Health

Withybush paediatric care gone for good in yet another blow for hospital

Published

1 year ago

December 2, 2023

OVER seven years after “temporarily” closing Withybush’s 24-hour Paediatric Ambulatory Care Unit (PACU), Hywel Dda UHB decided to close the department permanently on Thursday, November 30.
In January, the Board will meet to receive the plan for its implementation plan to make the change permanent.

A FOREGONE CONCLUSION

Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as Thursday’s meeting chugged along, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.
The Board’s ability to deliver its preferred option, which included returning some outpatient services for children to Withybush, is doubtful.
However, it now needs a plan to implement its plan. That plan to have a plan for its implementation plan will be discussed in January when the Board will discuss the planned plan for a plan.
If the planned plan for a plan doesn’t work out, the Board will go back to the drawing board to draw up another plan for its plan.

A “TEMPORARY” PROBLEM

In three years, the Board moved from a 24/7 service to a promise to return to a 12/7 service to a bold attempt to preserve an 8/7 service.
As our columnist Badger noted five years ago, the next step was bound to be a 0/7 service.
And then Covid came along.
PACU was closed, and its services “temporarily” transferred to Glangwili during the pandemic.
At the end of the pandemic, PACU didn’t return.
Instead, the Board justified its continued cessation because of the risk of a spike in respiratory viruses.
When that spike didn’t happen, the Board consulted on a “permanent solution”.
And that permanent solution – as glaringly obvious for years – was permanent closure.

A DECADE OF WORTHLESS REASSURANCE

In 2014, the Board stopped providing 24-hour paediatric care at
Withybush. At the time, it said that a 12-hour provision was deliverable, and it planned to return 24-hour paediatric care to Withybush once it recruited clinical staff.
By then, there was only ONE advert for a single paediatric consultant at Withybush and NONE for nurses specialising in paediatric care.
At one point at the end of 2015, the Board suspended its recruitment campaign for posts at WithyWithybush’s after claiming to have recruited staff to fill vacancies there. It announced an intention to launch a more focused campaign later.
In November 2016, the Board restated its commitment to maintaining the Paediatric Ambulatory Care Unit’s opening hours at Withybush from 10am-10pm, even though it faced “renewed and significant workforce challenges at the consultant level”.
In 2017, CEO Steve Moore said the Board was clear: “The changes to paediatric services are temporary and in response to us needing to ensure a safe and reliable service for our families with the consultant paediatricians available.”
After ending the 12-hour PACU cover, the Board did not launch an effort to recruit for three months after its closure.
By the end of the same year, the Board said: “Unfortunately, we have not been able to recruit a sufficient number of consultants to support the re-establishment of the 12-hour PACU service, although our recruitment efforts continue.
“In the meantime, the Health Board is working with staff and partners to explore a number of ideas to support a sustainable PACU service for the longer term.”
In 2018, the Community Health Council issued a report.
It said: “The health board needs to do all it can to resolve the current temporary reduced hours arrangements in PACU”.

CONSULT THE PUBLIC, THEN IGNORE THEM

Thursday’s meeting continued to offer mealy-mouthed platitudes instead of health services.

Board members suggested that parents of children in need of paediatric care would be reassured by the clarity the permanent removal of a key service from Pembrokeshire would provide.
Discussing the lack of transport options, Board members said they would publicise the availability of the Designated Ambulance Vehicle and the use of a taxi service to ferry children and parents from Glangwili.
The disconnection between the Pembrokeshire public and the Board over the issues could not be more complete.
Board members said that the main problem with the attitude of Pembrokeshire’s concerned parents was communication.
Pembrokeshire’s respondents to the Board’s conscientious rubber-stamping process were clear the issue was not communication but concern about timely treatment close to home.
70% said PACU should return to Withybush. The Board’s alternative, closing PACU for good, was overwhelmingly rejected.
If communication were the issue, not the provision of treatment at Withybush, the Board could have resolved it by being straightforward and transparent.
It wasn’t.
All the communication in the world, delivered by the best communicators money can buy, cannot circumvent that epic failure of honesty.
Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as the meeting ground on, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.

TOTAL DISCONNECTION

PERMANENT CLOSURE “BETTER”

Six years ago, “temporary” became the status quo.
Then “temporary” became a further “temporary reduction”. During Covid, the whole service was “temporarily” withdrawn.
So intense was Board members’ collective delusion at Thursday’s meeting that the permanent removal of the PACU service and its replacement with a vague promise of some outpatient clinics for children returning to Withybush sometime over the rainbow was represented as an improvement on the current position.
Even this Thursday morning, the current position was “temporary”, not permanent.
The Health Board’s thesaurus must look very peculiar.
Its word games demonstrate the extent to which the Board had long dispensed with the pretence of PACU’s closure temporary nature.
In the meantime, the Board plans to tell more people about its Dedicated Ambulance Vehicle and plans to fund taxis for distressed parents and sick and injured children.
You can bet that’ll make everything better.

Health

Pressures remain high despite the end of ambulance ‘critical incident’

Published

2 days ago

January 1, 2025

Tom Sinclair

AMBULANCE service pressures remain high despite the end of a 48-hour critical incident declared by the Welsh Ambulance Service.

The incident, triggered by overwhelming demand and a backlog of 340 emergency calls on Monday, was formally stood down after significant strain on resources.

Judith Bryce, assistant director of operations, said: “While the critical incident is behind us, significant pressures remain, and it’s really important that the public play their part to protect our precious resources for those who need them most.”

Ambulance chiefs have urged the public to use the service responsibly, advising people to only dial 999 in life-threatening emergencies and consider alternatives such as NHS 111 Wales symptom checkers, pharmacists, minor injuries units, or GPs.

“For anyone under the weather after New Year’s Eve celebrations, consider what you can do at home to self-care, including for common ailments like coughs, sore throats, and diarrhoea,” Ms Bryce added.

She also warned the public to take extra care while yellow weather warnings for heavy rain and high winds remain in place, highlighting the risk of accidents on the road and injuries from slips, trips, and falls.

The pressures extended beyond the ambulance service, with health boards including Cwm Taf Morgannwg, Hywel Dda, Aneurin Bevan, and Cardiff and Vale reporting increased demand. These boards introduced mask-wearing measures last week due to rising flu cases.

Jason Killens, chief executive of the ambulance service, described the critical situation as “very rare” and stressed the importance of using emergency services wisely.

This is not the first time a critical incident has been declared during winter pressures. In December 2020, south Wales experienced a similar crisis, while an extraordinary incident was declared in 2023 after an ambulance waited over 28 hours outside a hospital.

The Welsh government acknowledged the ongoing pressures on urgent and emergency care services and urged the public to carefully consider their options before seeking care.

Health

Critical incident declared by Welsh Ambulance Service due to demand

Published

3 days ago

December 31, 2024

Tom Sinclair

A “CRITICAL INCIDENT” was declared by the Welsh Ambulance Service on Monday (Dec 30) evening due to significantly increased demand and extensive handover delays.

The service, which covers more than three million people across Wales, reported over 340 calls waiting to be answered at the time the incident was declared.

More than half of the ambulance vehicles were stuck outside hospitals waiting to hand over patients, resulting in some people waiting “many hours” for an ambulance and delays in answering emergency calls.

***Ambulances outside Withybush Hospital in Haverfordwest (Image: Herald)***

Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, James Evans MS, said: “Another critical incident declared by the Welsh Ambulance Service with over 340 calls waiting, ambulances stuck outside hospitals, and patients waiting hours for care.

“This is not just a winter crisis, it is a symptom of long-term failures in Labour-run Wales. Patients and frontline workers deserve better.

“It’s time for real leadership to fix this problem once and for all.”

The public has been urged to call 999 only in the event of serious emergencies.

The Welsh Ambulance Services University NHS Trust said it had implemented additional measures to ensure services could continue.

Stephen Sheldon, Head of Service, said: “It is very rare that we declare a critical incident, but with significant demand on our service and more than 90 ambulances waiting to hand over patients outside of hospital, our ability to help patients has been impacted.

“Regrettably, this means that some patients will wait longer for an ambulance to arrive and for their calls to be answered.

“For that, we are very sorry because this is not the level of service we want to provide.

“We understand that this is frustrating for patients, but can assure them that we are doing everything we can to relieve the pressure on our service.”

A critical incident is the highest alert level used by the NHS, allowing management to take immediate steps to create capacity.

Sheldon added: “The public can help by only calling 999 in the event of a life-threatening emergency – that’s a cardiac arrest, chest pain, breathing difficulties, loss of consciousness, choking, or catastrophic bleeding.

“If it’s not a life-threatening emergency, then it’s important you use one of the many alternatives to 999, starting with the symptom checkers on our NHS 111 Wales website, as well as your GP, pharmacist, and minor injuries unit.”

Earlier on Monday, Walsall Healthcare NHS Trust, which operates Walsall Manor Hospital, also declared a critical incident due to rising numbers of people needing urgent and emergency hospital care, predominantly for respiratory conditions.

Health

Hospital visiting precautions in place ‘to protect patients’

Published

4 days ago

December 30, 2024

Tom Sinclair

VISITORS to hospitals across Carmarthenshire, Ceredigion, and Pembrokeshire are being asked to only attend if they are free of any potential flu-like symptoms, or any sickness or diarrhoea. Additionally, they may be requested to wear face masks before entry to certain wards or departments.

Seasonal flu and winter vomiting viruses are affecting patients on several wards with infection prevention and control actions being taken, as necessary.

Visitors are asked to only come to see their loved ones if they are free of any infections, to wash hands before leaving home and clean hands on arrival at the hospital/ward using the hand sanitiser. Visitors may also be asked to wear face masks/coverings on the ward/department they are visiting. Masks will be available at the hospital entrance or can be provided on affected wards.

There are additional restrictions in place that limit visitors to:

Acute Medical Assessment Unit (AMAU) at Prince Philip Hospital, Llanelli. Please discuss individual patient visiting arrangements at AMAU with the nurse in charge.
This arrangement will be reviewed daily, and restrictions will be lifted as soon as possible. The health board’s website will be updated daily with details of wards with enhanced restrictions on visiting.

Janice Cole Williams, Assistant Director of Nursing at Hywel Dda University Health Board
said: “Within affected wards, all staff are wearing masks and visiting is limited at Prince Philip Hospital’s AMAU to help stop spread of infection.

“Our local community can help us avoid outbreaks of infection by not visiting family and friends in hospital if they are feeling unwell themselves.

“Annual flu vaccination is also undoubtedly the best way to protect against catching or spreading flu. Not only can it prevent you from becoming very unwell, it can also help reduce your risk of secondary infections such as pneumonia, which can be dangerous if you are clinically vulnerable.”

Vaccination centres are open, with no appointment needed today (Monday), until 5.30pm and tomorrow, Tuesday, December 31 for all people eligible for flu and COVID-19 vaccinations. This includes children aged two years (on 31 August 2024) to those in year 11 who can access the nasal flu vaccine at the centres.

Drop in any time between 9.15am and 5.30pm to your nearest vaccination centre:

Aberaeron (Aberaeron Integrated Care Centre, Vicarage Hill, Aberaeron, SA46 0DY)
Llanelli (Unit 2a, Dafen Industrial Estate, Heol Cropin, SA14 8QW)
Neyland (Unit 1 Honeyborough Retail Park, SA73 1SE)
The following groups are eligible for vaccination:

Flu vaccination

Children aged two and three years on 31 August 2024 
Children in primary school from reception class to year 6 (inclusive)  
Children in secondary school from year 7 to year 11 (inclusive)   
People aged six months to 64 years in clinical risk groups   
People aged 65 years and older (age on 31 March 2024)   
Pregnant women  
Carers aged 16 and over 
People aged six months to 65 years who live with someone who has a weakened immune system   
People with a learning disability  
Frontline health and social care workers  
All staff working in care homes with regular client contact
Poultry workers at high risk
COVID-19 vaccination

People aged six months to 64 years with a long-term health condition (which includes pregnant women and people with a weakened immune system)
Residents in a care home for older adults
People aged 65 years and older (age on 31 March 2025)
Unpaid carers
Frontline health and social care workers
Staff working in care homes for older adults
If you have any questions about accessing the flu and/or COVID-19 vaccine, please phone the health board on 0300 303 8322 option 1 or email: [email protected]