SENEDD Member Paul Davies has called for urgent action over statistics which show that 63.3% of patient pathways assessed as being at highest risk of irreversible harm are waiting beyond their target date for treatment in the Hywel Dada University Health Board area. The latest figures from the Welsh Government show that 11,295 patients in the Hywel Dda University Health Board area are at the highest risk of irreversible harm because of waiting beyond their target date for treatment.

Mr Davies said, “These statistics are extremely alarming and behind them are thousands of people living in west Wales at risk of irreversible sight loss because they are waiting too long for their appointments. Not only are many of these patients in pain and discomfort, but some have also lost jobs because of their deteriorating eyesight.  

“We need action as a matter of urgency and I urge the Welsh Government to endorse the National Clinical Strategy for Ophthalmology and prioritise its implementation. Eye care services are still under huge pressures, its infrastructure requires significant investment and there are serious recruitment and retention issues. Therefore, it’s vital that this is prioritised immediately – as each month that passes without a commitment to improve eye care will result in more and more people being added to waiting lists.”

THE NHS in Wales continues to navigate a complex landscape of challenges and achievements as it strives to deliver quality healthcare to its population.

Recent reports highlight both the pressures faced by the system and the initiatives underway to address them.

Healthcare professionals across Wales have expressed concerns over increasing workloads and resource constraints. Hospitals are grappling with high patient numbers, leading to extended waiting times for elective surgeries and specialist consultations. According to figures released by NHS Wales in September 2023, the number of patients waiting for treatment exceeded 750,000—a record high.

Emergency departments have reported surges in attendance, putting additional strain on staff and facilities. In August 2023, A&E departments across Wales recorded their busiest summer on record. Dr. Rachel Davies, an A&E consultant at the University Hospital of Wales in Cardiff, commented, “We’ve seen unprecedented numbers of patients this year. Our staff are working tirelessly, but the demand is overwhelming.”

In rural areas like Pembrokeshire, the situation is compounded by geographical hurdles. This newspaper has recently highlighted concerns over ambulance response times in the county, noting that residents in remote locations often face longer waits for emergency services. Local resident Sarah Jenkins shared her experience: “When my mother fell ill, it took over an hour for the ambulance to arrive. In critical situations, every minute counts.”

A shortage of medical personnel remains a significant issue. Recruitment and retention of doctors, nurses, and allied health professionals are ongoing concerns. The Royal College of Nursing Wales reported in October 2023 that there are over 1,800 nursing vacancies across the country. Many professionals cite burnout and limited resources as factors influencing their decision to leave or avoid joining the NHS workforce in Wales.

Eluned Morgan, the Welsh Minister for Health and Social Services, acknowledged these challenges during a recent Senedd debate. “We are acutely aware of the staffing shortages and the immense pressure our healthcare workers are under,” she said. “Addressing these issues is a top priority for the government. We’re investing in training and recruitment to bolster our workforce.”

Opposition parties have called for more decisive action. Plaid Cymru’s health spokesperson, Rhun ap Iorwerth, stated, “The staffing crisis in our NHS is not just a numbers problem; it’s about the wellbeing of those who dedicate their lives to caring for others. We need urgent measures to support and retain our healthcare professionals.”

In response to the mounting pressures, the Welsh Government has increased funding for the NHS, aiming to improve infrastructure and service delivery. The 2023 budget included an additional £425 million allocated to health and social services. Investments are being made in modernising hospitals, expanding digital healthcare services, and streamlining patient care pathways.

The then First Minister Mark Drakeford addressed the situation during a press briefing in September 2023: “Our commitment to the NHS is unwavering. We are working closely with health boards to tackle waiting times and ensure that everyone in Wales has access to the care they need.”

The government has also launched targeted recruitment campaigns and enhanced training opportunities to bolster staffing levels. “We are investing in our future workforce,” Eluned Morgan added. “By supporting education and providing incentives, we aim to attract new talent to the NHS and retain our valued staff.”

Despite the hurdles, there are success stories emerging within the NHS in Wales. Community-based health programmes are making strides in preventive care, focusing on wellness and early intervention to reduce the burden on hospitals. For instance, the “Healthy Pembrokeshire” initiative aims to promote healthy lifestyles through local events and education.

Telemedicine initiatives have been accelerated, particularly in response to the COVID-19 pandemic, enhancing access to care for those in remote areas. Dr. Gareth Thomas, a GP in Ceredigion, noted, “Virtual consultations have been a game-changer for patients who live miles away from the nearest clinic. It has significantly improved access to care and reduced travel times.”

Healthcare professionals are also embracing collaborative approaches, with multidisciplinary teams working together to provide comprehensive care. These efforts aim to improve patient outcomes and increase efficiency within the system.

Patients have offered mixed feedback on the state of the NHS in Wales. While many praise the dedication of healthcare workers and the quality of care received, others express frustration over delays and difficulties in accessing services.

John Evans, a patient awaiting hip surgery, shared his experience with Wales Online: “I’ve been on the waiting list for over 18 months. The pain limits my mobility, and it’s affecting my quality of life. I understand the pressures the NHS is under, but the delays are disheartening.”

Advocacy groups are calling for increased transparency and patient involvement in decision-making processes. The Patients Association Wales has urged the government to “prioritise patient voices in policy development and healthcare planning.”

The Welsh Conservative health spokesperson, Russell George, commented, “Patients are bearing the brunt of systemic failures. The Welsh Government must take responsibility and implement effective strategies to reduce waiting times and improve service delivery.”

The NHS in Wales stands at a critical juncture. Balancing immediate demands with long-term strategic planning is essential to address the systemic issues at hand. Continued investment, innovative solutions, and collaborative efforts between the government, healthcare providers, and communities are key to strengthening the NHS for future generations.

As the nation navigates these challenges, the resilience and commitment of its healthcare professionals remain a beacon of hope. The path forward will require concerted efforts to ensure that the NHS can continue to uphold its founding principles of providing comprehensive, accessible healthcare to all.

SENEDD Member Paul Davies has criticised Hywel Dda University Health Board’s decision to
proceed with the transfer of patients from St David’s surgery to surgeries elsewhere in
Pembrokeshire. In a board meeting held on the 26 th September 2024, the Health Board also
confirmed that it is in discussions with Shalom House in St David’s about the establishment
of a branch surgery to deliver some services.
 
Mr Davies said, “It’s shameful that Hywel Dda University Health Board is pushing ahead with
these plans, despite the vocal opposition shown by the local community.
 
“The city of St David’s will soon be the only city in the United Kingdom without a GP surgery,
and I’m appalled that the Health Board has allowed this to take place. For many people the
travel to other surgeries from St David’s is just too far and too stressful and a weak
commitment to coordinate surgeries with bus times is just not going to cut it.”
 
“Residents have been trying to engage with the Health Board and urging the management to
look at a range of other options and it appears as though the Health Board is unwilling to
consider the views of the people of St David’s. The people of St David’s deserve better, and
I hope all political representatives in Pembrokeshire can work together to stand up for the
local community.”

But Hywel Dda University Health Board says it is continuing the work to prepare for the transfer of patients from St David’s Surgery in Pembrokeshire to nearby surgeries ahead of the end of October when the current contract will come to an end.

The Health Board agreed that the care of patients at St David’s Surgery in Pembrokeshire would be transferred to local practices as close as possible to where they live, in a meeting of the Board at the end of July.

The Health Board also committed to work on establishing a Branch Surgery in St David’s providing services for part of the week for those patients transferring to nearby Solva Surgery.

Jill Paterson, Director of Primary Care, Community and Long-Term Care, at Hywel Dda announced at a Board Meeting today (Thursday, 26 September) that the Health Board is in discussions with Shalom House in St David’s about the establishment of a Branch Surgery

“The location on Nun Street is convenient for patients and is a well-established organisation which is well-supported by the local community and we are delighted to be working with the Shalom Trustees to take forward this development,” said Ms Paterson.

“We are in the process of planning services to be delivered by a multi-disciplinary team and are planning community services there and some cluster-based services too.”

The decision to transfer patients from St David’s Surgery was made following an extensive period of engagement with patients at the practice and Llais, the patient’s voice organisation for Wales. This followed the decision by the one GP who runs the surgery to resign his General Medical Services Contract.

From 1 November 2024 the Solva GP Surgery will be known as the Peninsula Practice/ Meddygfa Penrhyn to reflect the broader reach of the Practice. The name was proposed by the Peninsula Working Group, which includes representatives from St David’s City Council and Solva and Llanrhian community councils. 

The employed staff at St David’s Surgery will transfer to Peninsula Practice to join the growing team there, including administration and nursing staff and the salaried GP.

All patients at St David’s Surgery will have been sent a letter informing them which Practice they will be transferred to, and everyone will be contacted soon with a welcome letter with further information.

Ms Paterson said: “The planning for the transition is well under way. Patients don’t need to do anything – we will be transferring all records and registrations.

“Meanwhile, work to adapt the surgery building in Solva to accommodate the additional staff and patients will be taking place in the coming weeks.  This involves internal alterations to the surgery building which will be taking place over the coming weeks to convert underused rooms into consulting and treatment rooms, and to move some office space to the first floor.”

Ms Paterson said that she was aware that some of the St David’s Surgery patients were concerned about travelling to Solva for appointments.

“In terms of travel, we recognise that this is a challenge. Some individuals are going to have to travel three miles to the Solva Surgery, but we hope that that need will not be significant because we are working to provide as many services in the local community that we can.

“We have also been working with PACTO – the Pembrokeshire Association of Community Transport Organisations. They have helped us develop a leaflet and they are looking for volunteer drivers to assist with this process, so that they can respond to need where buses are not available for individuals.

“We have also had a commitment from the surgery that, as far as possible, when people do need to go to the surgery, they will try to co-ordinate appointment times with bus times.”

For those who need to travel to the Peninsula Surgery in Solva, there will be information regarding public transport options for patients on the surgery website.

Patients who require help or further information should contact the Health Board by telephone us at 0300 303 8322 (option 5), or email [email protected].