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Ground breaking telehealth trial supports people with long term conditions in West Wales

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A GROUND breaking telehealth trial has been deployed across West Wales to support people living at home with long term health conditions. One third of adults in Wales, around 800,000 people, have a long term health condition.

Hywel Dda Local Health Board is working in partnership with Delta Wellbeing, global health and care technology solutions provider Tunstall Healthcare and local primary care services support patients across Carmarthenshire, Ceredigion and Pembrokeshire living with long term conditions, such as cardiac, lung and chronic disease, at home using pioneering telehealth equipment.

The initiative focuses on supporting wellbeing in the community using remote monitoring and is transforming the way that care services are delivered to people living with long term conditions. From a service perspective, telehealth means that patients can remain in their own homes, with the reduced need to travel to appointments, and decreasing the need for staff to see patients who can be supported remotely. This in turn reduces stress and expense, and improves the quality of life for patients and their families.

Commenting on the telehealth trial, Gavin Bashar, managing director at Tunstall Healthcare, said: “Long term health conditions account for approximately 50% of all GP appointments, and more than 70% of all inpatient bed days. Using telehealth can help to provide ongoing monitoring to these patients in their own homes, enabling early intervention and empowering them to feel more confident in managing their health.

“Patients in the trial use using telehealth equipment including a blood pressure cuff, weighing scales and a pulse oximeter. The readings from these devices are transmitted to the Tunstall myMobile app on their smartphone and all the information submitted by the patient can be viewed remotely by clinicians 24/7, allowing preventative action to be taken.

“The telehealth service means that changes to a patient’s health or any response to medication can be monitored in real time, ensuring help can be provided at the earliest opportunity. This can lead to a reduction in the need for more complex interventions. The service has protected the wellbeing of vulnerable patients, improved outcomes in patients living with long term conditions, enabled the faster discharge of patients from hospital and provided personalised monitoring of complex comorbidities.”

Clinicians use software that provides a dashboard which prioritises patients that are most in need of care, and allows specialist nurses and primary care to remotely monitor each patient’s symptoms and progress. Areas of concern will generate an email or text message to clinicians, enabling them to be addressed promptly. The technology also allows patients to have consultations by video helping to avoid unnecessary visits to clinics or hospitals. When required, face to face appointments will be arranged for further treatment and consultation.

So far around 300 patients have been supported through the service. Early assessment of patient reported outcome measures show improvement of quality of life and a change in behaviour with improved physical and psychological outcomes.

Speaking on the benefits of home monitoring, 79-year-old cardiac patient Pat , said: “My heart nurse asked me if I would try this new technology that they were bringing in. I’ve had absolutely no problems what-so-ever. It’s no more difficult than going into a GP surgery. It’s all connected to the iPad I have been given which then goes straight through to the heart clinic. It’s so easy! You can do everything from your own armchair no problem at all.”

Clare Marshall, heart failure specialist nurse for Hywel Dda Local Health Board, added: “Telehealth equipment allows me to manage medication changes from a distance, which patients really like. I have been able to prevent hospital admission and more complex care interventions for a patient whose heart rate had decreased following a change of medication.

“Overall, the service empowers patients to manage their own condition as they learn more about what impacts upon their health, and increases confidence in recognising their symptoms. The service builds upon the principles of shared decision making and co-production in healthcare, delivering improved outcomes.”

The trial follows Delta Wellbeing’s successful CONNECT proactive technology enabled care (TEC) programme which has been acknowledged as an exemplar in the UK, providing a good practice example of working across sectoral boundaries to deliver a radical, person-centred approach to wellbeing, care and support.

CONNECT focussed on supporting prevention and wellbeing through a technological and digital approach, and combining bespoke technology enabled care equipment with wellbeing calls, access to a 24/7 community response and digital support. Delta CONNECT is a pioneering national programme funded under the Welsh Government’s Transformation Fund through the West Wales Care Partnership Board.

 

Charity

Charity campaign showcases powerful bereavement support for local families

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HYWEL DDA Health Charities, the official charity of Hywel Dda University Health Board, is calling on local communities to help them provide comfort and support to families who have lost a child.

The charity is running a campaign this spring to highlight its Wish Fund which provides support to families during times of bereavement.

The Wish Fund supports Hywel Dda’s Paediatric Palliative Care team to provide personalised support to families of children and young people receiving palliative care, and helps them create treasured memories when their child sadly passes away. From hand moulds and fingerprint jewellery to memory boxes and specialist sibling support, the fund ensures bereaved families are not alone during the most devastating moments of their lives.

Frankie’s parents Phil and Veronica shared how the Wish Fund helped them during their darkest days:

“We had the absolute pleasure of looking after the most beautiful, awesome, wonderful, loving and brave little lad who was very poorly in the last years of his life.

Frankie

“We met his Paediatric Palliative Care team two years before his passing and boy what an awesome team they are.

“We will never be able to thank the Wish Fund enough. Thanks to the Wish Fund, we had the most amazing mementos, a Christmas bauble, a necklace with Frankie’s fingerprint on it and a mould of his hand. Those simple objects are our most treasured possessions along with a lock of his beautiful hair.”

The Wish Fund relies on charitable donations, and every contribution can have a lasting impact:

  • £15 provides a teddy for a bereaved sibling
  • £30 funds a sibling support session
  • £50 creates a hand mould keepsake
  • £70 provides a Memory Box
  • £85 funds bespoke hand‑printed jewellery

These meaningful items offer comfort to parents, carers and siblings who are navigating unimaginable loss.

Rebecca McDonald, Clinical Nurse Specialist – Paediatric Palliative Care, said: “I want to extend my heartfelt thanks to everyone who has donated and continues to donate to the Wish Fund.

“Thanks to your kindness and generosity, we have been able to provide meaningful memory-making items and bereavement materials. These resources make an immeasurable difference in helping us support our families through the most difficult time.

“Your compassion and support truly help us bring comfort, dignity, and lasting memories to the families we care for. Thank you for your support in helping us make a big difference to families we support across our health board.”

To find out more or to donate to the Wish Fund, please visit: https://hywelddahealthcharities.nhs.wales/campaigns/the-wish-fund/ 

 

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Business

Narberth Kadinsky gallery to dental surgery refused

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PLANS to convert a former art gallery to a dental surgery on the edge of a Pembrokeshire town have been refused.

In an application to Pembrokeshire County Council, Ahmed Abouserwel, through agent A.D Architectural Design Consultants LTD, sought permission for a change of use of the former Kadinsky gallery, Redstone Road, Narberth, to a dental surgery, along with associated works.

A supporting statement said: “The existing open plan gallery space will be transformed into the main dentist area, with a glazed internal lobby, leading directly into the open reception / waiting area. There will be five treatment rooms accessed directly off the reception, with a private archive room behind the reception desk.

“The rear lean-to projection will be extended to the north to accommodate a proposed decontamination room and to re-model the Staff area and W.C provision (number to remain as existing).”

It said the proposal would create 10 full and three part-time jobs.

An officer report recommending refusal said concerns were raised by the county Highways authority, who having assessed the application on safety, capacity and policy considerations, recommended the application be REFUSED on the grounds of insufficient evidence provided.

“The submitted design and access statement and block plan indicate on-site parking provision for 16 vehicles, located to the north and west of the building. The application form states that the site will employ 10 full-time staff and three part-time staff. However, the submission does not differentiate between practitioners and ancillary/support staff.”

It said, on planning guidance, health centres require three spaces per practitioner; and one space per three ancillary staff, adding: “As the applicant has not provided a breakdown of staff roles, the Highway Authority is unable to assess whether the proposed parking provision is adequate.”

It stressed: “Whist there is no in-principle objection to the redevelopment of this established site for a dental surgery, insufficient information has been provided to fully assess the proposal.”

It was refused on the grounds including it would lead “to the unjustified loss of an employment premises in a location which contributes to the local supply of employment land and buildings,” adding: “Insufficient evidence has been submitted to demonstrate that the building is no longer suitable or viable for continued employment use, nor that there is overriding community need to justify its loss.”

It was also refused on the grounds that “Insufficient information has been submitted to demonstrate that the development would operate without giving rise to unacceptable highway safety impacts or on street parking pressure”.

 

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Health

Patients in Wales waiting years for autoimmune diagnosis

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Study led by Swansea University says long delays, limited specialist access and referral barriers are leaving some patients worse off than those elsewhere in the UK

PEOPLE in Wales with autoimmune and rheumatological conditions are facing long waits for diagnosis, poor access to specialist care and repeated obstacles when trying to secure treatment outside their local area, according to new research.

The study, led by Swansea University, examined the experiences of patients with illnesses including lupus and other autoimmune disorders. It drew on interviews, survey findings and Freedom of Information responses from health boards across Wales.

Researchers found that specialist provision remains limited in some parts of the country. Some patients reported having no access to a lupus specialist in their area, while FOI responses indicated there is only one NHS neuro-ophthalmologist in Wales for patients with neurological or visual problems linked to autoimmune disease.

The report also highlighted a lack of diagnostic services. None of the Welsh health boards that responded said they currently provide nailfold capillaroscopy, a test used to help identify conditions such as scleroderma.

Diagnosis in rheumatology can also be difficult because many of the conditions involved are complex and may develop gradually over time. Illnesses such as ankylosing spondylitis can be mistaken in the early stages for more common causes of pain, while autoimmune disorders often present with symptoms that overlap with other conditions.

Patients may require a combination of investigations before a diagnosis can be confirmed, including HLA-B27 testing, routine blood work, MRI scans, X-rays and detailed clinical assessment. Doctors also rely heavily on patient interviews to build up a picture of pain, stiffness, mobility and the wider pattern of symptoms.

There have also been local pressures on services in west Wales. At Withybush Hospital, delays were caused after the departure of a specialist consultant, and it took some time for that post to be filled. That consultant has now been replaced. However, it is understood the workload remained heavy, with the specialist working through a backlog of cases.

In some cases, patients may also feel rheumatology is treated as a lower-profile service. At Withybush Hospital, for example, the department has been based in a portacabin in the hospital car park, which it shares with the lymphoedema service — a setting that can give the impression that two important but often overlooked specialties are being accommodated on the margins of the wider hospital system.

Rheumatology also places a significant burden on the NHS because of the cost of long-term treatment and follow-up care, although that is not the main focus of the study. Biological drugs used to treat conditions such as rheumatoid arthritis and ankylosing spondylitis can cost around £500 for a pack of four injections, according to local hospital sources. Patients on those medications often also require regular blood monitoring, consultant reviews, specialist nurse support and physiotherapy. The Herald understands that more than 1,000 patients in Pembrokeshire are currently being managed through this treatment pathway.

Researchers said patients were also being held back by the referral system. Under current NHS Wales rules, doctors must apply to their local health board for permission to send patients for treatment outside the area or across the border into England. The study said decision-making around those requests was often inconsistent and unfair.

One patient with systemic lupus erythematosus told researchers he waited two years for approval to be referred to England, despite believing the process should only have taken weeks.

The study found that patients in Wales often face longer journeys to diagnosis than elsewhere in the UK. In the sample reviewed by researchers, the average time from first symptoms to diagnosis was around 11 years, compared with around seven years across the UK.

Patients described the effect those delays had on their health. One woman in her 30s said requests to see a specialist in a neighbouring health board had been turned down, and that her lupus had worsened as a result. Another patient said access to care became more difficult after moving from England to Wales.

The research was led by Rupert Harwood of Swansea University Medical School, who himself lives with several autoimmune conditions.

His own experience reflects the wider concerns raised in the report. After developing visual symptoms in 2016, he was advised to see a neuro-ophthalmologist, but no such service was then available in Wales. A referral to England was not successfully made until 2025, and he is still waiting for an appointment.

Mr Harwood said the present system can leave patients at a disadvantage if they cannot afford to seek private treatment outside Wales.

The study concludes that while NHS Wales rheumatology teams provide high-quality care, patients in Wales face additional barriers compared with those in England.

Researchers are calling for a review of the out-of-area referral system, better access to specialist services and greater investment in diagnostic testing to reduce delays and improve outcomes.

 

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