everybody else at the moment so whether there would be people available to alleviate the crisis, I don’t know.

“What we are talking about is making sure that people are as comfortable and as safe as they can be.

“This also applies to our domiciliary care workers who are facing similar challenges, so the visits to people’s homes may not be as long or as often as they might have been until we get through this.

“Nobody understands the importance of care home visiting better than those that run and work in care homes. It’s essential to people’s wellbeing and we’ve had decades of open house visiting without any appointments.

“The last two years  have been incredibly challenging and I think people need to understand that safe visiting currently also requires a staffing input which makes it even more difficult if you are short of staff and don’t have the capacity to ensure safe visiting.

“I don’t think there have been any situations where people haven’t been allowed to visit for people in very extreme circumstances.

“I think what we’ll see is firebreaks or temporary pauses in terms of visiting individual care homes.

“The responsibility is clearly with the registered manager and the organisation running each setting.

“All the registered providers have legal responsibilities towards their residents and they also have responsibility for the health and safety of their own staff.

“I think what we’ll see – and we’re starting to see it already  – is that visiting will be restricted for a period of days or a week or so because quite simply there will not be the staff to ensure safe visiting.

“The other added complication is that care homes are now unable to secure insurance against Covid-related claims so they really cannot afford to take any risks.

“But as soon as we ensure safe visiting again, we will revert to that. That’s what people have been doing over Christmas and New Year. All I would ask from people is understanding because it is such a difficult time.”

in the same vein, Glyn Williams, director of a Holyhead care home, told ITV Wales that better PPE could be a potential solution to transmission in homes: “We could increase the PPE measures, we could increase the level of masks that we’re all wearing, from the flimsy FSMS to FFP3, perhaps that would cut down transmission.”

Care staff currently wear standard surgical masks in homes where aerosol-generating procedures are not present.

Back in September, Labour’s Health Minister, Baroness Morgan, was told by the Welsh Conservatives that her statement on PPE did not reflect healthcare worker experience.

It came after Dr David Bailey, Chairman of the British Medical Association Cymru, told the Western Mail on 15 September that one of the reasons NHS Wales is currently under such immense pressure is “inadequate personal protection equipment”.

Dr Bailey continued: “Some doubly vaccinated healthcare workers are still having to isolate due to treating vulnerable patients and not having sufficient equipment such as higher-grade respiratory masks to stop the spread of the virus.”

Commenting, Welsh Conservative and Shadow Social Services Minister Gareth Davies MS said: “If we have care bosses saying we must choose between lockdown and better PPE, then I have no doubt everyone would choose the Labour Government providing adequate equipment to hard-working care staff rather than closing down and damaging all of society and the economy once again.

“It is sadly not the first instance where the Labour Government in Cardiff Bay have been told that current PPE supplies were not enough: a survey of doctors in May 2020 found that 67% of doctors in Wales did not feel fully protected from Covid-19 in the workplace.

“Since then, only last summer, we had the British Medical Association say that one of the reasons NHS Wales has recently experienced such immense pressure is inadequate PPE, yet we gave supplies away to other countries rather than save up to look after our own.

“We are regularly told by the Labour Government that they are handling the pandemic well, but surely, nearly two years since coronavirus struck the UK, adequate PPE should not be an issue for service providers, but an integrated part of the supply chain and a matter of course.”

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Health

‘Serious concerns’ as Hywel Dda Health Board confirms closure Johnston Surgery

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  • Pharmacist slams “a dereliction of duty” putting patients at risk
  • Board ignores GPs who say they’re already overburdened
  • Managed practice in Neyland could still be short of GPs

EXCLUSIVE

GP SERVICES in Johnston will stop at the end of October, The Pembrokeshire Herald can reveal.

Current patients registered with the practice will be forced to other GP practices over their and those practices’ strenuous objections.

4,000 patients will remain registered with a GP practice managed by the Health Board and based in Neyland.

Based on their geographical location and list availability, the remaining patients will be forced to go to GPs in Haverfordwest or Milford Haven.

In reaching its decision, the Board ignored objections from patients based in Johnston, the lack of suitable public transport, rejection of the proposals by Johnston Community Council, concerns expressed by Johnston Pharmacy, IT issues, and other GP practices’ unwillingness and lack of capacity to deliver services.

Instead, the Board decided that a Health Board Managed Practice be established to operate from St Clement’s Surgery in Neyland to serve those patients living in Neyland and the surrounding area.
(approximately 4,000 patients).

Those patients living closer by travel time to another GP Practice than St Clement’s will be re-registered with the closest practice (approximately 2,000 patients).

The Board claims that decision is in line with the Health Board’s strategic aim of delivering care closer to home by delivering it in less convenient locations further from people’s homes.

No existing GP practices were prepared to run the General Medical Services contract for Neyland and Johnston.

One respondent said: “I have serious concerns about the systematic and insidious degradation of health services in Pembrokeshire by Hywel Dda Health Board.

“The inability to recruit and retain medical professionals in Pembrokeshire to run local GP surgeries and hospital facilities is a direct result of either deliberate or consequential actions by this health board and is deeply concerning.

“The fact that HDUHB sent out a six-page document requesting feedback on a serious situation of potential loss of the sole medical practice in the town, and less than half a page is given space to express those concerns, the remaining pages that are dedicated to requests for data on my ethnic, sexual and gender specifics would indicate to me that your attention is perhaps not focused on the right priorities of issues requiring being urgently addressed.”

Robert Street Practice in Milford Haven said: “We are very concerned that changing the practice boundary, deregistering patients, and allocating them to neighbouring practices will destabilize these practices.

“As you know, we have ongoing sustainability issues and feel that any change to our list size could exacerbate this.

“We continue to operate an open but closed list, in line with BMA guidance due to workload issues. However, our list size continues to grow due to ongoing patient allocations.

“We are concerned that the LHB have not considered our position and how the proposed sudden influx of patients could impact on our ability to provide services for our patients.”

St Thomas Surgery, Haverfordwest said: “We currently have sustainability issues ourselves. We have struggled to recruit suitable clinicians (doctors/nurses) over the last 2 to 3 years. We have not successfully replaced a retiring partner.

“Our practice will have 3 doctors over the age of 60 in the next 12 months. Retirement may occur at short notice, especially if clinical practice becomes unsustainable.”

St Thomas’s also points out the list reallocation comes at a particularly busy time, as GPs prepare to deliver flu vaccines and covid boosters during October and November.

Winch Lane Surgery made much the same points, adding: “Further increase in the practice population cannot be matched by an increased number of clinicians as there are no rooms for them to work in.

Responses from GP practices and the public also pointed out that new housing developments were already increasing the number of patients each practice registered before adding in extra patients from the closed GP base in Johnston.

And that’s before new patients’ details are screened and considered by the GP practices to which they are shunted.

Simon Noott of Johnston Pharmacy said moving GP services away from Johnston could undermine his business’s viability.

He added: “It would be a massive blow to the population of Johnston if they were to lose their surgery. Johnston village has a significant population; many needing medical services have limited mobility and would have to make the choice of postponing/not receiving treatment if moved to a different town.

“There is also a large population on low incomes who would find the cost of transport to another town prohibitive and an impediment to accessing GP services.”

Mr Noott concluded: “It would be a dereliction of duty for the Health Board to leave this population under provisioned and the result will lead to significant patient harm.”

Not only were Simon Noott’s concerns given a load of soft soap by the Board, but it also ignored every concern expressed by the GP practices.

The Board even acknowledges that position when defending its “challenging decision”.

It concedes regardless of the feeling of patients and stakeholders, the need to balance the risk of future service delivery outweighed public feedback and the concerns of health professionals.

On Monday (Sept 26) the Health Board issued a statement claiming no decision had been made.

However, if the Board contradicts its own expert panel, it will have to find enough GPs to staff both surgeries when its vacant practice panel says that can’t be done due to a lack of GPs. Contradicting a finding made twice by its own advisors would be unheard of.

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Veteran opens Slimming World in Milford Haven

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ARMY Veteran, Rachel, has launched her own Slimming World group in Milford Haven after her own positive experiences. 

“I changed lives in the army and hope to continue changing lives for people in Milford Haven.”

Rachel was born and raised in Milford Haven. As a small child, she was “active and busy” and a real tomboy alongside her brothers. 

In 1998, she joined the Army at 16-years-old as a Combat Medical Technician. Following training, Rachel served in Germany, all over the UK, overseas in Cyprus, and was deployed to Oman, Kosovo, Bosnia and Poland before retiring from service in May 2021.

Her role as a combat medical technician meant she often had to deal with soldiers who had been injured in war zones. Rachel described dealing with the range of injuries as “life-changing”.

Rachel’s job not only consisted of helping soldiers physically recover; she also helped them with their mental well-being. 

She said she: “always pointed out the positives ahead of them for their lives and their families.

“The fulfilment I would get from seeing them recover and their family made whole again is so rewarding, I cannot put it into words.”

She has always been a strong, physically fit person. She enjoyed an active lifestyle and felt as though she “could always eat what she wanted.”

In 2017, she was posted to Harrogate. Rachel was 36 years old and had recently given birth to her third child, a daughter, after already having two sons aged 13 and 5. 

She says she was almost two stone overweight even before her pregnancy. 

Rachel said: “So here I was with four stone to lose. I had lost all confidence and was at a loss.

“I was at a GP surgery when I saw a poster for Slimming World. I was there for my daughter’s first vaccinations and that’s when I decided to join my local Harrogate Slimming World group.”

Rachel said she was welcomed to the group with open arms. She described the members as being lovely, offering to make her a hot drink after being weighed or hold her baby while she got settled into the group. 

It was at this group that Rachel found her love for Food Optimising, which is Slimming World’s unique plan to lose weight and get healthy. 

She swapped takeaway meals for ‘fakeaways’ using recipes she learned from her group. 

After only a week, Rachel had lost 4 lbs and knew this new plan was one she could follow. 

Over the next 10 months, she enjoyed curries, chillis, chips loaded with a variety of toppings and cheese within her daily allowance, and she could still enjoy treats every now and then. 

By June 2018, she had hit her target and lost the whole four stone. She said she “felt amazing!”

Unfortunately, during lockdown, she became a single mum and was at an “all-time low”. She moved back to Pembrokeshire in December 2021 and quickly swapped healthy meals for quick and easy, high-fat processed meals.

Rachel said: “Being stuck in the house with three children during lockdown was hard. 

“As I was working from home with nowhere to go, I found myself mindlessly eating as I was only eating out of boredom. 

“I put almost two stone back on and I was devastated.”

In January 2022, she decided to get into shape again. She joined the local Slimming World group in Johnston. 

Rachel said she had two stone to lose and was determined to return to her target weight. 

She claims she was blown away by the consultant Kelly’s knowledge of the plan and her motivation. 

“She guided me back through the new member talk, reintroduced me to my love of Slimming World and allowed me to fall in love with the plan all over again!” Rachel added. 

“The warm atmosphere and the gentle reminder that the plan can be used for all the family reignited my passion.

“Since January 10, 2022, I have lost one stone and five pounds. I am only two-pounds away from my personal target.”

After talking about Slimming World and the freedom it allows Rachel to have, she joined Slimming World and trained to be a consultant. 

Thanks to her time in the Army, helping those with their physical and mental health, Rachel feels that she would be well suited to helping those achieve their goals. 

She commented: “The training is thorough and covers not only the plan but the psychology of wanting to lose weight. 

“It has totally changed my views on how I shop, cook and eat food, and I hope my drive and motivation will help others to do the same.”

To join Rachel’s Slimming World group, call Rachel on 07391 634033 or visit Milford United Football Club, Marble Hall Road, every Thursday at 5.30pm. 

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Health

Hywel Dda Health Board confirms Bank holiday arrangements

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FOLLOWING confirmation that Monday, 19 September, will be a Bank Holiday to mark the Queen’s State Funeral, the Health Board is contacting all patients to confirm or re-arrange their appointments, depending on service availability. Whilst all emergency services will be operating as normal, we need to adjust some elements of our planned care services and prioritise patients with urgent care needs wherever possible.

Our Chemotherapy Units will be operating as normal on Monday and some surgery for urgent cases will take place at our hospitals.

Where appointments need to be re-scheduled, patients are being contacted over the coming days by the relevant team to re-arrange their appointment as quickly as possible. In some cases, this may mean bringing appointments forward to this week. Some face-to-face outpatient appointments will still go ahead, and some may be held as an online/virtual appointment on Monday.

If you have an appointment on Monday, and have not been contacted by 1pm on Friday, please contact the health board’s communication hub on 0300 3038322 or email ask.hdd@wales.nhs.uk for further information and guidance. Staff at the communication hub are available to answer calls between 10am-4pm on Saturday, and 10am-3pm on Sunday and Bank Holiday Monday. We are contacting all patients by telephone or text message, please check your telephone for any messages.

As GP surgeries and most Community Pharmacies and Dental services will be closed on Monday, a Bank Holiday out of hours service will be provided. Individuals requiring repeat prescriptions are encouraged to arrange them in advance.

All urgent and emergency care services will continue as normal. If you are unwell and unsure what to do, you can visit the online symptom checker or call NHS 111. The Minor Injury Units at acute hospital sites will be open as usual. Opening hours for community walk-in services can be found on the health board’s website. Please attend an Emergency Department, or call 999, if you have a life-threatening illness or serious injury, such as: 

Severe breathing difficulties 

  • Severe pain or bleeding 
  • Chest pain or a suspected stroke 
  • Serious trauma injuries (e.g., from a car crash). 

We apologise for any inconvenience caused and thank you for your support and patience.

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