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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

‘Truly abysmal’ – Welsh NHS waiting list hits new record high

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THE LATEST NHS statistics paint a bleak picture of healthcare in Wales, with waiting lists reaching an unprecedented 802,268 patient pathways in November—marking the tenth consecutive month of increases. These figures have sparked widespread criticism, with opposition parties and healthcare charities lambasting the Welsh Labour Government for its handling of the crisis.

The latest figures have sparked widespread criticism of the Welsh Government (Pic: File)

Waiting lists and emergency care in decline

The 802,268 patient pathways recorded represent more than one in four of the Welsh population. Behind this staggering number lies a harsh reality for patients. The median waiting time has now climbed to 23 weeks, a stark contrast to the 14-week average in England. For those waiting more than two years for treatment, the figure has risen again to 24,361. This is a glaring failure considering Labour’s repeated promises to eliminate two-year waits by 2023 and 2024—targets that remain unmet.

Emergency departments also continue to struggle. The percentage of patients seen within four hours has dropped to 64.8%, well below the target of 95%. In December, 10,857 patients waited more than 12 hours for care, an 11% increase from the previous month. Only 47.6% of red calls, the most serious emergency cases, received an ambulance response within eight minutes in December.

Ambulances waiting to off load patients outside Withybush Hospital A&E in Haverfordwest (Pic: Herald)

Cancer treatment performance falls short

Cancer services are in an equally dire state. The performance against the critical 62-day target for starting cancer treatment has fallen to just 60.2%—far below the 75% benchmark. While Health Secretary Jeremy Miles highlights incremental progress, including a reduction in long waits for diagnostics and therapies, critics argue this is too little, too late.

James Evans MS, Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, called the statistics “truly abysmal,” adding:
“People are dying unnecessarily across Wales. Families are losing loved ones prematurely, and NHS staff morale is plummeting. The Welsh Labour Government has broken the NHS and continues to fail those who depend on it.”

Welsh Government defends record

Defending the NHS – Jeremy Miles said more money had been made available (Image: File)

In response, Jeremy Miles pointed to recent funding increases and measures to address long waits. He highlighted a £50 million investment aimed at improving outpatient services and diagnostics, alongside a decline in delayed hospital discharges over the last four months.

“The health service in Wales continues to provide quality care to thousands of people every day, despite immense pressures from winter illnesses, including Covid-19 and flu,” said Mr Miles. “These figures do not yet reflect the impact of our latest investments, but I am confident that we will see improvements in the coming months.”

Charities demand action on cancer

There have been several protests against closure of services in Pembrokeshire (Pic Herald)

Cancer charities have voiced their frustration over the slow progress in improving treatment waiting times. Kate Seymour, Head of External Affairs at Macmillan Cancer Support, described the current state of cancer care as “woefully inadequate.” She criticized the lack of strong national leadership and urged the Welsh Government to implement the recommendations of Audit Wales’s recent report on cancer services.

“The latest data shows real people are facing agonizing delays, unsure if they have cancer or when their treatment will start,” said Ms Seymour. “People in Wales with cancer deserve better.”

Judi Rhys MBE, Chief Executive of Tenovus Cancer Care, echoed these concerns, describing the findings of the Audit Wales report as “deeply disappointing.” She highlighted the lack of progress on stubbornly long waiting times for certain cancer types, including gynaecological cancers.

Political fallout

There has been heated discussion in the Senedd over NHS service delivery (Image: File)

The political repercussions have been swift. Last week, the Welsh Conservatives tabled a motion in the Senedd, calling for the immediate implementation of Audit Wales’s ten recommendations to improve cancer services. The motion criticized the Welsh Labour Government for its failure to meet national performance targets since 2020 and accused it of undermining its own Cancer Improvement Plan through poor communication and unclear priorities.

Labour members, however, voted against the motion, prompting sharp criticism from James Evans MS, who called the vote “shameful.”

“The Welsh Labour Government has broken the NHS, is out of ideas, and is on its way out of office. We stand ready to fix Wales,” said Mr Evans.

The human cost

Some patients are saying that they have been in pain whilst awaiting operations (Pic: NHS)

For patients and families across Wales, these statistics are more than just numbers—they represent painful realities. Behind every delay is someone anxiously waiting for a diagnosis or treatment, often with life-altering implications.

One such patient, Rhian Davies from Newport, has been waiting over two years for a hip replacement. “The pain is unbearable, and it’s getting worse,” she said. “I can’t believe I’ve been left to wait this long. It feels like they’ve forgotten about us.”

As pressure mounts on the Welsh Labour Government, health experts and opposition parties are united in their call for urgent reform. Whether the latest investments and strategies will be enough to reverse the downward spiral remains to be seen. For now, the people of Wales continue to endure a healthcare crisis that shows little sign of abating.

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Health

More than 400,000 visit pharmacies for common health issues

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THE WELSH public is being encouraged to visit local pharmacies for free advice and treatment for a wide range of illnesses. New figures reveal that over 400,000 people used the Common Ailments Service in the past year alone.

Pharmacies offer convenient access to healthcare professionals, often without the need for an appointment, freeing up GP slots for those with more complex or urgent medical needs.

Common ailments service

Available in 99% of pharmacies across Wales, the service provides free, confidential advice and treatments for 28 common illnesses, such as sore throats and urinary tract infections. Since its launch in 2013, it has supported nearly 1.25 million people.

Around 220 pharmacies now offer the Pharmacist Independent Prescribing Service, allowing pharmacists to treat conditions such as ear, skin, and respiratory infections, sinusitis, and migraines.

A survey found that 95% of patients who used the service would have otherwise sought help from a GP or other healthcare provider.

Prescribing services expanding

Each year, up to 100 community pharmacists in Wales undertake prescribing training. From 2026, all newly qualified pharmacists will be registered prescribers, enhancing the range of services available at local pharmacies.

Primary care reforms

The Cabinet Secretary for Health and Social Care, Jeremy Miles, highlighted ongoing reforms to deliver more care closer to home during a statement to the Senedd.

Key statistics include:

  • GPs handle around 100,000 calls and 68,000 appointments daily.
  • Optometrists conduct over 2,000 consultations each month.
  • More than 420,000 new dental patients have been treated since April 2022.
  • District nurses see approximately 31,000 patients each month, equating to 1% of Wales’ population.

Comments from key figures

Health Secretary Jeremy Miles said:
“We know there is very high demand for GP services in Wales, with around 1.6 million people contacting their practice each month.

“For most common health concerns, your local pharmacy is the best option, providing free and easy access to treatment.

“We are working with the NHS to provide more care in the community, closer to people’s homes, and to make it easier for people to choose the right service for their health needs.”

Gwawr Davies-Jones, a pharmacist at High Street Pharmacy in Barry, added:
“Since the new pharmacy contract was implemented in 2022, our role has changed considerably. Instead of being in the dispensary, we are now in the consultation room for most of the day, offering clinical services.

“On average, we carry out more than 20 consultations daily, from providing contraception to emergency medicine supplies.

“The demand for advice on common conditions is great, giving pharmacists an opportunity to share advice and treatment, including prescribing antibiotics and other prescription-only medicines without the need to see a GP. This helps free up much-needed appointments for more complex conditions.

“We feel we offer an invaluable service to our community. The services we provide alleviate pressures on the NHS, giving pharmacists great satisfaction knowing they are making a difference.”

Supporting NHS pressures

Pharmacies in Wales offer treatment for 28 common illnesses under the Common Ailments Service. Many also provide emergency contraception, annual flu vaccinations, and regular contraception services.

The Welsh Government has significantly supported this service expansion, increasing its investment by 24% since 2016-17, with an additional £9.9 million allocated this year.

Cabinet Secretary Jeremy Miles visited High Street Pharmacy in Barry today to meet pharmacist Gwawr Davies-Jones. 

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Health

Lymphoedema patients to benefit from online mental health support

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NHS Wales’ digital wellbeing service has teamed up with a pioneering clinic to help patients manage the mental health impacts of Lymphoedema and Lipalgia Syndrome.

The Lymphoedema Wales Clinical Network (LWCN) established a psychological support service – the only one of its kind in the UK – after patients spoke of the emotional challenges of living with these conditions.

Patients revealed how their physical symptoms were often accompanied by depression, anxiety and worries about appearance.

Support offered by the service’s two psychologists is now being complemented by direct referrals to SilverCloud® Wales, a suite of online, self-help courses based on Cognitive Behavioural Therapy (CBT).

Dr Jayne Williams, National Lymphoedema Consultant Psychologist for LWCN said: “This is an exciting time for us.

“We’re looking at different ways for people to access psychological therapies – SilverCloud being one of them. The aim is to provide timely, preventative support before people get to crisis point.

“As SilverCloud is online, it has the capacity to reach many more people than we could see face-to-face, and its flexibility means that it fits around busy work and family lives.

“Being able to offer something that patients can do in their own way, at their own pace is brilliant.”

NHS Wales online CBT project manager Fionnuala Clayton said the new referral pathway was inspired in part by feedback from a ‘Living Well with Lymphoedema’ event hosted by LWCN, where patients were asked what they would like from its emerging psychology service.

“Patients wanted to feel as though they were not alone and that they still had a healthy and happy life despite their condition,” said Fionnuala. “They wanted easy access to support for building resilience alongside help to help themselves.

“Coming away from the event, we knew a referral pathway would support many patients across Wales.”

Lipalgia Syndrome – also known as Lipoedema – is an abnormal build-up of adipose fatty tissue, usually in the lower half of the body, which more commonly affects women.

Lymphoedema is another incurable, long-term condition which develops due to a damaged or poorly-functioning lymphatic system. Damage can occur as a result of many factors including obesity, surgery, cancer treatment, infection or injury.

People who are sedentary are particularly vulnerable as the lymphatic system relies on movement to remain healthy and move the lymph fluid around the body. Symptoms include swollen and painful heavy limbs and a higher risk of skin infections and wounds.

Said Dr Williams: “These are conditions that people have to learn to live alongside forever, which can be incredibly difficult.

“They have to cope with swelling and pain, they may have to wear compression bandages or garments, carry out daily skin care routines and do lots of movement.

“We see lots of people with very low mood. There’s also a lot of anxiety around body image and intimacy.

“Feeling people are judging you, and perhaps not being able to find clothes or shoes that fit you, means your whole identity and your social confidence can be affected. You can feel more isolated and withdrawn.”

Around 25,000 people across Wales use LWCN services.

Local health board lymphoedema services can refer people to the psychology service within the National Lymphoedema Team, which is hosted by Swansea Bay University Health Board.

Dr Williams said several patients had been referred to SilverCloud’s Space for Positive Body Image programme after attending a body image workshop.

Other courses on offer include support for anxiety, depression and stress.

Anyone in Wales aged 16 or over can self-refer to SilverCloud, without seeing a GP and from the comfort of their own home.

Fionnuala Clayton added: “We’re delighted to onboard the Lymphoedema Wales Clinical Network. This has been a collaborative effort between services, working together to identify how best support patients living with Lipalgia Syndrome and Lymphoedema.”

For further information and support on Lymphoedema and Lipalgia Syndrome, visit https://lwcn.nhs.wales/

To self-refer to SilverCloud Wales, visit https://nhswales.silvercloudhealth.com/signup/

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