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.

More than 9,000 people in Wales are waiting for specialist psychological therapies, with almost half waiting longer than six months

MORE than 9,000 people with moderate to severe mental health conditions are waiting to access specialist psychological therapies in Wales, according to new figures obtained by Mind Cymru.

The charity says the number of people waiting for treatment is now at its highest level since the Covid-19 pandemic.

Freedom of Information data gathered from all seven local health boards shows that, as of December 2025, almost half of those waiting, around 47%, had been on the list for longer than 26 weeks.

Mind Cymru said more than 4,300 people had been waiting more than six and a half months for specialist psychological therapies by December 2025.

That figure has almost doubled since March 2024, when 2,305 people were waiting more than 26 weeks.

The charity is now calling on the Welsh Government to make mental health a priority during the next Senedd term, with a focus on reducing waiting times and improving early access to support.

Aled Edwards, from Bangor, said he was told he faced a two-year wait to see a psychologist as an outpatient at a mental health hospital near his home, despite experiencing depression and suicidal thoughts.

The father-of-two was instead placed on a list to see a psychiatrist in the hope he could access support more quickly, but said it still took another 18 months before he finally received the help he needed.

Aled, who was later diagnosed with a male form of post-natal depression, said: “This was at a point in my life where I had already tried to take my own life and I was considering trying again, so this time I went to ask for help instead.

“I was experiencing some really dark thoughts and I was desperate for support.

“When I did get to see a psychiatrist, they left their job after three sessions and I went back into the system to wait for a further six months before starting trauma therapy with another doctor.

“Finding the skills to cope with the kind of intrusive thoughts I was having in the meantime was really hard, and I feel fortunate that I had the means to access private counselling support to keep me going during that period, where so many others might not.”

Mind Cymru has requested the same waiting list data from local health boards three times since 2020, as part of its campaign for improved access to specialist psychological therapies in Wales.

Its original Too Long To Wait report called for more investment in specialist psychological therapies, stronger governance around how local health boards collect and submit waiting time data, and for the figures to be made publicly available.

The charity says those recommendations remain relevant, but that urgent action is now also needed to transform the mental health system so people can access support earlier.

Simon Jones, Head of Policy and Campaigns at Mind Cymru, said the findings showed that mental health must be a central priority for the Welsh Government.

He said: “There’s clearly a very real and growing need for increasing numbers of people to receive specialist psychological support for their mental health in Wales.

“These are people living with moderate, severe and enduring mental health conditions, and those most in need of support.

“That so many are waiting too long to access therapies is placing further demand on a system already under pressure, and there’s a need for significant investment to be made at all levels to help people access the support they need, when they need it.

“With plans already in place to transform Wales’ mental health system and help deliver open access care, we need now to ensure these plans are prioritised and invested in so that we can start to see that positive impact as soon as possible.

“No one should be waiting longer than six months for support with a serious mental health issue. With this in mind, Mind Cymru is calling on the new Welsh Government to make mental health a priority across the next Senedd term.”

Specialist psychological therapies are structured, evidence-based treatments delivered by trained clinicians for specific mental health conditions or complex psychological needs.

They include therapies such as Cognitive Behavioural Therapy, Eye Movement Desensitisation and Reprocessing, Cognitive Analytic Therapy and Dynamic Interpersonal Therapy.

As the health service marks its 78th birthday, people in Pembrokeshire are being urged to support local NHS charities helping patients, staff and communities across west Wales

AS THE NHS marks its 78th birthday on Sunday, July 5, NHS charities are urging people to use the anniversary as a moment to support their local NHS charity.

For Pembrokeshire, that means Hywel Dda Health Charities, the official charity supporting NHS services across Pembrokeshire, Carmarthenshire and Ceredigion.

The NHS has a particular resonance in Wales. It was founded in 1948 by Aneurin Bevan, the Labour Minister for Health and MP for Ebbw Vale, on the principle that healthcare should be free at the point of delivery and available to all, regardless of income.

That founding ideal remains one of the defining achievements of post-war Britain. It brought security to families who had previously feared the cost of illness, injury or childbirth. In Pembrokeshire, as across Wales, generations have relied on that promise.

But as the NHS turns 78, it does so under intense pressure.

Hywel Dda University Health Board serves a population of around 385,000 people across west Wales, covering hospitals, community services, mental health care and primary care across a large rural area. Demand continues to rise, while the challenges facing the health service grow more complex.

Wales has an ageing population, higher levels of long-term illness and areas of significant deprivation. Those pressures place greater demand on health and care services. At the same time, workforce shortages, waiting lists and financial strain continue to dominate debate about the future of the NHS in Wales.

The Welsh Government recently announced an extra £145m for NHS Wales this financial year, including funding aimed at reducing waiting times, developing surgical and diagnostic hubs, and tackling maintenance across the NHS estate.

But the wider financial picture remains difficult. Audit Wales has reported that all seven health boards in Wales again failed to meet their break-even duty in 2024/25, underlining the scale of the challenge.

That is why NHS charities say the birthday should not only be a celebration, but also a chance to give something back.

NHS Charities Together says more than 220 NHS charities across the UK collectively invest around £1.5m in the NHS every day. That funding helps support patients, staff and communities, paying for projects and equipment which go beyond core NHS provision.

Hywel Dda Health Charities allows donors to support a general fund for the areas of greatest need, or to direct donations to a particular hospital, ward, department or service. Funds can help provide medical equipment, staff training, research, patient comforts and community-based support.

Other local organisations also play an important role in supporting health and wellbeing in Pembrokeshire, including the VC Gallery in Haverfordwest, Honeyborough HOPE Therapy Centre and Pembrokeshire Samaritans. Their work in areas such as mental health, veterans’ support, therapy and community care helps ease pressure elsewhere in the system.

The NHS remains one of Wales’ most important institutions. It was created by a Welshman, built on a principle that still matters, and continues to serve people from birth to the end of life.

On its 78th birthday, the message from NHS charities is simple: celebrate it, value it, and support it where you can.