Health

Pembrokeshire links to Chester Hospital CEO in centre of Lucy Letby row

Published

4 months ago

August 20, 2023

THE SHOCKING case of Lucy Letby, a nurse found guilty of murdering seven babies and attempting to kill six others, has resonated across the medical community. This national scandal has taken a local twist with revelations of its ties to Pembrokeshire.

Tony Chambers, who once held a key position at Hywel Dda health board, and was often based at Withybush Hospital, Haverfordwest, moved on to become the Chief Executive at Countess of Chester Hospital around February 2013. Chambers was at the helm during the harrowing incidents involving Letby. According to the Guardian, he had directed senior doctors to apologise to Letby in 2017, even amidst ongoing concerns over her actions. These apologies were premised on two external reviews which did not specifically delve into Letby’s involvement in the infant deaths.

**Lucy Letby: Found guilty of murdering seven babies**

Back in 2010, as the director of planning, performance, and delivery, Tony Chambers initiated the downgrading of Withybush hospital. A leaked document from the Hywel Dda Health Board outlined long-term plans to remove histopathology from Withybush. Addressing this leaked information, Chambers stated that the report had been commissioned in light of increasing concerns regarding the “fragility” of the histopathology service. He remarked, “There is an issue around the safety and sustainability of that service. All you’ve got is a report with a range of options and a few recommendations but there’s no process around decision making, around a preferred option. We’ve tried to explain to you that safety and quality is our bottom line, but irrespective of all of that, your concern is that something is moving out.”

In 2012, autopsy and cellular pathology services were shifted from Withybush Hospital to Carmarthen. The local press acquired a document detailing the proposal to merge Cellular Pathology Laboratory and Autopsy Services. This report suggested the transfer of cellular pathology laboratory resources from Withybush to Glangwili and centralising all autopsies at the latter location. Chambers, who was instrumental in this decision, cited the need to address safety concerns. He stated, “The community health council has been fully briefed and we are currently engaging with staff and no decisions have been made.”

**Lucy Letby: Sent sympathy card to parents of baby she ‘murdered’, court told**

Furthermore, The Pembrokeshire Herald understands that Tony Chambers left his latest position with a hefty pension, estimated at £1 million. Subsequently, he held several other lucrative positions within the NHS.

The revelations of senior doctors being asked to extend apologies and express trust, particularly when suspicions loomed large, portrays a concerning picture. Chambers appears central to this narrative, with his decisions from both his tenure in Pembrokeshire and at Countess of Chester coming under the scanner.

Throughout the trial we heard that Lucy Letby’s colleagues were ordered to apologise to her after repeatedly raising concerns that the nurse may have been behind a series of unexplained baby deaths.

Senior doctors had warned for months that Letby was the only staff member present during the sudden collapses and deaths of a number of premature babies on the Countess of Chester hospital’s neonatal unit.

She was not removed from the ward until early July 2016, a year after a doctor first alerted a hospital executive to a potential link. By that time she had murdered seven babies and attempted to kill another six, a court found on Friday.

The Countess of Chester hospital NHS foundation trust is facing serious questions about how it responded to concerns raised about Letby and whether it should have acted sooner.

Hospital executives ordered a formal review into the spike in deaths in June 2016, a year after Letby’s killings began. Letby was removed from the unit the following month, and the police were not contacted for almost another year after that.

After the conclusion of the 10-month trial, a Guardian investigation based on new documents, interviews with hospital consultants and reporting from the trial, has found that: According to two consultant paediatricians, in July 2016 a hospital executive said contacting the police would damage the hospital’s reputation and turn the neonatal unit into a crime scene, after one senior doctor recommended bringing in criminal investigators.

As stated, Tony Chambers’ apology was ordered on the basis of two external reviews, which executives felt exonerated Letby. However, neither review was designed to examine whether she, or any other member of staff, was responsible for the deaths and both recommended that several deaths be investigated further. Doctors were told in early 2017 that Letby’s parents had threatened to refer them to the General Medical Council after her removal from the unit, according to internal documents.

While the grim events at Countess of Chester are a national tragedy, for Pembrokeshire residents, they also signify the need for introspection, especially given Chambers’ connection to local medical decision-making.

CONCERNS IN NORTH WALES

Welsh Conservative Shadow Minister for North Wales, Darren Millar MS, has called for a statement and assurances from the Betsi Cadwaladr University Health Board in the wake of the Lucy Letby trial.

Letby, who worked as a nurse at the Countess of Chester Hospital, was found guilty of murdering seven babies and attempting to murder six more in a trail that ended this week.

Commenting on the issue, Welsh Conservative Shadow Minister for North Wales, Darren Millar MS said:

“This is a devasting and shocking case which is causing a great deal of alarm in North Wales.

“Maternity services at the Countess of Chester Hospital have been used by many mothers from North East Wales over many years. So, it is vital that the Betsi Cadwaladr University Health Board makes a statement about when it was altered to concerns about baby deaths at the Countess of Chester and whether pregnant women from North Wales continued to be referred to the hospital after that date.”

“The people of North Wales need these assurances from the Health Board and the Welsh Government’s Health Minister, given that the NHS in North Wales was in special measures at the time that concerns were raised.”

He added: “We also need to know what action is being taken to ensure that there is full disclosure of such concerns in the future when cross border healthcare arrangements are in place between one NHS body and another to ensure that patients are protected from unsure risk of harm.”

Health

Withybush paediatric care gone for good in yet another blow for hospital

Published

5 days ago

December 2, 2023

Jon Coles

OVER seven years after “temporarily” closing Withybush’s 24-hour Paediatric Ambulatory Care Unit (PACU), Hywel Dda UHB decided to close the department permanently on Thursday, November 30.
In January, the Board will meet to receive the plan for its implementation plan to make the change permanent.

A FOREGONE CONCLUSION

Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as Thursday’s meeting chugged along, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.
The Board’s ability to deliver its preferred option, which included returning some outpatient services for children to Withybush, is doubtful.
However, it now needs a plan to implement its plan. That plan to have a plan for its implementation plan will be discussed in January when the Board will discuss the planned plan for a plan.
If the planned plan for a plan doesn’t work out, the Board will go back to the drawing board to draw up another plan for its plan.

A “TEMPORARY” PROBLEM

In three years, the Board moved from a 24/7 service to a promise to return to a 12/7 service to a bold attempt to preserve an 8/7 service.
As our columnist Badger noted five years ago, the next step was bound to be a 0/7 service.
And then Covid came along.
PACU was closed, and its services “temporarily” transferred to Glangwili during the pandemic.
At the end of the pandemic, PACU didn’t return.
Instead, the Board justified its continued cessation because of the risk of a spike in respiratory viruses.
When that spike didn’t happen, the Board consulted on a “permanent solution”.
And that permanent solution – as glaringly obvious for years – was permanent closure.

A DECADE OF WORTHLESS REASSURANCE

In 2014, the Board stopped providing 24-hour paediatric care at
Withybush. At the time, it said that a 12-hour provision was deliverable, and it planned to return 24-hour paediatric care to Withybush once it recruited clinical staff.
By then, there was only ONE advert for a single paediatric consultant at Withybush and NONE for nurses specialising in paediatric care.
At one point at the end of 2015, the Board suspended its recruitment campaign for posts at WithyWithybush’s after claiming to have recruited staff to fill vacancies there. It announced an intention to launch a more focused campaign later.
In November 2016, the Board restated its commitment to maintaining the Paediatric Ambulatory Care Unit’s opening hours at Withybush from 10am-10pm, even though it faced “renewed and significant workforce challenges at the consultant level”.
In 2017, CEO Steve Moore said the Board was clear: “The changes to paediatric services are temporary and in response to us needing to ensure a safe and reliable service for our families with the consultant paediatricians available.”
After ending the 12-hour PACU cover, the Board did not launch an effort to recruit for three months after its closure.
By the end of the same year, the Board said: “Unfortunately, we have not been able to recruit a sufficient number of consultants to support the re-establishment of the 12-hour PACU service, although our recruitment efforts continue.
“In the meantime, the Health Board is working with staff and partners to explore a number of ideas to support a sustainable PACU service for the longer term.”
In 2018, the Community Health Council issued a report.
It said: “The health board needs to do all it can to resolve the current temporary reduced hours arrangements in PACU”.

CONSULT THE PUBLIC, THEN IGNORE THEM

Thursday’s meeting continued to offer mealy-mouthed platitudes instead of health services.

Board members suggested that parents of children in need of paediatric care would be reassured by the clarity the permanent removal of a key service from Pembrokeshire would provide.
Discussing the lack of transport options, Board members said they would publicise the availability of the Designated Ambulance Vehicle and the use of a taxi service to ferry children and parents from Glangwili.
The disconnection between the Pembrokeshire public and the Board over the issues could not be more complete.
Board members said that the main problem with the attitude of Pembrokeshire’s concerned parents was communication.
Pembrokeshire’s respondents to the Board’s conscientious rubber-stamping process were clear the issue was not communication but concern about timely treatment close to home.
70% said PACU should return to Withybush. The Board’s alternative, closing PACU for good, was overwhelmingly rejected.
If communication were the issue, not the provision of treatment at Withybush, the Board could have resolved it by being straightforward and transparent.
It wasn’t.
All the communication in the world, delivered by the best communicators money can buy, cannot circumvent that epic failure of honesty.
Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as the meeting ground on, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.

TOTAL DISCONNECTION

PERMANENT CLOSURE “BETTER”

Six years ago, “temporary” became the status quo.
Then “temporary” became a further “temporary reduction”. During Covid, the whole service was “temporarily” withdrawn.
So intense was Board members’ collective delusion at Thursday’s meeting that the permanent removal of the PACU service and its replacement with a vague promise of some outpatient clinics for children returning to Withybush sometime over the rainbow was represented as an improvement on the current position.
Even this Thursday morning, the current position was “temporary”, not permanent.
The Health Board’s thesaurus must look very peculiar.
Its word games demonstrate the extent to which the Board had long dispensed with the pretence of PACU’s closure temporary nature.
In the meantime, the Board plans to tell more people about its Dedicated Ambulance Vehicle and plans to fund taxis for distressed parents and sick and injured children.
You can bet that’ll make everything better.

Health

Hywel Dda hosts distinguished clinical examination

Published

5 days ago

December 2, 2023

Tom Sinclair

HYWEL DDA University Health Board said this week that it was proud to have successfully hosted the distinguished Member of Royal College of Paediatrics and Child Health (MRCPCH) clinical examination on behalf of Royal College of Paediatrics and Child Health (RCPCH).

The RCPCH is responsible for setting the standards of paediatric training in the UK including producing the paediatric curriculum and assessment pathway.

Paediatric trainees were welcomed to Glangwili Hospital, the only Welsh test centre for 2023, to complete their final MRCPCH examination. This practical examination involves a series of ten scenarios some using real patients, whilst being assessed by trainers with extensive experience of working in paediatrics.

Dr Prem Kumar Pitchaikani, Consultant Paediatrician and Clinical Director said “The education and training of medical professionals is an on-going and continuous process and is of greatest value, when taking place in the real world dealing with genuine concerns, conditions and challenges. The MRCPCH clinical examination strives to do this.

“This process showcases our health board’s commitment towards the education and training of future paediatricians, and I would like to convey my thanks to all the members of the paediatric department and the senior management for supporting this event.”

Health

Miss Wales calls on communities across Wales to give blood this Christmas

Published

5 days ago

December 2, 2023

Tom Sinclair

A 22-YEAR-OLD is encouraging people across Wales to consider donating blood, platelets and bone marrow this festive season. Miss Wales winner Darcey Corria received multiple blood transfusions after a serious car accident left her fighting for her life.

Darcey was crowned Miss Wales in May 2022, but her success almost came to a tragic end when she sustained a broken pelvis, back, jaw and neck following a near-fatal car accident in January 2023 on the M4 near Bridgend.

Emergency services teams worked at the scene of the crash for more than three hours until Darcey was taken to the University Hospital of Wales (UHW), Cardiff. Her injuries were further complicated upon arrival when doctors identified she had internal bleeding. Darcey urgently needed two blood transfusions. Darcey then remained at UHW for the next 20 days, where she underwent treatment and began her rehabilitation and recovery.

Darcey, who is recovering well from her injuries and is currently preparing for her entry to Miss World in February next year, said: “Without the selflessness of blood donors, I would not be able to continue doing the things I love, and I may not be here at all today. I now have the chance to fulfil my lifelong dream and compete for the title of Miss World, and it’s thanks to blood donors. The blood donations were truly the best gift I have ever received.

“I am so grateful to those who give up their time to help others in need. Sadly, I cannot donate blood now following my transfusions, but I hope that by sharing the difference it made to me personally, it may encourage more people to consider donating. It really can change someone’s life.”

Darcey, who has Jamaican heritage through her father, is a black rights activist and is championing diversity here in Wales alongside her pageant work. With Christmas celebrations fast approaching, Miss Wales is supporting the Welsh Blood Service’s campaign, #thebestgift. The campaign encourages communities across Wales to support blood stocks over the Winter period by raising awareness of the importance of a blood, platelet or bone marrow donation and the difference those precious gifts make to patients in need like Darcey.

The Service provides lifesaving blood and blood products to 19 hospitals across Wales and four Wales Air Ambulance aircraft for use in emergencies. It also manages the Welsh Bone Marrow Donor Registry which recruits and supports bone marrow volunteers matched with cancer patients across the globe to make a potentially lifesaving bone marrow donation.

Currently, three in every ten patients requiring a bone marrow transplant do not find the match they need, and the risk of not finding a donor increases to seven in ten for patients of minority ethnic heritage due to the lack of representation on global donor registers.

Alan Prosser, Welsh Blood Service Director, said: “For patients who find themselves in need, a donation will be ‘the best gift’ they receive this Christmas.”

Blood and blood products, which are needed to support patients and save lives across Wales, have a short shelf life and are in constant need by hospitals every day, including bank holidays like Christmas Day and New Year’s Day.

Alan continued: “The Service must be prepared, so we’re reaching out to our communities across Wales encourage them to make a lifesaving donation over the Winter period, and for those aged 17 to 30 years old, to also sign up to our bone marrow registry.”

Darcey added: “I would urge everybody eligible to support the Welsh Blood Service, particularly those from a Black, Asian, Mixed or Minority Ethnic background. By coming forward, you are really helping patients in need and providing diversity to the donor panel, which will help a larger number of patients.”

Do something amazing this Christmas and New Year. Give someone the best gift, give blood and, if you are aged between 17 and 30, join the Welsh Bone Marrow Donor Registry either when you donate blood or by requesting a swab kit online.

Book to give blood at: www.wbs.wales/xmas23 or call 0800 252 266 today.

If you’re aged 17 to 30, find out how you can join the Welsh Bone Marrow Donor Registry at www.wbs.wales/bmvxmas23