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Health

Tragic baby Callum’s death was due to ‘acute and severe loss of blood’

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AN INQUEST into the death of a newborn baby from Haverfordwest has determined the cause of death as shock due to an ‘acute and severe loss of blood’.

The inquest into Callum Ragan James’ death on May 5, 2016 was heard at County Hall over a two day period.

Senior Coroner for Pembrokeshire and Carmarthenshire Paul Bennett offered his condolences to Callum’s parents Mr and Mrs James from Haverfordwest.

He said: “I cannot imagine how distressed Mr and Mrs James felt when their son did not survive.

“This has been a very difficult inquest to hear. I would like to pay tribute to Mr and Mrs James in their fortitude of this case.”

The inquest heard how on May 5, Ellie James went from Withybush Hospital over to Glangwili Hospital after it was established she was in the early stages of labour, where she was met by midwife Ebba Lewis.

Mrs James was taken to a midwifery led unit at the hospital and was offered the use of a  birthing pool.

It was from there that complications became apparent after a large amount of blood was seen within the pool.

It was decided that Mrs James would be taken to a bed and transferred to the labour-led ward, where there are consultants available. 

Mrs James’ labour was progressing at a speed which thwarted attempts to transport her to the labour-led unit and she gave birth in the midwifery ward.

Mr Bennett confirmed that Callum was born at 11.08pm and at 11.34pm and steps were taken to get his lungs working and circulation started, but efforts to resuscitate him were abandoned at 11.34pm.

Mrs James questioned the judgement of whether she was giving birth in the appropriate ward, due to complications with her first pregnancy, and said she was assured she would give birth to Callum in a labour-led unit.

Mrs James also questioned her own judgement on whether abdominal pain she had experienced earlier in the labour played a part in the fate of Callum.

Family counsel Jodie Kembery, asked whether Mrs Lewis was aware of the pain that Mrs Lewis was experiencing and whether she should have in fact been transferred to the labour-led unit instead.

Giving evidence at the inquest, midwife Mrs Lewis said: “No, because she was not deemed as high risk [on arrival to Glangwili]. There were no signs of deviation from the normal, so she was classed as low risk.

“We asked how she is feeling. I do not recall specifically asking about the abdominal pain.

Mrs Leeves, the senior midwife on duty and who assisted Mrs Lewis with Callum’s delivery was also called upon to give evidence.

Speaking on the delivery, Ms Leeves told the inquest: “I entered, and Mrs James was on the bed with there being concern about blood loss in the pool. I looked at it and was concerned, but Mrs James remained stable so our main objective was to transfer her [to the labour-led ward] to listen to Callum’s heart.”

The speed in which the delivery progressed, halted all plans to transfer Mrs James upstairs to the labour-led unit.

She added: “We felt it was not appropriate to transfer Mrs James to the labour ward.

“There were strong urges to push, which is normal, and we felt there was no time.”

Mrs James told the inquest: “When Callum was born, I was ecstatic. To me he looked perfect. It was not until I saw the midwife’s face that I knew something was not right.”

Dr Patrick Forbes, Consultant Obstetrics and gynaecologist agreed that the decisions that the midwife made that day were right.

Dr Forbes also wrote two reports on the case.

He said: “It was absolutely correct to take Mrs James out the pool and I agree entirely that the appropriate action is to move the patient to the labour ward. However, one of the things I would dread in that situation is getting into the lift and the baby appearing.”

“Mrs James did not identify to be considered high risk in the second pregnancy,” said Dr Forbes, “which meant it was suitable, if she agreed, for delivery in the midwifery unit. It was appropriate for her to stay on the MLU at Glangwili when she arrived.

“The descriptions by Mrs Ebba and Ms Leaves are much in line with standard practice.”

Concluding the case, Coroner Paul Bennett said: “Callum died as a result of hypovolemic shock brought about by an acute and severe loss of blood which occurred during the course of his delivery at Glangwili Hospital on May 5, 2016.”

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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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