A GROUND breaking telehealth trial has been deployed across West Wales to support people living at home with long term health conditions. One third of adults in Wales, around 800,000 people, have a long term health condition.

Hywel Dda Local Health Board is working in partnership with Delta Wellbeing, global health and care technology solutions provider Tunstall Healthcare and local primary care services support patients across Carmarthenshire, Ceredigion and Pembrokeshire living with long term conditions, such as cardiac, lung and chronic disease, at home using pioneering telehealth equipment.

The initiative focuses on supporting wellbeing in the community using remote monitoring and is transforming the way that care services are delivered to people living with long term conditions. From a service perspective, telehealth means that patients can remain in their own homes, with the reduced need to travel to appointments, and decreasing the need for staff to see patients who can be supported remotely. This in turn reduces stress and expense, and improves the quality of life for patients and their families.

Commenting on the telehealth trial, Gavin Bashar, managing director at Tunstall Healthcare, said: “Long term health conditions account for approximately 50% of all GP appointments, and more than 70% of all inpatient bed days. Using telehealth can help to provide ongoing monitoring to these patients in their own homes, enabling early intervention and empowering them to feel more confident in managing their health.

“Patients in the trial use using telehealth equipment including a blood pressure cuff, weighing scales and a pulse oximeter. The readings from these devices are transmitted to the Tunstall myMobile app on their smartphone and all the information submitted by the patient can be viewed remotely by clinicians 24/7, allowing preventative action to be taken.

“The telehealth service means that changes to a patient’s health or any response to medication can be monitored in real time, ensuring help can be provided at the earliest opportunity. This can lead to a reduction in the need for more complex interventions. The service has protected the wellbeing of vulnerable patients, improved outcomes in patients living with long term conditions, enabled the faster discharge of patients from hospital and provided personalised monitoring of complex comorbidities.”

Clinicians use software that provides a dashboard which prioritises patients that are most in need of care, and allows specialist nurses and primary care to remotely monitor each patient’s symptoms and progress. Areas of concern will generate an email or text message to clinicians, enabling them to be addressed promptly. The technology also allows patients to have consultations by video helping to avoid unnecessary visits to clinics or hospitals. When required, face to face appointments will be arranged for further treatment and consultation.

So far around 300 patients have been supported through the service. Early assessment of patient reported outcome measures show improvement of quality of life and a change in behaviour with improved physical and psychological outcomes.

Speaking on the benefits of home monitoring, 79-year-old cardiac patient Pat , said: “My heart nurse asked me if I would try this new technology that they were bringing in. I’ve had absolutely no problems what-so-ever. It’s no more difficult than going into a GP surgery. It’s all connected to the iPad I have been given which then goes straight through to the heart clinic. It’s so easy! You can do everything from your own armchair no problem at all.”

Clare Marshall, heart failure specialist nurse for Hywel Dda Local Health Board, added: “Telehealth equipment allows me to manage medication changes from a distance, which patients really like. I have been able to prevent hospital admission and more complex care interventions for a patient whose heart rate had decreased following a change of medication.

“Overall, the service empowers patients to manage their own condition as they learn more about what impacts upon their health, and increases confidence in recognising their symptoms. The service builds upon the principles of shared decision making and co-production in healthcare, delivering improved outcomes.”

The trial follows Delta Wellbeing’s successful CONNECT proactive technology enabled care (TEC) programme which has been acknowledged as an exemplar in the UK, providing a good practice example of working across sectoral boundaries to deliver a radical, person-centred approach to wellbeing, care and support.

CONNECT focussed on supporting prevention and wellbeing through a technological and digital approach, and combining bespoke technology enabled care equipment with wellbeing calls, access to a 24/7 community response and digital support. Delta CONNECT is a pioneering national programme funded under the Welsh Government’s Transformation Fund through the West Wales Care Partnership Board.

THE LOCAL health board has announced that from August 31, access to Mass Vaccination Centres (MVCs) in Carmarthenshire, Ceredigion and Pembrokeshire for COVID-19 vaccinations will be by appointment only in preparation for the start of the winter vaccine programme.

Anyone wishing to drop-in for their first or second dose during August is advised to check opening times on the day before travelling by visiting hduhb.nhs.wales/healthcare/covid-19-information/covid-19-vaccination-programme/mass-vaccination-centres or calling 0300 303 8322 as these are subject to change. If you still require a booster, please wait to be offered an appointment.

From 31 August 2022 onwards, please book an appointment by calling 0300 303 8322 or by emailing COVIDEnquiries.hdd@wales.nhs.uk

Bethan Lewis, Interim Assistant Director of Public Health at Hywel Dda University Health Board (UHB), said: “Throughout the vaccination programme we’ve aimed to make the vaccine easily accessible through a combination of drop-ins and appointments. This change will allow us to deliver the COVID-19 in partnership with primary care and minimise the risk of duplication or vaccine waste.

“If you are eligible for an autumn COVID-19 booster, please wait to be invited by either your GP or the health board. Everyone eligible will be offered an appointment by November.

“GP practices are also preparing to invite eligible patients for their seasonal flu vaccine and aim to offer an appointment to everyone eligible by December. Again, please do not contact your GP practice at this time, you will be invited when it is your turn.”

Scheduled drop-in sessions for children and young people who are home-educated or not in education to access childhood vaccinations routinely offered through school nursing teams will continue as advertised at selected MVCs.

The remaining drop-in sessions for children aged 5 to 17 years of age will be held between 12pm and 6pm in the following locations:

Aberystwyth MVC (Thomas Parry Library, Llanbadarn Campus, SY23 3AS) – Tuesday 30 August
Carmarthen MVC (Y Gamfa Wen, University of Wales Trinity Saint David, SA31 3EP) – Friday 2 September
Cwm Cou MVC (Ysgol Trewen, SA38 9PE) – Monday 22 August
Haverfordwest MVC (Pembrokeshire Archives, SA61 2PE) – Wednesday 31 August
Llanelli MVC (Dafen Industrial Estate, SA14 8QW) – Tuesday 23 August
These drop-in sessions are also open to any Carmarthenshire, Pembrokeshire or Ceredigion school attendees who may have missed their vaccinations.

If you are unable to attend one of these sessions and have any queries or wish for your child to receive their scheduled vaccines, please complete the form available here hduhb.nhs.wales/healthcare/services-and-teams/immunisation-and-vaccination/childhood-and-young-people-vaccinations/vaccine-access-for-home-schooled-children or call 0300 303 8322 to be contacted by a member of the health board’s immunisation nursing team.

HYWEL Dda Health Board have reduced the number of potential sites for the new “super-hospital” in West Wales from five to three. 

The new site has been narrowed down to two possible locations in Whitland or one in St Clears.

According to the plans provided in Hywel Dda’s technical appraisal reports, all sites will include a main building divided into planned and urgent care, as well as a separate facility for mental health services. Parking, administrative facilities, and a helipad are also planned.

The potential Narberth site is no longer being considered, meaning that the new hospital would be built outside of Pembrokeshire.

Hywel Dda presented the findings of a “transport infrastructure analysis,” stating that both sites had bus services that are “infrequent” and “short,” making shift work difficult.

For Whitland, it noted that there was an approximate 750m walking distance from the train station to the hospital site, with recommended walking distance of 400m, and that local roads do ‘not appear’ to suffer from significant congestion during a typical weekday. 

In St Clears, the report highlighted the impact a planned new railway station – expected to open in 2024 – could have on the town, saying it would be a ‘major boost’ to the area providing viable alternative car travel, with it being understood there is a commitment to increase the frequency of services at some stations along the west Wales line from two hourly to hourly.

After it was announced that Narberth would not be the site of the new hospital, Hywel Dda University Health Board Chair, Maria Battle, assured the residents of Pembrokeshire that their concerns would be taken into account.

“Our programme business case to the Welsh Government is seeking the greatest investment west Wales will have ever seen,” said Ms Battle.

“We have listened to and continue to listen to the fears and voices of the public we serve and our staff who understand the frontline challenges of trying to deliver services across so many sites and spread so thinly.

“Recognising the fragility of our services and the risk this poses every day, we do not intend to make changes at Glangwili or Withybush hospitals before a new hospital is built. And afterwards, they will continue to provide valuable health services to our communities.”