THREE internationally educated nurses shared their personal stories about moving to west Wales as part of Hywel Dda University Health Board’s annual general meeting on 26 September 2024.

Sithara Kunjumol and Soniya Jose from Kerala, India, and Kandace Winter-Lawson, from Trinidad and Tobago, talked passionately about their experience of leaving their family and home country behind to pursue their NHS nursing career and expressed their gratitude for the warm welcome they had from Hywel Dda UHB and local communities.

Kandace, a registered nurse in the Accident and Emergency Department in Glangwili Hospital said: “Moving from the warmth of Trinidad and Tobago to the freezing cold of London in January was quite an experience, but this was countered by the warm welcome, care and support from the outstanding team in Hywel Dda.

“I’m grateful for the amazing opportunities I have been given to progress my career here, and to be able to support other international nursing colleagues. I hope to become an advanced nurse practitioner here one day. The greatest moment of my career so far was meeting HRH The King at Buckingham Palace in November 2023 and I am so grateful for this once in a lifetime opportunity.”

Soniya, a Junior Sister, who also works in Glangwili Hospital’s Accident and Emergency Department said: “I have been able to progress my career since joining Hywel Dda, including moving to a higher band role. I’m enjoying the opportunities to develop in the nursing profession and I’m proud to be able to provide greater support in A&E at Glangwili.”

Soniya’s sentiments were echoed by Sithara, a registered nurse in the hospital’s Merlin Ward who added: “I am grateful to my managers, trainers and my colleagues for helping me settle in and empowering me to grow my career here in Hywel Dda. I also very much enjoy training and supporting other international nurses and helping them to adapt here.”

The Health Board has welcomed 97 nurses and 6 doctors from the international community, alongside nurses from Wales and the rest of the UK. It continues to develop new approaches to recruitment and retention to strengthen its workforce for the future.

Neil Wooding, Chair of Hywel Dda University Health Board said: “It was incredibly moving to listen to Sithara, Soniya and Kandace sharing their experiences and I was very humbled to hear how much they feel welcomed and supported as part of our workforce family.

“On behalf of the Board, I wish them well in advancing their careers within the organisation and look forward to welcoming more staff from the international community in the future.”

During its annual general meeting, the Health Board also reflected on the past year, reviewing the organisation’s annual report, and its financial accounts. The report and presentations set out to staff, patients and the public the Health Board’s activities between 1 April 2023 and 31 March 2024, what has been challenging, and how it intends improve services for local people. 

The main themes of the meeting also included how the Health Board is progressing against its strategic objectives, its ongoing recovery from the pandemic, new initiatives, and its performance against a number of measures, including planned care, diagnostics and therapies, urgent and emergency care, cancer, mental health, patient experience, infection control and workforce.  

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 £2.66million charitable income, and of the many services and activities above and beyond core NHS expenditure which were charitable funded.

Dr Wooding added: “This annual event gave us an opportunity to reflect on another busy year, but also to look ahead to 2024/25. 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 have significant service fragilities and, whilst the compassion and professionalism of our staff is to be cherished, we accept that the quality of care and patient experience is not always as we would wish. While we have made good progress in reducing the number of patients who are waiting for treatment, we know that it is difficult for people who are still waiting and we are deeply sorry for this.

“Thank you to everyone working in and with Hywel Dda University Health Board, whatever your role, for your dedication, professionalism, steadfastness and kindness as we care for our patients every day, often in very difficult circumstances. We are proud of our Hywel Dda family and privileged to serve our communities across Carmarthenshire, Ceredigion and Pembrokeshire now and in the year ahead.

WALES’ new mental health minister set out plans to improve people’s mental health, pledging to focus on reducing waiting times for support and treatment.

Sarah Murphy, who took office in July, provided an update on the Welsh Government’s draft mental health, suicide and self-harm prevention strategies after public consultations closed.

In a statement to the Senedd on October 8, Ms Murphy said the all-age mental health strategy will ensure joined-up, person-centred and needs-led support.

She told Senedd members: “The key challenges for our NHS services include workforce, digital, data and the estate – and whilst I expect to see a focus on this in the final strategy, I have asked officials to progress work in these areas now.”

The mental health minister said the suicide and self-harm prevention strategy sets out the Welsh Government’s key priority of reducing rates.

Ms Murphy added that consultation responses raised the need to do more to identify and address factors that increase the risks of suicide.

“The feedback was also clear that self-harm needed greater prominence,” she said.

Ms Murphy told the chamber or Siambr: “Across both strategies, it is clear we need to do more to prevent, reduce and provide better support and treatment for substance use, including removing barriers for those with co-occurring mental health conditions.”

She stated the new strategies and delivery plans will be published early in 2025, shaping the direction of travel for the next decade.

Ms Murphy, who has represented Bridgend since 2021, said the ‘111 press 2’ service, which provides mental health support, received more than 100,000 calls in its first year.

In light of world mental health day’s theme of mental health in the workplace on October 10, she added that 3,500 people accessed the government’s in-work support service in 2023/24.

The Conservatives’ Gareth Davies said 15% of workers are estimated to have a mental health condition and it is the fifth most common reason for sickness absence.

The shadow mental health minister warned that the new strategies are “long overdue”.

He said: “We need assurances that there will be a focus on delivery. With previous mental health strategies we have not seen the results … with repeated failures in delivery.”

Mr Davies, who worked in the NHS for more than a decade, including in mental health, called for a focus on suicide “which is higher in Wales than other parts of the UK”.

The Vale of Clwyd Senedd member, an ambassador for Bipolar UK, warned that suicide happens at twice the rate in the most deprived areas compared to the least.

Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, described plans to close the minor injuries unit at Prince Philip Hospital in Llanelli at night as a damning indictment.

He raised comments from Jen Caton, chief executive of Llanelli Mind, warning the change will harm access to mental health support.

Mr ap Gwynfor said: “There is a great deal more to be done to ensure that the provision of mental health services is proportionate to the needs of our population.”

He told the Senedd the number of mental health beds decreased from more than 2,000 in 2010 to 1,271 this year, “which is the lowest-ever level of capacity”.

Mr ap Gwynfor, who represents Dwyfor Meirionnydd, called for the law on safe staffing levels in the health service to be extended to include mental health nurses.

James Evans raised concerns about a rise in body dysmorphia caused by digitally altered images on social media platforms such as Facebook, Instagram and TikTok.

The Tory MS for Brecon and Radnorshire said young people are increasingly seeking cosmetic surgery, which could damage their mental health in years to come.

Plaid Cymru’s Luke Fletcher warned of a “lost generation” when it comes to mental health, raising concerns about male suicide rates in his South Wales West region.

John Griffiths, who represents Newport East, highlighted plans for a new Welsh Government-funded health and wellbeing Centre in Ringland.

His Labour colleague Jenny Rathbone welcomed more co-production of services, saying: “It’s crucial we don’t just tell people, we actually have to find out what they need and want.”

AN ARTS and Health Creative Prescribing Discovery Programme exploring the potential of creative prescribing to support physical and mental health has delivered promising results in Hywel Dda University Health Board (UHB). 

Social prescribing services focus on helping patients with health and social challenges who might feel isolated and require non-clinical support. The programme aimed at creating a nurturing environment for the growth of arts on prescription across Pembrokeshire, Carmarthenshire, and Ceredigion. Running from July 2022 to March 2024, over 866 participants took part, including patients, people from communities and healthcare staff and 18 artists. 

Activities ranged from artists working ‘in residence’ within healthcare teams and Creative Prescribing Cafes which served as hubs for discussion and engagement.  

The programme, funded by the Arts Council of Wales, Hywel Dda UHB and Tywi Taf Cluster funding was led by Hywel Dda’s Arts and Health team in partnership with Hywel Dda UHB’s Public Health Team, Public Health Wales, the Social Prescribing Community of Practice, Health Education Improvement Wales, and six arts partners; Span Arts, People Speak Up, Arts4wellbeing, Haul, Arts Care Gofal Celf and Wales Arts Health and Wellbeing Network. 

Kathryn Lambert, Hywel Dda UHB Arts in Health Coordinator, explained the importance of this initiative, saying, “Creative prescribing is a way of connecting people with the arts to help people to better manage their own health and well-being.  

It’s built on the growing evidence base that activities such as singing, dancing, craft or reading a good book boosts our mood, connects us with others, and improves our well-being.  

We’ve been asking what’s needed to better connect people with the arts in their local communities through a series of cafes, residencies and projects.” 

Frank Farrer from Pembrokeshire FRAME spoke about the impact the programme had on addressing mental health challenges: “We’re looking at people that maybe having issues with something that’s been neglected for a long time across the whole of the UK, like mental health issues.  

Even people just feeling really low and depressed, anxious about just stepping outside the doorstep.  Bringing the arts in, teaching the little things or sitting down like we’ve done today, have fun cutting things out, sticking on pieces of paper.  It brings together people who might not necessarily spoken to each other for a while or have never met anybody.” 

The programme also successfully connected professionals across the arts, health, and third sectors, creating new opportunities for collaboration. Di Ford, an artist from Span Arts, described the transformative effect of participation, noting, “By the end of it, it’s like they have a sense of empowerment or achievement that they’ve created something, it builds confidence, and it can build self-esteem and things as well.” 

Dr. Cath Jenkins, GP and Academic Fellow at Swansea University, echoed these sentiments, saying, “We’ve had some really positive feedback from people that they’ve enjoyed, that they’ve had physical benefits, but also that they’ve felt that it’s been good for their mental wellbeing and that they’ve made friends and social links through it.” 

 The programme has been evaluated independently by Hywel Dda UHB’s TriTech Institute and Innovation team. According to the report, health professionals noted an increased awareness and understanding of the benefits of arts in healthcare, with 100% of junior doctors attending training events reporting an increase in their knowledge of the evidence supporting arts in health. Additionally, at the creative connections event, 93% of attendees stated they learned more about arts in health for their clients.

The evaluation also highlighted several key learnings, such as the complexity of implementing creative prescribing, the challenges of data collection, and the need for sustained funding to support future arts and health initiatives.  

Based on these insights, Hywel Dda UHB has outlined four crucial recommendations: to foster cross-sector collaboration across the health board, to develop a health-board-wide pilot arts referral programme, to explore and overcome barriers to effective data capture, and to secure funding for larger-scale research and evaluation activities. 

A video has also been released alongside this report, capturing the essence of the programme and featuring the voices of participants and professionals. This video serves as a powerful testament to the potential of creative prescribing in transforming lives and it can be viewed here.

Read the case study story published on the Wales Arts Health and Wellbeing Knowledge Bank here: https://wahwn.cymru/knowledge-bank/creative-prescribing-discovery-programme-

To know more about Hywel Dda Arts and Health Charter click here: https://hduhb.nhs.wales/arts-and-health-charter/