PEOPLE living with the effects of brain injury and neurological conditions have praised the positive impact of Pembrokeshire’s first therapeutic neurorehabilitation gardening group.

The group is run by Hywel Dda University Health Board’s (UHB) community neuro-rehabilitation service, an inter-disciplinary team always looking at ways of improving a person’s health, recovery, and rehabilitation.

In a partnership between Scolton Manor Park and the community neurorehabilitation service, the group provides adapted gardening and outdoor activities for eligible patients as part of their community neurorehabilitation.

Following a successful six-week pilot in 2021, participants named themselves the Heads-Up Gardening Group – or HUG – with further seasonal groups continuing throughout 2024 with varied gardening activities.

Occupational therapy staff from the community neurorehabilitation service have been pivotal in initiating and developing the therapeutic gardening group, alongside invaluable input and support from Scolton Manor Park staff and the wider multidisciplinary team.

This has included physiotherapy, neuropsychology, speech and language therapy, Neuro nurse specialist and therapy assistant practitioners and the head gardener at Scolton Manor Park.

The pilot project in 2021 was led by Phillippa Lee, Clinical Lead Occupational Therapist at Hywel Dda UHB, who said: “It has been an absolute pleasure and privilege to be able to facilitate a local therapeutic group, bringing people together to develop themselves, learn to self-manage their symptoms and support each other’s rehabilitation journey.

“The team felt people’s needs and rehabilitation goals could be met in a therapeutic group setting, which had proved successful in other counties.

“We work as a team with a shared purpose, modifying therapeutic activities within a nourishing environment, to work on individual needs and goals as part of their community neuro-rehabilitation plan.

“We have seen positive patient outcomes, with people moving on from the HUG group to voluntary roles, returning to work and embarking on other life goals.

“We are now in the process of evaluating the impact on people’s recovery and rehabilitation as HUG approaches its eleventh cohort and is due to restart again in spring 2025.”

The gardening group activity is led by Scolton Manor Park’s head gardener, Simon Richards, alongside occupational therapists and therapy assistant practitioners, with support from the community neurorehabilitation service.

Participants of the group have opportunities to become mentors or move onto the voluntary roles and opportunities at Scolton Manor Park, such as being part of the ‘Green Team’. These opportunities can then lead to paid employment.

Here is some feedback from people who have attended the group, highlighting the positive impact HUG has had on their lives:

“When I first went to the group, I felt a bit nervous and awkward to meet new people and I didn’t know what we were going to do. But it only took a few sessions to feel at ease. The staff were very helpful, and it was great to meet people that understand similar situations.”

“Such a brilliant group to be involved with. It’s so helpful to spend time with people who have similar issues. I’ve learnt a lot about gardening and moved forward a lot as a person.”

“I have enjoyed the group very much; it has helped me with my confidence. Thank you all so much for giving me my life back and all the support everyone has given me. A big thank you to Simon for all the help he has given me on this journey of life.”

“Positive supportive environment to learn more about nature and how to manage fatigue and other symptoms of brain injury. Great way to meet and enjoy time with others affected by Brain Injury and make new friends. Diolch o’r galon to Simon and the neurorehab team for great outdoor experiences.”

Phillipa concluded: “We hope to be able to continue this joint venture with Scolton Manor Park and would like to thank all those involved for making this rehabilitation opportunity possible.

“A special thanks to our partners at Scolton Manor Park, Mark Thomas and Simon Richards, and to all the staff working within the community neurorehabilitation service for their enthusiasm and commitment to continuing with this valuable group.

“We would like to especially thank our patients for inspiring us to develop HUG, for all their hard work, dedication and creativity.”

A SENEDD Member called for reform of the way the Welsh Parliament handles backbench legislation after pulling a mental health bill that received cross-party support.

James Evans announced the withdrawal of his standards of care bill, which aimed to replace outdated mental health legislation, in a statement to the Senedd on November 27.

The Conservative called for change to processes for backbench bills, which are proposed by Senedd Members who are not part of the Welsh Government.

Mr Evans, who represents Brecon and Radnorshire, won a ballot to introduce the legislation and Senedd Members unanimously backed the bill at the first stage in December 2023.

But, withdrawing the bill, he warned backbenchers face extremely difficult challenges in introducing legislation that is fit for purpose and serves people across Wales.

He said: “A guiding principle for me, since I’ve come here, is that we shouldn’t introduce legislation … that is defective and that I don’t think meets the needs of the people we serve. So, for that reason, I’ve decided to withdraw my bill.”

The Senedd has not passed a backbench bill since legislation on safe nurse staffing levels, which was introduced by the Liberal Democrats’ Kirsty Williams in 2013.

Warning the bill would take two years or more to develop, Mr Evans said: “Not many of us come into the Senedd with fully fledged law written, done, and all the regulation-making done around it – it simply doesn’t happen ….

“We’re not the government, we don’t have all the civil servants and the expertise but I do think it is something … we really do need to look at – how we improve this process.”

Mr Evans also pointed to the new UK Government bringing forward a mental health bill, saying it is important that parts of the legislation work on a Wales-and-England basis.

He urged the new “future Senedd committee”, which is examining reforms for the next term from 2026, to look into greater opportunities for backbench legislation.

Sarah Murphy, Wales’ mental health minister, was disappointed by the withdrawal of the bill but hopeful many of its aims will be achieved through the UK legislation.

Plaid Cymru’s Mabon ap Gwynfor similarly regretted withdrawal of the Welsh bill, saying it was a significant step forward in addressing serious deficiencies in mental health law.

Warning the Senedd too often falls short in living up to the promises of devolution, he added: “It shouldn’t be the height of our ambition here to simply wait for Westminster.”

Elin Jones, the speaker or Llywydd, said the Senedd’s business committee will be beginning a review of legislative processes at its meeting on December 3.

A TARGET for ambulances to respond to the most urgent 999 calls in eight minutes could be changed after services missed the mark for more than four years.

Jeremy Miles, who was appointed Wales’ health secretary in September, announced a clinician-led review of the appropriateness of emergency ambulance response targets.

The target of responding to 65% of immediately life-threatening “red” calls within eight minutes has not been met since July 2020, with latest performance standing at 50%.

In a statement on November 26, Mr Miles raised concerns about “unstainable” levels of demand, with 36,700 emergency calls in October, an average of 1,183 a day.

He told the Senedd the proportion of red category calls has soared from 4% to 5% when the target was introduced in 2015, to nearer 15% today.

Mr Miles said the ambulance service received 177 “red” calls a day in October, warning: “This was the second highest number of daily red calls to the ambulance service on record – a level of demand that is, frankly, becoming unsustainable.”

The health secretary added: “Despite the fact that the category of red calls is now approximately three times the size since the target was set in 2015, in October just over half of red calls were responded to within the target time of eight minutes.

“The ambulance service is still off target but this equates to the highest number of red calls responded to within eight minutes on record.”

He announced an expert group will review the target in the context of the Welsh Ambulance Services University NHS Trust’s evolving model of rapid clinical screening for most 999 calls.

Mr Miles said the group will consider whether new measures are required, with no response time targets currently in place for the amber nor green categories.

Sam Rowlands, the Conservatives’ shadow health secretary, suggested any change to the target could be seen as the Welsh Government trying to move the goalposts.

Mr Rowlands expressed concerns about handover delays at emergency departments, recognising a big part of the challenge remains outside the ambulance service’s control.

Mr Miles stressed the review was launched on the back of a recommendation from the Senedd’s health committee, rejecting any suggestion of seeking to swerve accountability.

“That way lies madness,” he said. “The health service is hedged around with dozens of targets. There is not a shortage of targets in the system.

“But if we are to have an honest discussion about performance in the health and care systems, we have to apply that rigour to how we look at the priorities that we set and the targets against which we measure performance.”

Plaid Cymru’s Mabon ap Gwynfor warned of grave problems in Wales’ care service, with patients unable to leave hospital to return to the community.

He told the Senedd that response time delays are a symptom of a far wider problem and the entire machinery of the health care system is in fundamental gridlock.

Mr ap Gwynfor said: “These missed targets are of course a reflection of chronic handover delays; whereas the average handover period is supposed to be 15 minutes, the current average is in excess of two hours.

“The cumulative impact was 260,000 hours being lost to handover delays at emergency departments last year.”

Mr Miles accepted that patient handover times remain “far too long” as he stressed that reducing delays is a key priority for the health service.

Labour’s Lesley Griffiths welcomed more rapid clinical screening of 999 calls after meeting Jason Killens, the chief executive of the Welsh Ambulance Services NHS Trust, last week.

The Wrexham Senedd Member said: “Having clinicians inside control rooms I think is absolutely right to target reducing harm and make sure people who are genuinely a red call receive the correct service.”

Conservative Laura Anne Jones said: “This isn’t just about statistics, it’s about lives at stake – families left waiting in fear while precious seconds tick by.

“Instead of improvement, we’re witnessing decline.”

Plaid Cymru’s Peredur Owen Griffiths welcomed the statement but argued it “stops short of the major surgery and investment that’s needed within the ambulance service”.