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Health

Health annual meeting reflects on another extraordinary year

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REFLECTING on what it calls ‘yet another extraordinary year’, Hywel Dda University Health Board has looked back at its achievements and challenges throughout 2022/23 during its annual general meeting.

Held today [Thursday 28 September 2023], the AGM reviewed the organisation’s Annual Report, including its financial accounts. The report and presentations set out to staff, patients, and the public what has been achieved between 1 April 2022 and 31 March 2023, what has been challenging, and how the health board intends improve services for local people.

The main themes included how the health board is progressing against its strategic objectives, its ongoing response to COVID-19 and its performance against a number of measures including planned care, urgent and emergency care, cancer, mental health, neurodevelopment services, infection control and workforce.

Reference was made to new initiatives to support patients and improve services, progress through research and partnership opportunities, workforce developments and capital developments across the three counties. Progress on well-being objectives, Welsh language services, and the health board’s submission of its programme business case for £1.3billion investment in its long-term strategy was provided. Praise was also given to all staff, including those who have won or been shortlisted for dozens of local and national awards as well as for the health board as an employer.

The support of patients, families and local communities for the health board’s charity, Hywel Dda Health Charities, was also recognised. Examples were provided of fundraising activities which contributed to £3.99million charitable income, and of the many services and activities above and beyond core NHS expenditure which were charitable funded.

In addition to the presentation of the Annual Report and financial accounts, the Annual General Meeting also heard from members of the Apprenticeship Academy. Representatives of the health board’s apprentices shared what they have enjoyed about their time with the health board, and how they are looking forward to advancing their career within the organisation.

Maria Battle, Chair of Hywel Dda University Health Board said: “This annual event gives us an opportunity to reflect on another extraordinary year, but also to look ahead to 2023/24. While things are still very challenging for the NHS, we have a clear vision to help us recover from the impact of the pandemic, address our long-standing financial challenge, and build a health system resilient and sustainable for the future.

“We recognise too that access to a wide range of services has been constrained over the past three years, resulting in delays in treatment and care within our health board. We are deeply sorry if you have experienced delays in access to your care and treatment. While we have made significant progress in reducing the number of patients who are waiting for treatment, we are aware that it remains difficult for people who are still waiting, or have their treatment further delayed. We are committed to further reducing our waiting lists to pre-pandemic levels and meeting the Welsh Government target.

“The highly focused response to the pandemic has left a financial legacy too. We could not identify and deliver savings and efficiencies in the way we would normally, and as a result we faced significant financial challenges as funding for the COVID-19 response tailed off, leaving us needing to make up for two years of lost time.

“The resolve of our staff continues to astound us, with colleagues committed to delivering the best possible patient care in difficult circumstances.

“Being the last AGM I will chair before my retirement from the health board in October, I want to take this opportunity to sincerely thank everyone working in and with Hywel Dda University Health Board, whatever your role. Thank you also to all our volunteers, and our partners, for your extraordinary service caring for patients and our communities during these challenging times.”

The Annual Report details areas where the health board’s performance needs to improve, along with mitigations and actions being taken, in areas such as waiting times for planned care, outpatient, mental health, neurodevelopment services, and infection control. Performance in these and other areas have been negatively impacted by issues with patient flow, patient acuity, demand and capacity, and staff shortages.

Quality improvement continues to be a key focus across the organisation to ensure the safest and best care for our patients and community, and part of this work involves listening to and acting on the feedback received from those who use our services.

Through close working with its partners on a shared vision for our communities to live healthy, joyful lives, the health board continues to engage with local people on topics such as its health and care strategy and the land appraisal process for a proposed new hospital, the future of children and young people’s services, as well as changes to some local GP practices.

The health Board has also worked in partnership to support vulnerable groups, care homes, social care and safe discharge, developed new opportunities with local universities and continues as an active member of the Dyfed-Powys Local Resilience Forum.

Health

Mind, Body and Spirit Awareness Day at North Pembrokeshire venue

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This Saturday, April 12, thoughts will be turning to the mind, body and spirit, thanks to the ever-popular Awareness Day that takes place at Canolfan Hermon in North Pembrokeshire.  

This is the fourth event of its kind  at the village hall and each year the event continues to grow from strength to strength.

This year, there will be a total of  eight therapists in attendance as well as  two mediums, a card reader and ten stall holders selling spiritual, mind and body items including crystals, jewellery, honey and cosmetics.  There will also be a stall from the Jig-So Children’s Centre in Cardigan while  hot food and refreshments will also be served throughout the day by Fusion Kitchen.

As with previous events, the Mind, Body and Spirit Awareness Day will be raising funds for Breast Cancer and Thrombosis UK.  As a result, there will be a £1 entry fee as well as optional raffle tickets and a Memory Tree for additional donations. A  light language healing demonstration will take place at 1 pm.

People near and far are invited to experience the different therapies, while  event organiser Lynda Barnes says there is guaranteed to be something here for everyone. The event starts at 11 am and will continue until 3 pm.

For further information, contact Lynda Barnes on 07920249194.

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Health

‘Nobody taking responsibility’ for paying care workers the real living wage

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CARE HOME providers urged the Welsh Government to follow through on a key commitment to ensure care workers are paid the real living wage.

Giving evidence in the Senedd, Care Forum Wales, which represents more than 450 care homes, warned funding did not reach all parts of the sector in 2024/25.

The non-profit organisation said funding for the real living wage (RLW) was not ringfenced, so some councils chose to spend the money on libraries and teachers’ salaries instead.

Care Forum Wales raised concerns about “nobody taking responsibility”, with the Welsh Government claiming to have provided the money and councils saying it was insufficient.

Labour’s manifesto for the 2021 election contained a pledge to “ensure care workers are paid the real living wage during the next Senedd term”.

But Sanjiv Joshi, Care Forum Wales’ treasurer, warned the Welsh Government’s push for care workers to receive the real living wage has become an aspiration rather than a reality.

He told the local government committee: “The first year when it was announced … providers had to give an undertaking to commissioners that we were paying the real living wage.

“Since then, that’s now become aspirational as commissioners have not had the funds – or so we are told – to follow through and maintain those real living wages.”

Giving evidence on April 3, Melanie Minty, policy adviser at Care Forum Wales, said: “The real living wage, as Sanjiv said, isn’t reaching the sector necessarily.”

But, describing the RLW as a drop in the ocean, she warned care homes cannot compete with councils and the NHS which pay a higher rate than used in costing commissioned care.

Under the Welsh Government’s 2025/26 budget, funding for the real living wage is allocated to councils within the revenue support grant, meaning it can be spent on other areas.

Ms Minty also voiced concerns about an increasing number of councils receiving grants to build care homes that “will never recover their costs”.

She pointed to the example of Carmarthenshire Council building a £19.5m residential home despite free capacity in the county’s independent sector.

Cautioning that commissioning too often focuses on cost over outcomes, she said: “I’ve heard of commissioners going into homes and saying ‘you’re spending too much on food’.

“Things like holidays have been drastically cut back for younger people.”

Mr Joshi, who runs the Caron group of care homes in mid and south Wales – which includes Valley View Care Home in Hengoed – warned of a £9,000-a-year difference in nursing fees between neighbouring councils.

He said: “We’re talking about Cardiff and RCT … imagine the pressure that puts on and it’s not driven by the needs, the needs would not be that different.”

Pressed about the minimum level of profits required to make services feasible, Mr Joshi replied that he targets an 11% return which is unachievable in parts of Wales.

Warning of an “irrational” policy direction, he said: “We have the private sector delivering incredible value for money [yet] being eroded by underfunding. Then we have the public sector spending four or five times that amount, it doesn’t make sense.”

Mr Joshi told the committee families are increasingly having to make up a difference in costs that should be provided by councils and health boards.

Warning charity providers are exiting the market, Ms Minty said: “Most of our third-sector members have sold their care homes because they are not viable.”

Ms Minty called for a fee methodology that can be applied consistently across Wales, with some councils far more transparent and understanding of the costs than others.

“Cardiff, while giving a really good increase this year, has been very honest in admitting they know it’s not going to meet all the changes,” she said. “Whereas other local authorities … have been known to make an offer and say this will cover all sorts of things.”

She said the sector has stabilised since the pandemic and Brexit but increasing employer national insurance contributions have added to the pressure.

She told the committee: “I think we’ll see an unintended consequence will be that employers are forced to suppress pay increases … and some will be forced to make redundancies.”

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Health

New patient deal aims to cut NHS waiting times across Wales

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A NEW deal between the NHS and the public is at the centre of a plan to drive down the longest waiting times for healthcare in Wales.

Health Secretary Jeremy Miles is expected to unveil a strategy this week aimed at reducing the overall waiting list by 200,000 patients by March 2026. The plan also sets targets to eliminate two-year waits for planned treatments and restore a maximum eight-week wait for diagnostic tests.

A key part of the announcement is the introduction of a new “patient deal”, which aims to improve transparency, reduce missed appointments and ensure better preparation for surgery. This deal will be incorporated into updated referral-to-treatment guidelines due later this month.

What the new deal includes:

  • Faster access to planned care with patients told how long they can expect to wait once added to the list.
  • Waiting time tracking through the NHS Wales App, with updates available from June.
  • Only fit and well patients will be added to surgical waiting lists, in line with evidence showing they recover more quickly and have better outcomes.
  • Support to get surgery-ready, with help to improve health before treatment.
  • Appointment changes, where patients will be offered two dates. If they miss both without good reason, they will be removed from the waiting list.
  • Alternatives and risks explained, so patients are fully informed before deciding on surgery.

Each year, around 700,000 outpatient appointments in Wales are either missed by patients or cancelled. Health boards will now be under stricter obligations to reduce these disruptions, and to minimise the number of cancellations made by the NHS itself.

Mr Miles said: “The NHS will do all it can to prioritise faster access to treatment. In return, we are asking the public to prioritise and keep their appointments so that, together, we make the best possible use of scarce NHS resources.

“We cannot continue losing one in seven appointments due to no-shows or other avoidable reasons. These missed slots delay care for everyone and waste vital resources.

“Evidence shows people in better health recover more quickly and require shorter hospital stays. By preparing patients properly and ensuring they understand all treatment options, we can deliver better outcomes and greater efficiency.”

The Welsh Government hopes the new plan will bring waiting lists closer to pre-pandemic levels. As well as reducing overall waiting list size by 200,000 by March 2026, the government has pledged to ensure no one waits more than two years for planned treatment and to restore the eight-week target for diagnostic testing.

Health boards will be expected to continue transforming how they deliver planned care over the next 12 months. This includes adopting more regional working models and implementing recommendations from the Ministerial Advisory Group on NHS Performance and Productivity, due to report later this month.

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