Health

Concerns over standards at A&E following report highlighting ‘significant challenges’

Published

2 years ago

March 26, 2023

OVERCROWDING and patients sleeping on floor at a west Wales A&E were some of the issues raised by a report raising serious concerns, but also saying that there had been some improvements made to a hospital’s standards of care.

The health board involved, Hywel Dda, now says it has come up with a plan to address the issues raised by a report published by Healthcare Inspectorate Wales (HIW) who carried out an inspection of the emergency department at Glangwili Hospital, Carmarthen, in December.

Despite the best efforts of staff, the independent body said patients did not always receive consistently safe care.

Hywel Dda health board said it recognised “significant challenges” within the department.

Although patients and carers were said to be “generally satisfied with the service”, HIW identified several issues with the service provided at the department.

The report highlighting concerns at Glangwili came out at the same time that figures were released saying that waiting times at Welsh A&E departments had fallen slightly. Responding to those Emergency Department performance figures for February 2023 for Wales, Dr Suresh Pillai, Vice President of the Royal College of Emergency Medicine Wales, said: “We welcome the improvement in Emergency Department performance shown in February’s data. The reduction in patients facing four-, eight- and 12-hour waits is a testament to the hard and skilled work of Emergency Medicine staff who continue to tackle the crisis in Emergency Care.

“While we welcome this improvement, the situation remains serious. Exit block – where patients cannot be admitted from the Emergency Department to a bed because out of the limited bed base, many are taken up by patients who are unable to be discharged in a timely way causing a ‘traffic jam’ in the system – remains a significant issue in Emergency Departments in Wales. On the ground we continue to face severe problems around flow throughout our hospitals and delays to patient care.

“We must see faster and more tangible action around discharging patients and social care.

“We are pleased to have met with the Health Minister, Eluned Morgan MS. We recognise that there is the political will to engage with the issues facing Emergency Care. The Welsh Government is focused on delivering the six-goal programme.

“As part of this they are appointing Clinical Leads for each of the Six Goals with some overlap instead of the current model of one for all Unscheduled Care. We look forward to engaging with these Leads and would be pleased to continue engaging with the Health Minister and the Welsh Government and have further such meetings.

“There is an ongoing retention and recruitment crisis in Emergency Medicine in Wales. Our workforce census, published earlier this year, made this clear. Not only are junior doctors’ continuing to be stretched, but difficulties in recruiting persist. It is vital that both retention and recruitment in Emergency Medicine is recognised and made a priority by the Welsh government, otherwise Emergency Care will remain in crisis to the detriment of patients and existing staff.”

The report highlighted the following areas where the service is doing well or actions are already in place, including:

pressure damage care and prevention;
assessing and monitoring patients waiting in ambulances to maintain patient safety;
availability of food and fluids;
triage and supervision of areas by staff;
easy navigation of patient records, handwritten entries were legible and logically set out.

But the report, by Healthcare Inspectorate Wales (HIW), found that patients at an accident and emergency department in Wales were not consistently receiving safe care.

The HIW carried out three unannounced inspections at Glangwili General Hospital in Carmarthen in December 2022 and identified several areas requiring immediate action by the health board.

The report found that overcrowding, a lack of toilet and washing facilities, and patients waiting in non-designated areas of the unit were having a negative impact on patients’ privacy, dignity, and infection prevention and control procedures. Delays in children being seen were also identified in the Paediatric Care and Assessment Unit (PACU).

Although patients and carers were generally satisfied with the services they received, frustration was expressed around waiting times and the lack of updates on patients’ care and treatment.

The health board has produced a comprehensive plan to improve the emergency department.

Andrew Carruthers, of Hywel Dda health board, said: “While the report states that generally patients and carers were satisfied with the service they had received at the emergency department at Glangwili Hospital, we do, however, recognise that there are significant challenges within the department.

“We also recognise the regrettable impact these have on our patients and their experience of using our services.

“We wish to reassure people that we are focusing on our improvement plan to address the recommendations of the report, and to provide ongoing assurances for our communities of the quality of the services we have to offer and provide.”

Health

Hywel Dda urges responsible use of ‘under pressure’ A&E service

Published

2 days ago

December 20, 2024

Tom Sinclair

HYWEL DDA University Health Board is appealing to the public to carefully consider how they access healthcare services as local A&E units, including Withybush Hospital in Haverfordwest, face increasing pressure.

A spokesperson said: “Our services are under pressure. Please help us to help you by choosing how you access our services carefully, ensuring that emergency departments (A&E) are reserved for urgent or life-threatening care needs.”

Unwell and unsure what to do?

If you’re unwell and uncertain about the best course of action, the Health Board recommends visiting the online symptom checker or calling NHS 111 Wales for advice.

When to attend A&E

Emergency Departments should only be used for life-threatening illnesses or serious injuries, such as:

Severe breathing difficulties
Severe pain or bleeding
Chest pain or suspected stroke
Serious trauma injuries (e.g., from a car crash)

Minor Injuries Units (MIUs)

For less serious injuries, MIUs offer treatment for:

Minor wounds, burns, or scalds
Insect bites
Minor limb, head, or face injuries
Foreign bodies in the nose or ear

MIUs are available at Cardigan Integrated Care Centre, Tenby Hospital, and main acute hospitals. Visit the Minor Injuries Unit page for opening hours and directions.

Urgent care, not an emergency

For urgent health needs that cannot wait but are not emergencies, call NHS 111 Wales for advice or access to out-of-hours GP services. This free service is available 24/7.

Mental health support

If you need urgent mental health support, call NHS 111 Wales and select option 2 to speak with a mental health professional. The number is free to call, even from a mobile with no credit.

Community care options

Community pharmacies offer walk-in services for common ailments such as sore throats, hay fever, and conjunctivitis. A full list of ailments and participating pharmacies can be found on the Common Ailments Service pages.

Helping reduce hospital stays

The Health Board emphasizes the importance of reducing hospital stays to ensure acute care is available for those who need it most. If a loved one is ready to be discharged, families are urged to collect them promptly to free up beds for other patients.

For more information on the inpatient experience, visit the Inpatient Information pages.

A thank you from the NHS

The Health Board expressed gratitude for the public’s cooperation: “Your support not only helps you and your loved ones but also eases the strain on NHS and social care services.”

For further updates, contact:
Hywel Dda University Health Board Media Office
Email: [email protected]

Health

More than 300 healthcare workers from Kerala take up NHS jobs in Wales

Published

3 days ago

December 20, 2024

Tom Sinclair

AN EMPLOYMENT agreement has exceeded its target for recruiting healthcare workers from India.

The Welsh Government outlined a commitment to recruit 250 qualified healthcare workers from India as part of a Memorandum of Understanding with the Kerala Government earlier this year.

The recruitment drive has outperformed that goal, with just over 300 healthcare workers taking up positions across all of Wales’ health boards and the Velindre University NHS Trust. Further recruitment is due to take place next year.

The commitment was made as part of Wales in India, a year-long series of events to improve economic, educational, artistic and sporting ties between the two nations.

Sharoon Kolickatharayil Nowshad, 24, had long held ambitions to move to Wales and work as a nurse, inspired by his uncle Siji Salimkutty who began working in the Welsh NHS in 2004.

Since arriving in Wales and beginning his job with Aneurin Bevan University Health Board, Sharoon said he has reunited with his family and appreciated the kindness shown by his new colleagues.

“I was really excited to work in the NHS” Sharoon said. “It’s always been my ambition to contribute to society, and now I get to do that here in Wales.

“Everything moved quickly once I saw the opportunity to apply, and I’m proud to work for the NHS. I tell my family and friends that it feels great to help people when they need it the most.

“When you work for the NHS, it’s not just a job or salary. It’s a great life. You feel proud knowing you’ve supported and helped others.

“The NHS has given us a great opportunity and we should always work sincerely because we love our jobs. There are lots of opportunities to advance your career, your colleagues always support you and there’s a great support network.”

Sharoon said he hopes to continue his career in the Welsh NHS by progressing to become an Advanced Nurse Practitioner.

He added: “People in Wales are so kind, they always make time for us, whether that’s at work or at home.

“I would encourage anyone thinking of coming to Wales not to hesitate and to apply, it’s the best decision I’ve made.”

Dr Devangana Bora has taken up a position as a Senior Clinical Fellow in Oncology at Velindre NHS Trust. Born in Guwahati, a large city in the Northeast Indian state of Assam, Dr Bora has worked as an Oncologist since 2019.

“I was really nervous for the interview. When I got there they told me it was in three stages and I became more nervous,” Dr Bora said.

“After the interview, I was offered the job and I was so happy. I thought they were joking. I was so excited to take this next step in my career and move to Wales.

“The weather is cold here but the people are so warm. I have received nothing but support from my colleagues and generally the people in Wales are so friendly and helpful.”

Dr Bora said her sister is currently studying Medicine at university and has been inspired to move to Wales once she completes her studies.

Jeremy Miles, Cabinet Secretary for Health and Social Care, said: “Alongside continued investment in training healthcare staff in Wales, international recruitment has always been one of the ways we can help address NHS workforce vacancies.

“India and Kerala in particular has a fantastic record in training doctors and nurses. We are grateful for the commitment to delivering high-quality care our new NHS recruits have shown.

“The contribution of these healthcare workers is already being felt across our NHS and it’s wonderful to see them settling into happy lives in Wales.”

Wales in India was launched on St David’s Day, March 1, by the then First Minister Mark Drakeford and Minister for Health and Social Services Eluned Morgan, beginning a year of events and cultural engagements to strengthen links between the two nations.

One of the biggest impacts on policymaking in India drew inspiration from Wales’ innovative Well-being of Future Generations Act. Through partnership working, the Maharashtra Legislative Assembly introduced its own draft law called the Maharashtra Future Generations Welfare Bill in July.

Welsh Government, the British Council and Wales Arts International also made commitments to further cultural collaborations between Wales and India by investing in arts projects through a dedicated culture fund. With the support of these organisations, as well as the Deputy High Commission in Kolkata, Wales was recently a partner country for Hornbill, one of India’s largest music festivals, which saw Mari Mathias and Gareth Bonello perform on the main stage with Indian musicians Seyievinuo Chuzho and Benedict Hynniewta.

In February 2025, 10 young women, chosen from 140 applicants, will travel to Kolkata to complete humanitarian work as part of a joint project with Urdd Gobaith Cymru and Her Future Coalition. The volunteers will provide support to vulnerable girls including survivors of trafficking and other forms of gender-based violence. Sport and art workshops for children will also be run by the group.

Health

Hoax calls reach three-year high, says Welsh Ambulance Service

Published

5 days ago

December 18, 2024

Tom Sinclair

THE WELSH AMBULANCE SERVICE has seen a staggering 37% rise in hoax calls over the past three years, wasting valuable time and resources, a new investigation reveals.

Data from Medical Negligence Assist highlights that over 700 hours—equivalent to nearly 29 full days—of ambulance crew time has been lost responding to malicious calls since 2021.

During this period, WAS crews attended 463 face-to-face incidents later identified as deliberate hoaxes, severely straining emergency services already under pressure.

Rise in hoax calls over three years

2021/22: 334 hoax calls; 84 face-to-face responses.
2022/23: 373 hoax calls; 85 face-to-face responses.
2023/24: 457 hoax calls; 163 face-to-face responses.

The upward trend continues, with provisional figures for 2024/25 (April 1 to October 31) already recording 345 hoax calls and 131 face-to-face responses.

Strain across Wales

The geographic impact is widespread, with hoax calls reported in all areas of Wales. WAS officials warn that such incidents divert resources from genuine emergencies, potentially putting lives at risk.

A call to action

The 701 hours spent on hoax calls between 2021 and 2024 represent a critical drain on ambulance availability. A WAS spokesperson said: “Every minute wasted on a hoax call is a minute lost to someone in real need. These actions have serious, life-threatening consequences.”

“The Welsh Ambulance Service is urging the public to recognize the harm caused by hoax calls and act responsibly.

“For information or to report suspicious activity, contact the Welsh Ambulance Service through their official channels.”