Early warning system aims to prevent hospital-related decline and support faster recovery

HYWEL DDA University Health Board is among the first in Wales to introduce a new approach to spotting and preventing hospital-related decline in patients.

The Deconditioning Early Warning Indicator, known as DEWI, helps staff identify early signs that a patient may be losing strength, mobility or confidence during a hospital stay.

The aim is to make sure patients remain as active and independent as possible while receiving care, helping them return home at the same level of independence they had before admission, or even before they became unwell.

Deconditioning can develop quickly, even during a short stay in hospital, and can affect a patient’s physical, mental and emotional wellbeing.

The DEWI tool uses a structured set of indicators to build a picture of each patient’s abilities and to highlight any changes at an early stage. This allows staff to put timely support in place, including help with movement, nutrition, hydration and confidence.

Developed by NHS Wales Performance and Improvement, the tool has been tested across a number of health boards and was formally launched in November 2025. It is now being rolled out across Hywel Dda hospital sites.

More than 650 patients have already been supported using the DEWI tool during their hospital stay, with early indications showing positive trends in maintaining or improving function during admission.

Sharon Daniel, Executive Director of Nursing, Quality and Patient Experience, said: “We recognise that deconditioning can cause significant harm to our patients, often developing quickly and impacting independence and recovery during a hospital stay.

“It is therefore highly encouraging to see the Health Board leading the way in embedding the DEWI tool, alongside the development of a complementary Action Bundle which helps patients to stay active and independent.”

Across Hywel Dda, ward teams are now building the tool into everyday care. This includes the use of visual information boards and activities designed to encourage patients to remain active, engaged and independent.

Estelle Williams, Sister on the Acute Frailty Unit at Withybush General Hospital, said the tool was already helping staff focus on practical steps.

She said: “From a ward perspective, the DEWI tool has been really useful in helping our staff think about deconditioning as part of everyday care.

“It keeps things simple and focuses on practical actions we can take, like supporting patients to stay mobile, encouraging independence and paying attention to nutrition and hydration.

“It also fits nicely alongside the initiatives we already have in place, including the use of fortified milkshakes, bringing everything together in a more joined-up way.”

James Severs, Executive Director of Allied Health Professions and Health Science, said preventing deconditioning was central to improving outcomes for patients.

He said: “Preventing deconditioning is fundamental to improving patient outcomes and reducing the long-term impact of illness.

“This work highlights the vital role all ward staff have in keeping people active, supporting recovery and maintaining independence throughout their hospital stay.

“By identifying risks early and intervening promptly, we are helping patients recover faster and return home with greater confidence.”

The Health Board said future phases will focus on further developing the DEWI tool and embedding it as part of standard care before, during and after hospital admission.

Caption: The Deconditioning Team at Withybush General Hospital. From left: Annie, Occupational Therapy Technician; Ruth and Rosie, nurses; Lauren, Health Care Assistant; Estelle, Sister; and Violet from Hotel Services.

Child airlifted to hospital as two men arrested on suspicion of dangerous driving

FIVE people were seriously injured following a multi-vehicle collision on the A4067 near Craig-y-Nos, Powys, on Sunday evening.

Dyfed-Powys Police said the crash happened at around 5:50pm on Sunday, July 5, and involved a green Ford Fiesta, a black Volkswagen Polo and a grey Vauxhall Grandland.

A five-year-old child was airlifted to hospital with injuries believed to be life-threatening. Police said the child remains in hospital in a stable condition.

Four other people were also seriously injured and taken to hospital for treatment.

The driver of the green Ford Fiesta, a 39-year-old man, was arrested on suspicion of causing serious injury by dangerous driving and child neglect.

Police later identified a yellow Ford Fiesta as also being involved in the incident. Its driver, a 65-year-old man, was arrested on suspicion of causing serious injury by dangerous driving.

Both men remain in police custody.

Officers are now appealing for witnesses, particularly anyone who was travelling on the A4067 near Craig-y-Nos at the time of the collision and may have dashcam footage.

Anyone with information is asked to contact Dyfed-Powys Police online, by emailing [email protected], or by calling 101.

Those who are deaf, hard of hearing or speech impaired can text the non-emergency number on 07811 311 908.

Quote reference: DP-20260703-277

Former coxswain praised for four decades of dedication, major rescues and service to the Pembrokeshire coast

ST DAVIDS RNLI has paid tribute to Dai John after an extraordinary 40 years of dedicated service to the lifeboat station and the wider community.

Dai joined the crew in 1986, continuing a proud family tradition. His father served as coxswain at St Davids, while his grandfather was also a member of the crew.

Over the past four decades, Dai has been involved in countless rescues and emergency launches, serving as coxswain for 16 years and helping to save lives in some of the most challenging conditions off the Pembrokeshire coast.

Among the many incidents remembered by the station are the 14-hour rescue of the trawler Western Belle and her five crew during a night of rough seas and gale-force winds, and the dramatic rescue of three fishermen from the burning Yves Marie Amil near South Bishop Lighthouse in 2004.

Dai also recalls his very first launch, which was to a crashed jet while serving aboard the old wooden lifeboat Ruby and Arthur Reed. His service also included major incidents such as the Sea Empress disaster, as well as many other rescues which have left a lasting impression on him and his fellow crew members.

His contribution to St Davids RNLI has extended far beyond emergency call-outs. Dai was coxswain during the construction of the new lifeboat station, welcomed the arrival of the Norah Wortley lifeboat to St Davids, and helped mark the station’s 150th anniversary in 2019.

Reflecting on his 40 years of service, Dai thanked current and former crew members for their friendship, support and dedication. He also extended his thanks to RNLI fundraisers, supporters, neighbouring lifeboat crews and the emergency services he has worked alongside throughout his time with the charity.

Although his time at St Davids RNLI has now come to an end, Dai hopes to continue serving the charity by transferring to Penarth Lifeboat Station as a Launch Authority and shore crew member.

In a statement, St Davids RNLI said: “From everyone at St Davids RNLI, thank you, Dai, for 40 years of selfless service, dedication and friendship. We wish you every success in your next chapter and fair winds for the future.”