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Future of paediatric services at Glangwili and Withybush to be decided next week

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HYWEL DDA University Health Board says it has received the final independent evaluation report following the end of its 12-week public consultation on potential changes to urgent and emergency children and Young People’s (Paediatric) services in Glangwili and Withybush Hospitals.

The report was commissioned from, and written by, Opinion Research Services (ORS), who have independently advised, collated, and managed the consultation responses.

Held between the 26 May and 24 August 2023, the consultation invited the public, health board staff, partner organisations, and the wider community to share their views on how paediatric services should be delivered.

Following the temporary changes to paediatric services made since 2016, the health board now needs to find a longer-term solution, that will be in place until the proposed new urgent and planned care hospital is developed.

Consultation respondents were presented with and asked to consider three options for changes to the current services provided at Withybush and Glangwili Hospitals. At this stage, there is not a preferred option for how urgent and emergency paediatric services at will be delivered in the future.

Professor Phil Kloer, Executive Medical Director and Deputy Chief Executive Officer of Hywel Dda University Health Board said: “For all three options, it is important to note that access to children’s emergency care will be retained at Glangwili Hospital’s emergency department, and minor injuries for children will continue to be treated at both Withybush and Glangwili hospitals. Also, systems are already in place to ensure that any child or young person with critical conditions arriving at Withybush Hospital has the best care available and in the most appropriate place. This will continue as part of the new service.”

As part of the formal consultation, a number of health board stakeholder groups were asked to take part in a process called conscientious consideration. This involved them reading the ORS report alongside all other evidence and relevant information collated during the process so far, considering the available options, and then evaluating them. In doing so, they were asked if there were any further changes the health board should consider, whether the report has identified all equality issues, and any final points that had not already been captured. This process is ongoing.

The ORS final report, together with the output of the conscientious consideration process, and the technical and commercial reports, will be considered at a meeting of the Board on Thursday 30 November 2023 at 9.30am. During this meeting, the health board’s Board members will also be asked to conscientiously consider the key findings from the ORS report alongside the findings from the stakeholder groups’ own considerations. The Board will then make a decision on which option to proceed with.

Lee Davies, Executive Director of Strategy and Planning for Hywel Dda University Health Board, said: “The health board would like to thank the community, staff, partner organisations and everyone that took the time to meet with us and share their views during this consultation process. The Board looks forward to the next steps in the consultation process as it considers all the feedback received.”

The meeting of the board is available for public viewing, details of how to do so can be found on the health board’s website: https://hduhb.nhs.wales/about-us/your-health-board/board-meetings-2023/board-agenda-and-papers-30-november-20232/ The Board papers that will be discussed at the meeting, are also available at the same link.

For further information on the consultation, please visit the health board’s website: https://hduhb.nhs.wales/future-children-services

Health

Calls to prioritise dementia as nearly half remain undiagnosed in Wales

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Alzheimer’s Society Cymru launches petition amid fears of rising cases and missed care

A CAMPAIGN has been launched to urge the Welsh Government to make dementia a national priority, as figures show that nearly half of those living with the condition in Wales remain undiagnosed.

Alzheimer’s Society Cymru is asking the public to back its Wales Takes on Dementia petition, which aims to send a clear message to current and future ministers that urgent action is needed. More than 50,000 people in Wales are currently living with dementia, yet around half have no formal diagnosis — meaning they may be missing out on vital treatment, care and support.

Geoff Mock, from Swansea, who lives with vascular dementia, is calling on the public to add their names. He said: “Living with vascular dementia hasn’t been easy, but it hasn’t taken away who I am. A diagnosis is the start of a new chapter — one that can still be full of purpose and dignity.”

Geoff chaired the Alzheimer’s Society Wales Dementia Conference on Tuesday (July 8), held at the Pierhead Building in Cardiff Bay. The event brought together healthcare professionals, policy experts and people with lived experience to discuss Wales’ dementia diagnosis rate — the lowest in the UK at just 56%.

Luke Fletcher MS, Chair of the Senedd Cross-Party Group on Dementia, also addressed the conference and backed calls for dementia training to be made mandatory for all social care workers.

Gemma Roberts, National Influencing Manager for Alzheimer’s Society Cymru, warned that the number of dementia cases in Wales is projected to rise by more than 37% by 2040 — to nearly 70,000. She said: “It currently costs Wales £2.3 billion annually — a figure expected to double by 2040. But beyond the financial toll, the human cost is immeasurable. Now is the time for bold, innovative leadership on dementia.”

The charity is calling for the introduction of a new Wales Dementia Action Plan and is urging all political parties to commit to making dementia care a core priority for the next Welsh Government.

To sign the petition, visit: alzheimers.org.uk/petition-wales

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‘The future for general practice is grim’: GPs sound alarm about funding crisis

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GENERAL practitioners called for an overhaul of an “outdated, unfair” funding model, warning of an “enormous and growing” inequity putting patient safety at risk.

Doctors gave evidence as the Senedd’s health committee began an inquiry into the future of GPs amid concerns about more than 100 surgeries across Wales shutting since 2012.

James Pink, a GP partner in Llanishen, Cardiff, expressed concerns about the Carr-Hill formula, used to allocate funding to practices, which was designed in the late 1990s.

He said: “There’s almost no correlation between funding and deprivation which beggars belief. And the correlation between age, sex and funding isn’t as clear cut as you’d think.”

Dr Pink told the committee variation across Wales means an average practice could be £862,000 worse off than another similarly looking after 10,000 patients.

Noel McLoughlin, a partner at St Isan Road Surgery in Heath, said his colleague found Cardiff and Vale GPs were the worst-funded in the whole of Wales and England.

Dr McLoughlin wrote to the committee: “This means that the Carr-Hill formula regards Cardiff as the wealthiest and healthiest area with the lowest needs.

“This is clearly nonsense. The inequity in funding in Wales alone is enormous – worse still, it is growing. This must stop or the future for general practice and primary care in Cardiff is grim. No-one will want to work here.”

The GP warned: “All patients in all areas are having difficulty accessing primary care. We are struggling to maintain safe levels of working with the current demand and it is going to rise.”

Kate Baker, another Cardiff GP, wrote: “It has been distressing to see the deterioration in funding and support for general practice over the 17 years I have worked as a GP.

“The partners in our practice have not seen a pay rise for nine years and, in fact, the imposed contract for 2023/24 led to a pay cut.”

Giving evidence on July 10, Richard Stratton, a GP partner in Powys, agreed about the necessity of updating the “unfair” formula but cautioned that it will remain a blunt tool.

Dr Stratton told the health committee: “What we also need to factor in is the supplementary services that general practices participate in on top of the core contract.”

He said: “The combination of a revised formula plus better use of local services… would take us forward enormously. At the moment, both feel hamstrung by budgetary constraints.”

Asked about the system of annual negotiations on the General Medical Services (GMS) contract, Dr Stratton said single-year budgets have a debilitating impact on investment. “Without that ability to plan, everything is crisis management,” he warned.

John Williams, a practice manager in north Wrexham, described the contract process as piecemeal and rushed, criticising “tokenistic” smaller investments for posters and suchlike.

Mr Williams pointed to a “double whammy” on employer national insurance contributions, with no public exemption and no £10,500 employment allowance like private businesses.

He said his 13,000-patient practice also faces a £70,000 or 20% overnight increase in its wage bill due to changes to the national living wage.

In its written evidence, the Royal College of General Practitioners said GPs worked across 516 practices in Wales in 2002 but only 374 remain today.

Angharad Fletcher, a GP in Flintshire, warned health board-managed practices are much more expensive to run compared with GMS surgeries yet deliver a “vastly inferior service”.

“GMS is underfunded,” she wrote. “Costs have risen significantly over the past five years and income has not matched that which means in some cases surgeries are having to cut staff when the demand is greater than ever.”

Dr Fletcher added: “There is no longer a workforce crisis. There are many qualified GPs looking for work. Practices cannot afford to employ them.”

One GP, who wished to be anonymous, expressed grave concerns, warning: “We are struggling to provide an acceptable service to our patients. The funding for our practice has been eroded over the last 12 years, such that I have fears there will be harm to patients.”

Another concluded: “If politicians are to be the driver of change then we need politicians on board who have vision and energy to drive this forward.

“I have dealt with two politicians from different parties over the past nine months and each left me with the feeling that no-one really understands the issues or even cares.”

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Health

Welsh Lib Dems launch major survey on health and social care

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Party seeks 100,000 responses to shape future NHS reform in Wales

THE WELSH LIBERAL DEMOCRATS have launched a nationwide survey to gather public views on the state of the NHS and social care system in Wales.

Aiming for 100,000 responses, the NHS and Social Care Survey is designed to uncover what is working — and what is not — within Welsh healthcare. The results will help the party develop what it describes as a bold, evidence-based plan to reform services ahead of the 2026 Senedd elections.

Launching the initiative, Welsh Lib Dem leader Jane Dodds MS said: “Despite the incredible dedication of our doctors, nurses and care workers, after 25 years of Labour rule the NHS and social care system here in Wales simply isn’t working for too many people.

“Whether it’s unacceptable waits for surgery or the growing crisis in NHS dentistry, people are being let down — and it’s time for change.

“That’s why we’re asking people across Wales to share their experiences and ideas. Your voice will help shape a bold, evidence-led plan to fix our health and social care services and ensure they’re fit for the future.”

The survey is available online and in print, with party volunteers distributing copies in communities across Wales. The party is encouraging anyone living in Wales to take part.

Health and social care reform is expected to be a key pillar of the Welsh Liberal Democrats’ manifesto for 2026.

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