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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

Nurses warn of pay and burnout crisis as new report exposes pressures in Wales

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A NEW national report has laid bare the growing pressures facing nurses and midwives in Wales, with concerns over pay, burnout and lack of professional development threatening the long-term future of the workforce.

The findings, published by the Nursing and Midwifery Council in its Spotlight on Nursing and Midwifery 2025 report, show that while many nurses remain deeply committed to their roles, large numbers feel undervalued, overstretched and reluctant to recommend the profession to others.

Responding to the report, Royal College of Nursing Wales said the data should act as a wake-up call for government and health boards.

Professor Sandy Harding, Associate Director of Nursing, Policy and Professional Development at RCN Wales, said:

“We welcome the determination and commitment shown by our existing nurses in Wales, with more than half surveyed saying they are satisfied with their day-to-day work and motivated by making a difference to people’s lives. However, the findings also present a stark reflection of the poor health of nursing in Wales.

“Too many nurses are not recommending the profession to others, are struggling and are facing abuse and discrimination in the workplace.”

Pay falling behind responsibility

One of the most pressing concerns raised in the report is pay.

Nursing leaders say salaries have failed to keep pace with the growing complexity of the job, heavier caseloads and the rising cost of living, leaving many staff feeling undervalued and financially squeezed.

For some, the pressure is forcing difficult decisions about staying in the profession or reducing hours.

RCN Wales argues that without meaningful improvements to pay, recruitment and retention will continue to suffer, placing further strain on already stretched hospital wards, community services and care settings.

Training and career progression gaps

The report also highlights inconsistent access to continuing professional development, with many nurses struggling to secure protected time or funding for further training.

According to the union, this not only limits career progression but risks undermining patient care in the long term.

Harding said: “Access to protected time and funding for continuing professional development remains inconsistent, undermining both career progression and the sustainability of the workforce.

“RCN Wales believes this is unacceptable and we will continue to support nurses and fight for fair pay, meaningful investment in professional development and better working conditions across Wales.”

Commitment remains strong

Despite the challenges, the report does note strong dedication among nursing staff.

More than half of those surveyed said they were satisfied with their day-to-day work and remained motivated by the difference they make to patients’ lives.

Health leaders say that commitment is a strength the NHS in Wales cannot afford to lose.

With around 35,000 members in Wales, the Royal College of Nursing says it will continue pressing ministers to address what it describes as a “workforce crisis” before it deepens further.

The union is calling for fairer pay settlements, safer staffing levels and guaranteed investment in training to ensure nursing remains an attractive and sustainable career.

 

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Health

Doctor struck off after sexual misconduct findings at Withybush Hospital

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Tribunal history reveals medic was removed in 2012 for dishonesty before being allowed back to practise

A DOCTOR accused of sexually harassing junior colleagues while working at Withybush Hospital had previously been struck off the medical register for lying about his qualifications, the Herald can reveal.

Dr Velmurugan Kuppuswamy is currently at the centre of fitness-to-practise proceedings after allegations he made sexually inappropriate comments and subjected two female doctors to unwanted physical contact during his time as a locum consultant in Haverfordwest.

But records show this is not the first time his conduct has come before regulators.

In 2012, an independent tribunal found he had been dishonest during an application and interview for a postgraduate cardiology training post at an NHS deanery in England.

The panel heard he falsely claimed to have submitted a Doctor of Medicine thesis, said he was a member of the Royal College of Physicians and stated he had passed a practical clinical skills assessment.

He initially admitted misleading information before later retracting parts of his account. The tribunal concluded he had “maintained his dishonest accounts” and had wrongly accused a witness of giving misleading evidence.

He was erased from the register and returned to India, where he later worked in a cardiac hospital.

In 2020, he applied to be restored to the UK medical register.

The General Medical Council investigated and opposed the application, arguing his expressions of remorse had come years late and raising concerns about a lack of independent evidence regarding his work overseas, as well as the absence of relevant ethics training.

However, an independent Medical Practitioners Tribunal at the Medical Practitioners Tribunal Service accepted his assurances that he had changed. His evidence was described as “compelling, heartfelt and genuine”, and the panel decided a well-informed member of the public would not be concerned about his return to practise.

His name was restored to the register.

Shortly afterwards, he began working shifts as a locum consultant at Withybush Hospital, which is run by Hywel Dda University Health Board.

Within months, fresh allegations emerged.

A tribunal has heard claims that between August and September 2021 he hugged junior colleagues without consent, touched their backs and waists, squeezed their wrists and arms and made sexually suggestive remarks at a staff social event.

On two occasions, he is alleged to have gripped one doctor so tightly it caused pain and ignored her requests to stop. He is also accused of staring at female colleagues, following groups of women around the venue, making comments about their bodies and placing a hand high on one doctor’s thigh.

Further allegations relate to behaviour at work, including sitting extremely close to a colleague, draping an arm behind her on a sofa and grabbing her arm while whispering comments.

According to the charges, his conduct created “an intimidating, hostile, degrading, humiliating or offensive environment” and amounted to a sexually motivated abuse of his senior position.

Dr Kuppuswamy denies wrongdoing.

Following the investigation, the case was referred to a tribunal by the General Medical Council. The decision on his fitness to practise was made independently by a Medical Practitioners Tribunal at the Medical Practitioners Tribunal Service.

The tribunal determined his behaviour amounted to serious professional misconduct and ordered that he be erased from the medical register.

Asked whether the doctor remains employed, the health board said it does not comment on individual staffing matters.

Medical director Mark Henwood said: “We have robust policies and procedures in place to ensure the safety of both staff and patients in our care and we take seriously our responsibility for their wellbeing. We are committed to providing a safe, supportive environment where patients and staff can be confident that best practice is being followed at all times.”

 

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Health

‘Parking fine or miss my appointment’ say patients pressure mounts at hospitals

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From sleeping on chairs to parking fines, patients say everyday barriers are pushing the NHS to breaking point

PATIENTS across West Wales are describing a health service under such strain that some say they now expect to be penalised simply for trying to access care.

At Glangwili Hospital, stories of patients sleeping on chairs for days due to a lack of beds have been accompanied by growing frustration over issues that begin long before anyone reaches a ward — including parking, access, and the sheer difficulty of getting through the hospital doors.

One disabled patient said they had resigned themselves to receiving a £25 parking fine in order to attend hospital appointments.

“I now accept I will be fined,” they said. “Parking is impossible, but it’s that or miss my appointment. I am too disabled to park miles away and the disabled spaces are always full.”

Others have described spending days in A&E or side rooms, unable to lie down, while waiting for a bed to become available. One patient admitted on New Year’s Day with pneumonia said they slept in a chair for four nights without a pillow or blanket before being moved, only to later discover they also had flu and should have been isolated sooner.

Across social media and in correspondence with the Herald, patients and families repeatedly stress that frontline NHS staff are not to blame — instead pointing to a system that they say is buckling under years of structural strain.

Glangwili, the largest hospital managed by Hywel Dda University Health Board, serves Carmarthenshire and is home to the county’s only accident and emergency department following the closure of A&E at Prince Philip Hospital. That closure, along with reductions in services elsewhere, is frequently cited by patients as a turning point.

Several people said the loss of local A&E and cottage hospitals has forced more patients into already stretched units, increasing ambulance reliance and long-distance travel — particularly difficult in a largely rural region.

Further west, uncertainty over services at Withybush Hospital continues to fuel anxiety, especially given the scale of reinforced autoclaved aerated concrete (RAAC) identified across the site.

Hywel Dda has acknowledged that almost 90% of Withybush is affected by RAAC, while Glangwili itself is the oldest acute hospital in Wales. The health board says more than £50 million has been spent on the two hospitals in recent years, largely to address critical safety and infrastructure risks rather than expand capacity.

Patients, however, question where that money is felt on the ground.

Some have criticised NHS procurement and management structures, while others point to social care as the missing piece. Repeated comments highlight the lack of care packages and closed care homes, which many believe are leaving medically fit patients unable to be discharged — effectively blocking beds and creating bottlenecks throughout the system.

“There’s nowhere for people to go,” one reader said. “Until social care is sorted, nothing will change.”

Concerns have also been raised about staff morale, with some alleging bullying cultures and burnout contributing to recruitment and retention problems. Again, blame is consistently directed upward rather than at nurses, doctors or porters.

Behind it all looms the long-promised new ‘super hospital’ for Carmarthenshire — first discussed in 2006 and formally launched in 2018. Eight years on, construction has yet to begin, and public confidence in the project is fading.

While Hywel Dda and the Welsh Government insist improvements are under way — including additional funding to expand capacity at Glangwili and improvements to patient experience — many patients say their reality feels far removed from official assurances.

For those attending appointments, sleeping in chairs, or weighing up a parking fine against missing care, the crisis is no longer abstract.

“It’s not politics,” one patient said. “It’s whether you get treated — and how.”

 

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