HYWEL DDA heath board’s announcement that its plans to transform clinical services are ‘to move to the next stage’ did not include the detail of what those plans include.

At a public board meeting held in Llandeilo on November 21, Board members approved the move to phase two (the Design Phase) of the Transforming Clinical Services (TCS) programme having considered the independent analysis report (undertaken by Opinion Research Services) on the TCS listening and engagement exercise (the Discover Phase), which concluded in September 2017.

The transformation consultation, in which the Board sought to seek public responses on proposed cuts to local services, was followed by an independent clinical review by Dr Alex Mayor.

The content of that review, while obliquely referred to in a Board press release, is not detailed.

The Herald examined the report before the board, on which it intends to engage in ‘a comprehensive programme of communication and engagement activities with [the] local population across Carmarthenshire, Ceredigion and Pembrokeshire next year’.

The Board has agreed to take these forward and to incorporate further planning of Women and Children’s services under the umbrella of our ‘Transforming Clinical Services’ programme.

The Board expresses the hope that the further engagement ‘will build on the success, and learning points, from the TCS listening and engagement exercise ‘the Big Conversation’.’

However the Board’s press release fails to mention what the recommendations actually are upon which it has set up a task and finish group ahead of public consultation on the decisions it intends to make.

The recommendations include the following:

• No return to twelve hour care provision at Withybush for the Paediatric Ambulatory Care Unit (PACU)– ‘whilst recruitment attempts to all vacant posts should continue, transition to a consultant ‘delivered’ PACU model Monday to Friday 10am to 6pm by a single, integrated team of acute paediatric consultants should be explored and confirmed at the earliest opportunity’;
• Consultant-led PACU services to be concentrated at Glangwili at weekends;
• Acutely unwell children should be admitted directly to Glangwili;
• Glangwili to be the centre for the whole board area for children and young people;
• Elective paediatric surgery should return to Withybush;
• Emergency paediatric surgery at Withybush should end.

Those recommendations are supported by the independent expert engaged by the Board confirming that many of the fears expressed by campaigners during the long – and ultimately unsuccessful – fight to retain core services at Withybush have come to fruition.

The papers considered by the Board state: ‘Dr Mayor has advised that, although well intentioned, the UHB’s desire to provide as much acute care as possible at WGH since 2014 without a comprehensive supporting infrastructure of 24/7 paediatric, anaesthetic and A&E skills has effectively weakened the overall acute paediatric service as limited staff resources have been stretched and care pathways have become confused’.

Dr Phil Kloer, the Board’s Medical Director, said: “It is important to reassure people that, at the present time, the operating hours of the PACU at Withybush Hospital will continue to be from 10am to 6pm, seven days a week.

“We are making significant efforts to progress the development of a safe and sustainable longer term staffing model for the unit as part of the wider Transforming Clinical Services design phase and formal consultation in 2018 and we will provide further updates as this work develops.”