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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

Local health board to consider how children’s hospital services will be delivered

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HYWEL DDA University Health Board will receive an update on a review into children’s hospital services, and a timeline for further work needed, at a meeting on Thursday 26 May 2022.

Since March 2020, the daytime Paediatric Ambulatory Care Unit at Withybush Hospital, Haverfordwest, referred to as Puffin Ward, has been relocated to Glangwili Hospital, in Carmarthen.

The Board will be asked to approve the proposed approach to the review, to include a clinically-led appraisal of different options for provision of children’s hospital services in the interim years ahead of a new Urgent and Planned Care Hospital being established in the south of the Hywel Dda area.

Deputy Chief Executive and Medical Director Professor Philip Kloer explained: “Our review of the temporary changes to hospital paediatric services in the south of Hywel Dda, began in March this year. One of the first tasks has been developing a detailed scope, project plan and timeline.

“We want to undertake a clinically led appraisal of the options for the service between now and the establishment of the new hospital network, predicted to be around 2029. We want to hear the voices of our stakeholders, building on the feedback and engagement undertaken since 2014, to assess what else may be needed. We continue to work with the Consultation Institute to ensure the scope, approach, and timeline for the engagement are appropriate.”

The Executive Steering Group overseeing this review, is asking Board to approve the option appraisal process to take place in Autumn 2022, as well as an output report back to Board in November 2022. This would outline a list of options for interim paediatric services, and consider, along with the Community Health Council, whether formal engagement and or consultation is needed.

Since March 2020, the daytime Paediatric Ambulatory Care Unit at Withybush Hospital, Haverfordwest, referred to as Puffin Ward, has been relocated to Glangwili Hospital, in Carmarthen.

This was due to the need for space at the hospital for the COVID-19 response. It was later extended due to an expected surge in children with respiratory illnesses (RSV) and the fact that the daytime service was then co-located with overnight services and a children’s high dependency unit, should a child’s condition deteriorate.

What this means is that children with serious illness, across the south of the Hywel Dda area, have been referred, asked to attend, or taken by ambulance, directly to Glangwili Hospital. Children with minor injuries or scheduled outpatient appointments have continued to be able to access this care and treatment at Withybush Hospital, as well as at Cardigan Integrated Care Centre.

In the meantime, the health board continues to monitor the pathway, ensuring it is safe for children and young people, and collecting data including patient outcomes and experiences for consideration in the review.

Children, young people and their families whom have received care from Hywel Dda University Health Board are encouraged to give their feedback on their experiences at any time. You can do this by visiting our website https://hduhb.nhs.wales/ and searching ‘patient feedback’ and you will find age appropriate questionnaires.

Clinical Director for Women & Children’s services, Consultant Paediatrician Dr Prem Kumar Pitchaikani said: “I want to reassure people that whilst this review takes place, we continue to provide stable, clinically safe and high quality hospital children’s services for children and young people across the south of our area from Glangwili Hospital.”

Clinical teams in the Emergency Department at Withybush Hospital and the Welsh Ambulance Service NHS Trust are using a ‘triage tool’ to ensure rapid identification of children with significant illness who may present in Pembrokeshire or Withybush Hospital and quick onward transfer for specialist care.

You can watch the Board Meeting on Thursday 26 May through a link on the Health Board’s web pages – https://hduhb.nhs.wales/about-us/your-health-board/board-meetings-2022/board-agenda-and-papers-26-may-2022/ – which will be added on the day.

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Health

Health board and staff shortlisted in national BAME awards

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HYWEL DDA University Health Board, along with a number of its Black Asian and Minority Ethnic (BAME) staff, have been shortlisted in the 2022 National BAME Health and Care Awards (BAMEHCA).

The BAMEHCA is an annual event, hosted by DiversityQ, that recognises the hard work and resilience of BAME professionals in the UK health and care sectors.

The staff who have been shortlisted as finalist in nine categories are:

Joe Jaimangal, Nurse Specialist at Memory Assessment Service in Pembrokeshire for BAME nurse of the year
Dr Tipswalo Day, ST7 Specialty Trainee in Obstetrics and Gynaecology at Glangwili Hospital for Clinical Champion
Jefferson De Vera, ITU staff nurse at Prince Philip Hospital, for Clinical Champion
Dr Rajeev Vaikanthanathan, GP at Ashgrove Medical Centre, Llanelli, for Clinical Champion
Community Development Outreach Team for Community Initiative of the Year
Augusta Stafford-Umughele, Workforce Culture, Diversity & Inclusion Manager, for Compassionate and Inclusive Leader
Dr Anand Ganesan, Consultant Psychiatrist for Carmarthen CMHT & CRHTs based in Wellfield Resource Centre, Carmarthen for Compassionate and Inclusive Leader
Dr Premkumar Pitchaikani, Consultant Paediatrician at Glangwili Hospital for Compassionate and Inclusive Leader
Chris Martin, Digital Business Change Manager, for Digital Champion
Dr Hashim Samir, Consultant Radiologist at Glangwili Hospital, for Inspiring Diversity and Inclusion Lead
Dr Akhtar Khan, Consultant Liasion Psychiatrist at Glangwili Hospital, for Mental Health Initiative
Beverly Davies, Strategic Partnership and Inclusion Manager for Outstanding Achievement of the Year
Hywel Dda UHB for Outstanding Corporate Achievement of the Year
Maria Battle, Chair of Hywel Dda UHB and the health board’s BAME Advisory Group, said: “I am really pleased to see all the outstanding work of our BAME colleagues in Hywel Dda being recognised nationally. It’s excellent that so many staff, and the health board itself, have been shortlisted for these prestigious awards. Good luck everyone and thank you for your dedication and compassion.”

The awards ceremony will take place on Thursday 9 June 2022 in London.

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Health

Those eligible for the Spring Covid-19 booster should get jabbed by end of June

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ALL those eligible for the Spring Covid-19 booster are being urged to take up their offer of the vaccine before the end of next month.

A deadline of 30 June has been introduced to ensure all those eligible for the spring booster will have a long-enough interval between this and the autumn 2022 booster, if they are also eligible.

An announcement by the Joint Committee on Vaccination and Immunisation (JCVI) about which groups will be eligible for the autumn booster is due to be published shortly.

The JCVI has advised that people over-75, older care home residents and all those aged 12 years and over who are immunosuppressed are eligible for the spring booster.

Those who are 75 on or before 30 June, can get their booster at any point up to the deadline.

Health Minister Eluned Morgan said: “It is important we continue our very high take up levels of the vaccine to help protect us against the risk of serious illness from Covid-19. I would urge everyone who is offered a spring booster vaccination takes up the invitation.”

If someone eligible for a spring booster has had a Covid infection recently, they will need to wait 28 days from the date they tested positive before they can be vaccinated. They will still be able to get vaccinated after 30 June as part of this campaign if they have to postpone their appointment.

All those eligible for spring boosters will be invited by their health board or GP.

It is not too late for anyone who needs a primary dose (first, second or third) to be vaccinated.

Please check for local arrangements.

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