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Health

Striking drop in home care hours in Carmarthenshire despite rising demand

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Richard Youle – Local Democracy Reporter

THE NUMBER of hours of home care commissioned by Carmarthenshire Council has halved over the last decade, despite rising demand from an ageing population.

Jake Morgan, director of social services, said in a report that this “striking” trend was the result of measures such as helping people who might need support at an earlier stage, more help for people who have left hospital but who need care before they can go home, and more instances of one home carer – where appropriate – visiting a client when previously two had.

At the end of April this year, the council commissioned 8,601 hours of home care for people who need help with things like washing and dressing. A decade ago it was around double that.

Mr Morgan’s annual report said the council was managing home care demand, although there are more than 100 people waiting for the service. It added: “However, had we not made these radical reforms over the last 10 years then we would have a waiting list of 500 people and spend of an additional £20 million annually.”

His report, covering key trends in adult services and children’s services, was discussed by the council’s health and social services committee on October 4.

Speaking at the meeting, Mr Morgan said Carmarthenshire was the only area in Wales where home carer pay was on a par with NHS peers, and that this had helped with recruitment and retention. “But it has not solved fundamental shortages in the workforce,” he said.

In Carmarthenshire, as across Wales and the UK, many elderly people in hospital are medically fit for discharge but remain in a ward due a lack of onward support. Mr Morgan said a fortnightly meeting took place reviewing all long hospital waits, and that this had had a positive impact.

He said: “Seventy five per cent of our beds in hospital, sometimes upward of 80%, have frail and elderly people within those beds – hospitals that are designed for mending broken legs and dealing with cancer and all those kinds of functions are now largely overwhelmed by people who have multiple chronic complex illnesses.”

He said the average length of stay in Glangwili and Prince Philip hospitals, in Carmarthen and Llanelli, was more than double the equivalent of comparable hospitals. The more time frail and elderly people remained in a hospital bed with minimal movement, he said, the more they deteriorated and the harder it became to discharge them.

Mr Morgan said the health board had a very good relationship with Hywel Dda University Health Board, but he was concerned that significant health board budget deficits in Wales could mean funding being cut for initiatives to reduce hospital stays.

Moving on to social workers, Mr Morgan said the council was focusing on sponsoring and training its own, while still recruiting externally where possible.

“I think we had 22 (social workers) join last year who we had some role in sponsoring or supporting in doing their professional qualification,” he said.

His report, though, pointed out that the council had been unable to fill social worker posts that were created via a “significant” investment” in mental health services by the authority last year.

Meanwhile, referrals to the child and family services department have increased by around 70% from a decade ago. Mr Morgan said outcomes for children helped by the council were the best in Wales compared to other authorities. “We still have low numbers of looked-after children, and we are good at keeping families together,” he said.

Caerphilly Council, he said, spent £20-25 million more per year on children’s services than Carmarthenshire did. However, Mr Morgan said numbers of young people on the child protection register had risen in Carmarthenshire.

He added that the authority had plans to ramp up its provision of residential care for looked-after children to avoid them having to go outside of the county. “The looked-after children market, particularly in terms of residential care, is not serving children well,” he said.

Councillors asked questions about the fortnightly hospital stay meetings, a rise in suicide in the region, and home care agency funding, among other things, and accepted the report.

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Community

Fresh pleas to save much-needed Pembroke Dock day centre

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A PLEA to keep Pembroke Dock’s Anchorage Day Centre open is to be heard at a full meeting of Pembrokeshire County Council next week.

The Anchorage Day Care Centre in Pembroke Dock has been a “safe and happy place” for adults with learning difficulties and additional needs for decades.

In more recent years it has expanded to support elderly dementia sufferers.

But now the centre is expected to close, with services instead being offered elsewhere in the county, including Haverfordwest and Milford Haven.

A series of engagement events have taken place at The Anchorage recently, outlining the reasons and the options in continued service.

One parent, who wished to remain anonymous, said: “One young woman who attends ran out of the first meeting sobbing when she was told it was going to close. Another, at the second meeting, tried to address the meeting but was so choked up at the thought of not seeing her friends anymore she could hardly speak.”

In a submitted question to be heard at the May 9 meeting, member of the public Peter Welsh will ask: “Is the council aware of the huge impact the impending closure of the Anchorage Adult Day-care Centre in Pembroke Dock is already having to the health and mental wellbeing of my daughter and 20 other vulnerable adults with special needs and learning difficulties, who are unable to cope with changes to routine, or to process and understand what is happening to them?

“And would the council, therefore, please review its closure decision and retain the centre and the vital and invaluable service it provides not only to the individuals concerned but also to the parents?

“If not, what specific measures does the cabinet member have in place to support my daughter and these other individuals who need extra assistance to enable them to maintain their independence, value and allow their carers to have valuable respite from their caring responsibilities and what are the estimated costs for these substitute measures?”

A Pembrokeshire County Council spokesman has previously said: “Following the engagement sessions held with families and service users regarding the future of the centre on April 10 and 17 at the Anchorage, families said that they would like to maintain the Anchorage Day Centre and explained that they would write to the council in order to ask for the decision to be overturned.

“People who attend the service will be offered alternative care, all service users are currently having their individual care needs assessed by social work teams to fully understand which other services best meet those care needs.”

An online e-petition, on the council’s own website has been launched calling for it to stay open.

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Health

Chairman opens new NHS 111 Wales Service Centre in Haverfordwest

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IN a ceremonial occasion on Thursday (May 2), Thomas Baden Tudor, Chairman of Pembrokeshire County Council, inaugurated the new NHS 111 Wales service centre at Haverfordwest Ambulance Station. The event was marked by Mr. Tudor cutting the red ribbon, a task he was honoured to perform at the behest of Matthew Jones, Locality Manager of the Pembrokeshire Ambulance Service.

The NHS 111 service, which is accessible round the clock, offers urgent health advice and information about available services, including dental care and general medical guidance. This vital resource also provides support on managing illnesses and conditions and ensures continuity of care when GP offices are closed.

Speaking at the event, Mr. Tudor expressed his pride and privilege in participating in the launch, which underscores the community’s commitment to enhancing healthcare accessibility. The new service centre is expected to play a pivotal role in providing prompt medical advice and support to the residents of Pembrokeshire.

The service is free and can be reached by dialling 111 from any phone, ensuring essential healthcare advice is just a call away.

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Health

Junior doctors secure strike extension in pay negotiations with WG

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BMA Cymru Wales has confirmed a positive development in its pay negotiations announcing that Junior doctors have secured a three-month extension to their overwhelming strike mandate.

This means that junior doctors in Wales now have the right to enact industrial action over their pay until 17 September 2024 instead of 17 June when the mandate was due to run out.

Recognising the strength of feeling amongst junior doctors and the overwhelming 98% vote by members in favour of industrial action back in December 2023, employers have agreed to honour this extension to allow talks with the Welsh Government to continue.

Co-chairs of the Welsh Junior Doctor Committee Dr Oba Babs-Osibodu and Dr Peter Fahey said of this development:

“We are pleased to be able to secure an extension to our overwhelming strike mandate. Whilst we hope to put an end to our pay dispute through pay negotiations by reaching a credible deal and restoring our pay, it was important to secure more time for our mandate.

“The extension allows us to focus on talks but also provides us with the scope to get organised and enact our legal right to strike should we need to. This is about honouring the emphatic mandate of our members.

“Doctors have experienced real terms pay cut of almost a third since 2008. They voted overwhelmingly to put an end to the devaluing of their service, they know they are not worth a third less than their predecessors and they know the time is now to stick up for the profession and turn the tide of the continued erosion of their pay once and for all”.

The Welsh Government and NHS employers have agreed to the extension as part of ongoing pay negotiations where all parties hope to reach an end to the pay dispute with junior doctors, SAS doctors and Consultants in Wales.

Last month, BMA Cymru Wales announced it was suspending forthcoming industrial action for Consultants and SAS doctors and putting plans on hold to announce more strike dates for junior doctors to allow pay negotiations to take place*.

The decision to enter pay negotiations was based on a significant proposal from the Welsh Government to form the basis of talks to end the pay disputes with all secondary care doctors including Consultants, SAS, and Junior doctors, with the aim of reaching deals which can be taken separately to their respective members.

In August last year, the BMA’s committees representing secondary care doctors in Wales voted to enter separate trade disputes with the Welsh Government after being offered another below inflation pay uplift of just 5% for the 23/24 financial year. SAS doctors on some contracts were offered as little as 1.5%. This was the lowest pay offer any government in the UK offered and less than the DDRB, the pay review body for doctors and dentists, recommended last year.

As part of their disputes, SAS doctors, consultants and junior doctors carried out successful ballots for industrial action. Since then, junior doctors have taken part in 10 days of industrial action since January this year.

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