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Better pregnancy or baby loss bereavement care for people in Wales

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SANDS the UK’s leading pregnancy and baby loss charity, is supporting the National Strategic Clinical Network for Maternity and Neonatal Services to create tailored bereavement care pathways for those who have experienced pregnancy or baby loss in Wales.  

The pathways aim to reduce inequalities and improve the quality of bereavement care provided to parents and families, and has been made possible by funding from the Welsh Government. The pathway materials will include guidance for healthcare professionals based on evidenced best-practice, and a set of standards relating to important aspects of bereavement care.

Good quality bereavement care is vital for parents who have experienced the loss of a pregnancy, or whose baby has died. It includes sensitive communication with parents, providing a bereavement room away from maternity or labour wards, and parents being given informed choices about decisions relating to their care and the care of their babies.
 Clea Harmer, Sands’ Chief Executive, said: “Everyone affected by pregnancy loss or the death of a baby deserves high quality bereavement care and support. 

“We know that no level of care can remove the grief that many parents will feel after pregnancy loss or the death of a baby, but good care can make this devastating experience feel more manageable. We also know that poor quality or insensitively delivered care can compound and exacerbate pain.

“This launch follows a huge amount of hard work and determination from our partner organisations, the generous support of many bereaved parents and families, and medical professionals who have shared their experiences.

“We hope that through supporting the National Strategic Clinical Network for Maternity and Neonatal Services, we can work together to make sure everyone affected by pregnancy or baby loss gets the care that they need.”

In developing the pathways for Wales, Sands carried out a series of listening events for parents and health professionals during 2024, to understand how bereavement care in Wales can be improved. 

These insights will be incorporated into work with the National Strategic Clinical Network for Maternity and Neonatal Services to introduce pathways to address specific needs after miscarriage, Termination of Pregnancy for Foetal Anomaly (TOPFA), stillbirth, neonatal death or Sudden Unexpected Death in Infancy (SUDI).

Chief Midwifery Officer for Wales, Karen Jewell said: “We are delighted that we have been able to support this important initiative to develop and implement a National Bereavement Care Pathway for Pregnancy and Baby Loss.

“Pregnancy loss or the death of a baby is devastating, and this initiative will help to ensure that every family who suffer from this are appropriately and compassionately supported.

“Our significant investment into bereavement services will improve care and ensure consistency across Wales, the Bereavement Support Grant will continue to support organisations like Sands to extend and deepen bereavement support and fill the gaps that currently exist.”

Healthcare professionals are an important part of the Sands community, and the charity wants to support them to deliver good bereavement care. The pathways will introduce dedicated support for medical staff who care for bereaved families in Wales.

Cara Moore, Lead Midwife from the National Strategic Clinical Network for Maternity and Neonatal Services said: “We are thrilled to be leading the development and implementation of the development and implementation of bereavement care pathways in Wales in collaboration with Sands. The development of pathways will ensure consistent high quality and sensitive bereavement care is offered to all bereaved parents in Wales. This will be supported through training, interdisciplinary collaboration and continuous monitoring and promises a sustained improvement in the experiences of bereaved parents.

“We are also pleased that the implementation of the pathways align with and supports long term plans for the delivery of high quality maternity and neonatal care in Wales.”

Marc Harder, Head of Bereavement Care & Hospital Liaison at Sands, said: “Earlier this year, bereaved parents and families in Wales generously shared their stories of pregnancy and baby loss with us during a series of listening events. Key themes that arose included gaps in compassionate care, inappropriate and insensitive medical terminology, care outside of the hospital and inconsistency in bereavement care provision.

“We are delighted to be working in partnership with the National Strategic Clinical Network for Maternity and Neonatal Services to develop bereavement care pathways that will begin to address these concerns and lead to higher quality care at such a difficult time for parents and families. We will continue to work with parents, professionals and other stakeholders to ensure an evidence-based and community-led approach to the development of Wales-specific pathways.”

More information about the bereavement care pathways in Wales
The project in Wales is led by Sands in collaboration with a number of other charities and professional organisations, and funded by the Welsh Government. The project provides dedicated, evidence-based care pathways designed for all healthcare professionals and staff involved in the care of women, birthing people, partners and families at all stages of pregnancy and baby loss.

Five experiences of pregnancy or baby loss are included in the pathway project including miscarriage, TOPFA, stillbirth, neonatal death and SUDI.

Sands is here to support all bereaved families in Wales and across the UK. The charity provides support through its Freephone helpline, online community and resources, and through a network of regional support groups run by trained befrienders, all offering in-person peer support. 
 Find out more about all the ways the charity offers bereavement support.  

Health

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

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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.

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Health

Critical incident declared by Welsh Ambulance Service due to demand

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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.

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Health

Hospital visiting precautions in place ‘to protect patients’

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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]

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