Health
Welsh NHS crisis deepens
WALES’s Health Minister Eluned Morgan has warned that the health and social care system in Wales is currently under ‘extraordinary pressure’.
Significant challenges caused by COVID outbreaks within hospitals limiting available bed capacity, high levels of COVID in the community, staff sickness absence and blockages in patient flow through hospitals leading to difficulties discharging patients have put the sector under strain.
These issues have been exacerbated by a recent increase in levels of demand.
People in Wales are being urged to ‘help us, help you’ by accessing the NHS 111 Wales website and its symptom checkers, helping to ensure they access the right care in the right place the first time.
This will help reduce avoidable delays to care and support more acutely ill people to be treated most appropriately.
It comes after the Aneurin Bevan University health board declared a business continuity incident yesterday, also known as a Black alert, in light of unprecedented pressures at its Grange University Hospital and other sites.
This is the highest level of escalation available and indicates the severe pressure being experienced by our health and care services.
Previous health minister Vaughan Gething rushed through the Grange’s opening before last May’s election despite understaffing and without all facilities for its operation being ready.
Hospital sites across Wales are under extraordinary pressure, which has affected the timely delivery of care.
This has resulted, at times, in lengthy ambulance patient handover delays, limits on ambulance capacity, increased waits for admission from emergency departments to a hospital bed and longer waits for discharge home once treatment has been completed.
Measures have already been taken across all health board areas to relieve pressure to ensure patients can continue to receive the care and treatment they need in a safe and timely manner.
To manage the situation in the Aneurin Bevan University Health Board area, where The Grange University Hospital is based, all non-essential activities have been cancelled, with clinical and non-clinical senior colleagues re-prioritising their workload accordingly to manage the position across the Gwent region.
Health Minister Eluned Morgan said: “The health and social care system in Wales is currently under extraordinary pressure, and we would strongly urge anyone seeking care to make sure they access the right care in the right place, whether that’s through ‘help us, help you’, access to the NHS Wales 111 website or urgent and emergency care.
“We have been open about the challenges that NHS Wales and 999 and Emergency Departments are under. This is not a unique situation in Wales; health services across the UK face similar challenges.
“Our priority is to ensure the safe and efficient delivery of healthcare services. Anyone with a serious or urgent need for hospital treatment and those who have ‘a life-threatening illness or serious injury’ should still attend the emergency department.
“Those who have a less urgent need or could access the treatment they need at an alternative setting can help reduce pressure by choosing the right service.
“The public can also help by supporting the timely discharge of their family members when they are ready to leave hospital.
“If you have a relative or loved one in hospital who is well enough to go home but is waiting to be discharged with home care and community health support, you MAY be able to help them to get home more quickly if you and your family are in a position to support them at home.”
THE LOCAL PICTURE
Emergency and unplanned care services in community and hospital settings are under unprecedented pressure across the Hywel Dda UHB area on Wednesday, March 30.
The Board’s Director of Operations, Andrew Carruthers, said: “We are dealing with a combination of high numbers of attendances, particularly in our Emergency Departments, and challenges in health professional staffing due to COVID-19.
“Our GP practices and hospitals are busy, and we still need to follow specific requirements for the safe treatment of those patients with COVID-19 and those without.
“We are working with our local authorities as there are difficulties in discharging some patients due to similar staffing challenges the social care sector faces. This means we have very few beds to accommodate patients who need admission.
“Our teams are helping patients by their clinical priority, but this does mean that in some cases, waits in our Emergency Departments are hours long and far more than what we would strive to deliver.
“If you need medical help, please think carefully about the services you choose.”
If you are unwell and unsure what to do, you can visit the online symptom checker or call NHS 111 if you are unsure what help you need.
Only attend an Emergency Department 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)
If you have a less serious injury, please visit a Minor Injury Unit. They can treat adults and children over 12-months of age with injuries such as
• Minor wounds
• Minor burns or scalds
• Insect bites
• Minor limb, head, or face injuries
• Foreign bodies in the nose or ear
Minor injury or walk-in services to serve Pembrokeshire are located at Cardigan Integrated Care Centre, Tenby Hospital, and main acute hospitals.
Many community pharmacies can also provide walk-in, common ailment or triage and treat services without an appointment.
However, due to Covid infection, several community pharmacies in Pembrokeshire are already closed to the public, leaving patients with Hobson’s Choice of where to go.
Suppose you have an inpatient relative waiting for a formal care package. You may be able to offer support and care on a short term, temporary arrangement, or you might want to consider whether your loved one could be supported in a temporary residential or nursing care setting.
If you feel that this is an option you could consider, please speak to the ward manager or your social worker to explore further and see what support is available.
Health
More than 400,000 visit pharmacies for common health issues
THE WELSH public is being encouraged to visit local pharmacies for free advice and treatment for a wide range of illnesses. New figures reveal that over 400,000 people used the Common Ailments Service in the past year alone.
Pharmacies offer convenient access to healthcare professionals, often without the need for an appointment, freeing up GP slots for those with more complex or urgent medical needs.
Common ailments service
Available in 99% of pharmacies across Wales, the service provides free, confidential advice and treatments for 28 common illnesses, such as sore throats and urinary tract infections. Since its launch in 2013, it has supported nearly 1.25 million people.
Around 220 pharmacies now offer the Pharmacist Independent Prescribing Service, allowing pharmacists to treat conditions such as ear, skin, and respiratory infections, sinusitis, and migraines.
A survey found that 95% of patients who used the service would have otherwise sought help from a GP or other healthcare provider.
Prescribing services expanding
Each year, up to 100 community pharmacists in Wales undertake prescribing training. From 2026, all newly qualified pharmacists will be registered prescribers, enhancing the range of services available at local pharmacies.
Primary care reforms
The Cabinet Secretary for Health and Social Care, Jeremy Miles, highlighted ongoing reforms to deliver more care closer to home during a statement to the Senedd.
Key statistics include:
- GPs handle around 100,000 calls and 68,000 appointments daily.
- Optometrists conduct over 2,000 consultations each month.
- More than 420,000 new dental patients have been treated since April 2022.
- District nurses see approximately 31,000 patients each month, equating to 1% of Wales’ population.
Comments from key figures
Health Secretary Jeremy Miles said:
“We know there is very high demand for GP services in Wales, with around 1.6 million people contacting their practice each month.
“For most common health concerns, your local pharmacy is the best option, providing free and easy access to treatment.
“We are working with the NHS to provide more care in the community, closer to people’s homes, and to make it easier for people to choose the right service for their health needs.”
Gwawr Davies-Jones, a pharmacist at High Street Pharmacy in Barry, added:
“Since the new pharmacy contract was implemented in 2022, our role has changed considerably. Instead of being in the dispensary, we are now in the consultation room for most of the day, offering clinical services.
“On average, we carry out more than 20 consultations daily, from providing contraception to emergency medicine supplies.
“The demand for advice on common conditions is great, giving pharmacists an opportunity to share advice and treatment, including prescribing antibiotics and other prescription-only medicines without the need to see a GP. This helps free up much-needed appointments for more complex conditions.
“We feel we offer an invaluable service to our community. The services we provide alleviate pressures on the NHS, giving pharmacists great satisfaction knowing they are making a difference.”
Supporting NHS pressures
Pharmacies in Wales offer treatment for 28 common illnesses under the Common Ailments Service. Many also provide emergency contraception, annual flu vaccinations, and regular contraception services.
The Welsh Government has significantly supported this service expansion, increasing its investment by 24% since 2016-17, with an additional £9.9 million allocated this year.
Health
Lymphoedema patients to benefit from online mental health support
NHS Wales’ digital wellbeing service has teamed up with a pioneering clinic to help patients manage the mental health impacts of Lymphoedema and Lipalgia Syndrome.
The Lymphoedema Wales Clinical Network (LWCN) established a psychological support service – the only one of its kind in the UK – after patients spoke of the emotional challenges of living with these conditions.
Patients revealed how their physical symptoms were often accompanied by depression, anxiety and worries about appearance.
Support offered by the service’s two psychologists is now being complemented by direct referrals to SilverCloud® Wales, a suite of online, self-help courses based on Cognitive Behavioural Therapy (CBT).
Dr Jayne Williams, National Lymphoedema Consultant Psychologist for LWCN said: “This is an exciting time for us.
“We’re looking at different ways for people to access psychological therapies – SilverCloud being one of them. The aim is to provide timely, preventative support before people get to crisis point.
“As SilverCloud is online, it has the capacity to reach many more people than we could see face-to-face, and its flexibility means that it fits around busy work and family lives.
“Being able to offer something that patients can do in their own way, at their own pace is brilliant.”
NHS Wales online CBT project manager Fionnuala Clayton said the new referral pathway was inspired in part by feedback from a ‘Living Well with Lymphoedema’ event hosted by LWCN, where patients were asked what they would like from its emerging psychology service.
“Patients wanted to feel as though they were not alone and that they still had a healthy and happy life despite their condition,” said Fionnuala. “They wanted easy access to support for building resilience alongside help to help themselves.
“Coming away from the event, we knew a referral pathway would support many patients across Wales.”
Lipalgia Syndrome – also known as Lipoedema – is an abnormal build-up of adipose fatty tissue, usually in the lower half of the body, which more commonly affects women.
Lymphoedema is another incurable, long-term condition which develops due to a damaged or poorly-functioning lymphatic system. Damage can occur as a result of many factors including obesity, surgery, cancer treatment, infection or injury.
People who are sedentary are particularly vulnerable as the lymphatic system relies on movement to remain healthy and move the lymph fluid around the body. Symptoms include swollen and painful heavy limbs and a higher risk of skin infections and wounds.
Said Dr Williams: “These are conditions that people have to learn to live alongside forever, which can be incredibly difficult.
“They have to cope with swelling and pain, they may have to wear compression bandages or garments, carry out daily skin care routines and do lots of movement.
“We see lots of people with very low mood. There’s also a lot of anxiety around body image and intimacy.
“Feeling people are judging you, and perhaps not being able to find clothes or shoes that fit you, means your whole identity and your social confidence can be affected. You can feel more isolated and withdrawn.”
Around 25,000 people across Wales use LWCN services.
Local health board lymphoedema services can refer people to the psychology service within the National Lymphoedema Team, which is hosted by Swansea Bay University Health Board.
Dr Williams said several patients had been referred to SilverCloud’s Space for Positive Body Image programme after attending a body image workshop.
Other courses on offer include support for anxiety, depression and stress.
Anyone in Wales aged 16 or over can self-refer to SilverCloud, without seeing a GP and from the comfort of their own home.
Fionnuala Clayton added: “We’re delighted to onboard the Lymphoedema Wales Clinical Network. This has been a collaborative effort between services, working together to identify how best support patients living with Lipalgia Syndrome and Lymphoedema.”
For further information and support on Lymphoedema and Lipalgia Syndrome, visit https://lwcn.nhs.wales/
To self-refer to SilverCloud Wales, visit https://nhswales.silvercloudhealth.com/signup/
Health
Tufnell talks tough on health care following ‘in-depth survey’
TOP Hywel Dda health board officials are turning a blind eye to its escalating health care failings despite pocketing six-figure salaries.
So says Mid and South Pembrokeshire MP Henry Tufnell who is calling for an urgent meeting with Hywel Dda’s chief executive, Phil Kloer.
“The Hywel Dda Health Board needs to recognise that there’s a problem with health care outcomes and care delivery, but what is it going to take for them to recognise that?” Henry Tufnell commented this week.
His comments followed an in-depth survey of 1,000 people living in Pembrokeshire which confirmed that a staggering 62% have to wait more than a week for a GP appointment. 43% have cited a lack of available appointments as their biggest challenge, while no fewer than 87% claim healthcare services have worsened in recent years.
“But it’s the real stories that show the scale of the crisis,” continued Henry Tufnell.
“I know of a cancer diagnosis that has been delayed by over a year, while ambulance waiting times can be more than 13 hours, even for urgent cases. Critical care needs are going unmet and this is forcing patients to seek private treatment.”
Tufnell has now submitted a Freedom of Information (FOI) request to Hywel Dda University Health Board demanding greater transparency on waiting times, service provision and a plan strategy to fix the crisis.
“Despite all the latest evidence, in addition to everything we gathered during the election campaign, there’s still no acceptance by the Board that there’s a problem,” he said.
“But it’s their responsibility to deliver health care within this county, and they’re failing. The management is failing us here in Pembrokeshire and there’s a complete lack of transparency and accountability. All these people sitting in management roles are being paid huge amounts of money, some bringing in six figure salaries. But they’re failing.”
Mr Tufnell has now requested an urgent meeting with Hywel Dda chief executive Phil Kloer which is expected to take place on February 14.
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