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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.

Community

Plea to save at-risk Anchorage day care centre

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AN ONLINE plea to save a Pembrokeshire day centre from being closed has been lodged with the county council.

The Anchorage Day Care Centre in Pembroke Dock has been a “safe and happy place” for adults with learning difficulties and additional needs for decades.

In more recent years it has expanded to support elderly dementia sufferers.

But now the centre is expected to close, with services instead being offered elsewhere in the county, including Haverfordwest and Milford Haven.

A series of engagement events have taken place at The Anchorage recently, outlining the reasons and the options in continued service.

One parent, who wished to remain anonymous, said: “The parents and carers are all very upset at the way we have been treated, kept in the dark and then presented with what is a fait accompli to close the Anchorage, while at the same time going through the motions of a ‘consultation’ with us.

“The clients at The Anchorage have friendships with each other and staff going back decades in some cases.

“One young woman who attends ran out of the first meeting sobbing when she was told it was going to close. Another, at the second meeting, tried to address the meeting but was so chocked up at the thought of not seeing her friends anymore she could hardly speak.”

She added: “The Anchorage has been a respite in the day for parents and a safe, happy place for the clients.

“Everyone feels that the county council is not considering the feelings of the clients, most of whom are upset and frightened by change to their routine.”

Another person raising concerns said: “The centre is set to close as early as next month – meaning the sudden retraction of a service which, for many families in the area, is nothing short of a lifeline.

“I’m not sure PCC understand the gravity of the impact that closing the centre will have on the lives of many people, particularly the customers, some of whom may not understand or cope well with such a total upheaval of the familiarity of their daily routine.

“It’s so upsetting that the people who will be most affected by the closure of the centre are as much a part of the Pembrokeshire community as anybody else that the council claims to represent, and yet in this decision, I feel they’re not being seen as such.”

Since then, an online e-petition, on the council’s own website has been launched calling for it to stay open.

It says: “The centre provides day-care support to a number of vulnerable adults with varying levels of disability who are unable to process, and understand, the implications of such a decision.

“Some of those attending the centre have been doing so for over 20 years and continuity is a vital part of their lives. Removing this service will have nothing other than a huge detrimental impact on their health and mental wellbeing.”

The petition has attracted 284 signatures to date.

A Pembrokeshire County Council spokesman said: “Following the engagement sessions held with families and service users regarding the future of the centre on April 10 and 17 at the Anchorage, families said that they would like to maintain the Anchorage Day Centre and explained that they would write to the council in order to ask for the decision to be overturned.

“People who attend the service will be offered alternative care, all service users are currently having their individual care needs assessed by social work teams to fully understand which other services best meet those care needs.”

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Health

Dental services ‘facing collapse’ in Wales

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DENTAL services are at risk of catastrophic collapse, with people resorting to “DIY dentistry” and pulling their own teeth with pliers, the Senedd heard.

Peter Fox warned that NHS dental services are seeing rapid decline following the Welsh Government’s introduction of a new contract in 2022.

He told the Senedd: “These contracts don’t work for dentists, nor do they work for patients,” as he highlighted a 60% fall in the number of NHS dental posts compared with 2021.

Echoing concerns raised by the British Dental Association, the Conservative MS said dental services face potential catastrophic collapse due to the contract reforms.

Mr Fox, who represents Monmouth, cautioned that patients are being left with a choice between years’-long waiting lists or paying hundreds of pounds for private care.

He said: “This lack of accessibility has led people to drastic action – from harrowing stories of people pulling out their own teeth with pliers or people being forced to take 200-mile round trips to get dental appointments. Clearly, this is just simply unacceptable in the 21st century.”

Leading a debate about primary care on April 24, Mr Fox warned GPs are also struggling due to a lack of contract funding, which is not uplifted in line with rising costs and pay uplifts.

He told MSs some GPs are having to pay staff and utility bills out of their own pockets, with practices forced to withdraw more and more services.

The Conservative said some constituents face 50-mile round trips and 50-week waits for services in hospitals that were previously carried out routinely and timely in GP practices.

Mr Fox, who led Monmouthshire council for more than a decade before being elected to the Senedd in 2021, urged the Welsh Government to urgently review GP and dental contracts.

Eluned Morgan told the chamber the majority of contacts with the NHS are in primary care – with up to one-and-a-half million contacts a month in a population of three million people.

Wales’ health secretary recognised the extreme pressure on practices, saying the contract last year provided a 5% uplift not just to GPs but also staff who work in their surgeries.

She said: “We want to reform the dental contract on a preventative basis, responding to risk and need, and we have introduced up to 300,000 appointments to new dental patients.”

Baroness Morgan, who is married to a GP, stressed the importance of other professionals in the community, such as pharmacists and opticians, to the preventative agenda.

She said most pharmacies in Wales provide a free service for 27 common ailments, helping to reduce pressure on GPs and other parts of the healthcare system.

During first minister’s questions on April 23, Sian Gwenllian said many of her constituents are unable to access public dental services – “an entirely unacceptable situation”.

The Plaid Cymru MS for Arfon raised concerns a new dental academy in Bangor closed its books to NHS patients despite promises it would help tackle a lack of public services.

Sam Rowlands, the Conservatives’ new shadow health secretary, said far too many people across north Wales do not have access to an NHS dentist.

He raised comments from Russell Gidney, chair of the Welsh general dental practice committee, warning of a rise in “DIY dentistry” due to a lack of proper access.

Vaughan Gething said the Welsh Government is committed to reforming the dental contract to unlock capacity and access to NHS services is one of the health secretary’s top priorities.

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Health

Pembrokeshire residents suffer severe health decline ‘due to landfill gases’

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A PEMBROKESHIRE couple, Mr Richard and Revd Patricia Rogers of Crud yr Awel, are experiencing severe health issues attributed to emissions from the Withyhedge Landfill, resulting in drastic lifestyle changes and severe symptoms.

Revd Rogers, who has managed asthma since childhood, reported a significant deterioration in her condition following exposure to landfill gases. Despite having controlled her asthma with minimal medication for years, she now requires intensive treatment including increased doses of Symbicort and Salbutamol Sulfate inhalers, alongside courses of steroids and antibiotics. Her symptoms have escalated to include extreme breathlessness, a hacking cough, frequent nosebleeds, continual headaches, and vertigo, culminating in a severe impact on her ability to perform daily tasks and care for her disabled daughter.

The couple’s health is closely monitored through their doctor’s surgery, and they attend the asthma clinic regularly. However, feeling powerless to directly change the situation, they have taken a stand by cancelling their council tax payments, a decision they plan to maintain until the landfill issue is resolved.

Revd Rogers has also prepared a letter to the Coroner, outlining the severity of her health issues as potentially life-threatening due to the landfill’s impact. This dramatic step underlines the gravity of their situation and their desperation for a resolution.

The Rogers’ story is not just a personal tragedy but a stark example of the broader environmental and health challenges faced by the community surrounding the Withyhedge Landfill.

They are calling for punitive measures against those responsible, including compensation for the financial impacts of their ordeal.

Their story has surfaced on the same day we reported that Natural Resources Wales is taking further enforcement action against the firm running the site.

NRW has issued site operators Resources Management UK Ltd (RML) with a further Regulation 36 Enforcement Notice which requires the operator to deliver a series of actions by specified deadlines to address ongoing smells from the landfill.

You can read more about the Enforcement Notice on the NRW website.

Outgoing Council Leader, Cllr David Simpson, said in a statement this week: “The smell from Withyhedge is having a major impact on residents and visitors. This situation has gone on too long and it is unacceptable.

“We now need to see RML act on the demands of the Notice and within the deadlines.

“The Council fully backs NRW’s stance that nothing is off the table in terms of further enforcement, including suspending the site’s environmental permit if appropriate, and we remain committed to working with NRW to ensure a long term solution to these issues.”

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