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‘Once in a lifetime’ reorganisation planned by Health Board

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THE LOCAL Health Board is embarking on a ‘once in a lifetime’ reorganisational plan which is looking at all potential options to ‘change the status quo and focus on improving health’ of locals.

This will involve, a press release has revealed, transferring more hospital services into the community where appropriate.

This is part of a strategy that the Health Board is looking into, to help solve an acute recruitment problem which is putting a great deal of pressure on the way that the Heath Board operates – and is leading to an untenable level of use of costly temporary staff to plug gaps and services.

In the summer of 2017, the Health Board embarked in an engagement with the public called ‘The Big Conversation’ which involved public workshops and drop-ins being held across the three counties of Pembrokeshire, Carmarthenshire and Ceredigion.

The Health Board now says the it has independently analysed opinions of the general public and has been using that data to explore, challenge and test different scenarios.

It is yet to be seen what these changes will mean for end service users.

The Herald understands it is likely to mean hospital services being reduced or cut, and replaced with community alternatives.

The Health Board has said it will not make any changes, unless it can guarantee the safety of the people which it serves.

The Health Board has insisted that no preferred option for change has yet been determined, and nothing has been signed off or agreed at this stage.

Medical Director Dr Philip Kloer said: “This is a once in a lifetime opportunity for our health service and community to work together to design an NHS which is fit for our generation and beyond. It has been acknowledged for some time across the UK that healthcare services are challenged like never before and we need significant change. Indeed this has been recognised in the recently published ‘Parliamentary Review of Health & Social Care’ here in Wales.

“We need to develop more proactive, resilient and better resourced local community services to support and improve people’s health and wellbeing, and avoid deterioration where possible. This will involve closer working with our partners, particularly colleagues in social care. We are also looking at ways of providing the most modern clinical practice, using the latest digital, technological, and new scientific developments, in fit for purpose facilities to provide better patient outcomes and experience.

“A number of our services are fragile and dependent on significant numbers of temporary staff, which can lead to poorer quality care. For us specifically in Hywel Dda, the geography we cover is large, with many scattered communities that are getting older, needing more holistic health and social care treatment and support. Because of this, we need to better resource our community based care, which is where most of our patient contact is, and help people manage their health conditions. We also need to evolve traditional ways of working and provide a more proactive approach. This should give patients – young, older and frail and everyone in between – the services they need when the need it, so people do not have to wait too long.

“This will mean changing hospital-based care, as well as community care, and we appreciate the attachment local people and our own staff have for their local hospitals. They have been cared for in them, or work in them, and they also play an important role in our wider communities. The options may propose change to a local hospital; however this is about more than the buildings. This is about investing in our communities, attracting doctors, nurses and therapists by operating a modern healthcare system and keeping hospitals for those who really need hospital care.

“We will not put in place any change that isn’t safe for our patients and population. And we will look at all the impacts from ensuring services are safer with better patient outcomes, to considering the wider impact on people, including the most vulnerable.”

Dr Kloer added: “The potential options are evolving, with changes to them on almost a daily basis. Many will never even reach public consultation, for a variety of reasons including safety, accessibility and affordability, or will change significantly as they are tested against population needs and healthcare standards.

“We will be coming back to the public in the spring with fewer options that have been more rigorously tested and we will open and honest about what we think our preferred option is and why. We would not, and cannot, propose something that would not be safe for our population.

“We live in this community, use our NHS and work for our NHS and we want to work with our patients, staff, partners and public to ensure it is the best it can be.”

Meanwhile, Elin Jones, Ceredigion’s Assembly Member, has called for urgency in the implementation of electronic records for NHS patients in Wales, following the publication of a report by the Wales Audit Office, ‘Informatics systems in NHS Wales’.

The report outlines several of the opportunities that electronic patient records can bring to patients and health boards, as well as the current obstacles to achieving this goal.

Elin Jones, who has long-called for a paperless NHS has welcomed the report, saying: “This is an important step in the development of health services in Wales, which is long-overdue. It would make our NHS more sustainable and more flexible to every patient’s needs.

“I have heard of many instances where patients have turned up to appointments in Llanelli, Swansea or Cardiff, only to find that their medical records have not arrived. These are people who have, in some cases, had to wait a long time for a specialist appointment, and have had to travel long distances, sometimes leaving very early in the morning or have arranged overnight accommodation in order to get to a 9 am appointment.

“Being turned away because their paper record has not arrived is a failure in the current system, and would be addressed directly by electronic records.

“The technology is available, it’s just a case of putting the funding in place.

“With the proper investment into the Welsh NHS by the Welsh Government, electronic patient records can help the NHS to deliver better outcomes for patients and to make more efficient and effective use of scarce financial and human resources.”

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Police urge visitors to ‘check the rules’

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POLICE in Powys are reminding people to check the rules before they travel, as tourists from the Midlands, London and Bristol continue to visit despite lockdown restrictions.

Last weekend more than 1,000 cars were turned around by police in the Brecon Beacons after visitors attempted to access the area around Ystradfellte known as ‘waterfall country’.

Many of those stopped claimed they thought the rules around travel were the same as in England, while others had deliberately flouted them.

Seventy-two per cent of people reported for breaches of Covid-19 restrictions in Powys since March 27 have been from outside the police force area.

“I would like to thank the communities of Powys for their cooperation in recent months in complying with requirements of the Covid 19 legislation and also reassure them we are still working hard with our partners to police the restrictions that remain in place across Wales,” said Superintendent Steve Davies.

“Our officers have worked hard to engage with the public at every opportunity throughout these unprecedented times by explaining what we are doing and why, and encouraging people to make the best choices to protect public health in Wales.

“But where people have clearly flouted the rules we have dealt with them appropriately and issued fines.”

He said officers will continue to conduct stop checks throughout Powys and across the force area this weekend.

In England, people can now travel an unlimited distance for exercise and to access so-called ‘beauty spots’.

But the Welsh Government has said people must remain local – ideally not travelling further than five miles from their home – for exercise or limited leisure pursuits, and this also applies to anyone travelling across the border.

Wales’ three national parks – which include popular sites such as Snowdon, the Elan valley and the Pembrokeshire coast – currently remain closed to the public, as do all National Trust car parks and properties.

The latest Welsh Government advice is available at gov.wales/coronavirus.

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‘Check in, Catch up and Prepare’ All school’s in Wales prepare to enter next phase

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ALL children will have the opportunity to “Check in, Catch Up, Prepare for summer and September”, the Education Minister Kirsty Williams announced today as she published details of the next phase for schools in Wales.

It is proposed that all schools will start the next phase on 29 June, with the term extended by a week, therefore ending on 27 July.

In the next academic year, beginning in September, the intention is that the autumn half-term break will be expanded to two weeks.

In each school there will be a phased approach. Year groups will be split into cohorts with staggered starts, lessons and breaks. It is expected that this will mean, at most, a third of pupils present at any one time, though schools may need time to reach this level of operation.

There will be much smaller classes, providing secure dedicated time with teachers and classmates. This time will include online and personalised classroom experience, getting children and teachers ready for a similar experience in September.

Next week, the Welsh Government will publish guidance to support schools, as well as further and higher education institutions. This will include information on managing their facilities and logistical arrangements, including buildings, resources, cleaning and transport.

The Government is also today publishing a paper from its COVID-19 Technical Advisory Group, representing the latest understanding of the virus with respect to children and education.

Further Education colleges are ensuring that appropriate measures are being taken to re-open for face-to-face learning from 15 June. They will prioritise those students requiring licence to practice assessments and vulnerable learners. This follows close working with Government and the joint trade unions.

Guidance for childcare providers will also be published in the next week, supporting them to increase the numbers of children in attendance alongside schools.

Kirsty Williams said:

“My announcement today gives schools three and a half weeks to continue preparing for the next phase.

“We will use the last weeks of the summer term to make sure pupils, staff and parents are prepared – mentally, emotionally and practically – for the new normal in September.

“29 June means there will have been one full month of test, trace and protect, which will continue to expand. I can also announce that teachers will be a priority group in our new antibody-testing programme. As we continue to keep Wales safe, this approach will be critical.

“The evolving science suggests that warm weather and sunlight gives us the best opportunity to ensure more time in school. Waiting until September would mean almost half a year without schooling. That would be to the detriment to the wellbeing, learning progress and mental health of our young people.

“This is and has been a worrying period for us all. I know that many will feel apprehensive. We have not rushed this work and this decision.

“The three and a half week period before the next phase also gives us time to keep watch on developments elsewhere and provides further check-points to review evidence and the roll-out of testing.

“This is the best practical option that meets my five principles which underpin my decision making.

“I am also convinced that it is only by returning to their own school that we will see increased attendance from our more vulnerable and disadvantaged children.

“Working together we will secure equity and excellence for pupils as they check in, catch up, and prepare for summer and September.”

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Four further coronavirus cases confirmed in Hywel Dda area

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THE LATEST figures from Public Health Wales (PHW) reveal four new cases of coronavirus have been reported in the Hywel Dda Health Board Area.

As of today, June 2, Carmarthenshire identified three new cases, Pembrokeshire has one new case and none in Ceredigion, meaning the new totals stand at 732, 279 and 42.

Wales now has a total of 14,121, with 67 new cases and seven additional deaths recorded, bringing the death total to 1,354.

With Hywel Dda reporting 61 deaths to date.

Dr Giri Shankar, incident director for the Novel Coronavirus (Covid-19) outbreak response at Public Health Wales, said: “Contact tracing continues in Wales as part of the Welsh Government’s ‘Test, Trace, Protect’ strategy. Contact tracing is the process of identifying people who have come in contact with an individual with Novel Coronavirus (Covid-19) in order to prevent the risk of others spreading the infection in our communities.

“Anyone who has a positive Novel Coronavirus (Covid-19) test will be contacted by a team of contact tracers, and asked for details of everyone they have had close contact with while they have had symptoms.

“Please keep a note of your activities so you can easily remember your whereabouts on a given day, along with who were in contact with. You do not need to have any concerns about providing names to the tracing team. This is for everyone’s benefit and we are grateful for your continued cooperation.

“If you are asked to self-isolate, you should also comply with this request to prevent further spread of the virus.

“Tracers are trained staff and personal information that you provide will handled in line with data protection regulations and will not be shared widely.

“Over the last few weeks, Public Health Wales has been setting up the methods and guidance for how contact tracing will operate. We will continue to work closely to support local health boards and local authorities in delivering contact tracing.

“Welsh Government’s revised lockdown arrangements also continue. People from two different households in the same local area can meet up outdoors, provided they continue to maintain social distancing and strict hand hygiene.

“The announcement adds that, as a general rule, people should not travel more than five miles from home. This will help to reduce the risk of coronavirus spreading as people begin to travel more.

“Revised lockdown arrangements also apply to people in Wales who have been told to ‘shield’ from the virus. They are able to go outside and meet people from another household, provided they keep a two-metre distance.

“Future relaxation of lockdown measures will also be dependent on everyone following advice set out in the ‘Test, Trace, Protect’ strategy, including self-isolating when required.

“Information about the symptoms of Novel Coronavirus (Covid-19) to look out for is available on the Public Health Wales website, or members of the public can use the NHS Wales symptom checker.

“Anyone experiencing Novel Coronavirus (Covid-19) symptoms can now apply for a home testing kit using the new UK online portal. For further information and a link to the booking website, visit: www.gov.wales/coronavirus or www.llyw.cymru/coronafeirws. This will be supported by a national 119 phone service, through which people can also order a home test.

“We are encouraging everyone to download the Novel Coronavirus (Covid-19) Symptom Study app, which has been supported by Welsh Government. The app allows users to log daily symptoms to help build a clearer picture of how the virus is affecting people. For more information, including how to download the app, visit covid.joinzoe.com.

“As part of wider support measures for families, Public Health Wales is offering all parents, parents-to-be, grandparents and care-givers free access to a series of online courses designed to help them understand the development and emotional milestones of their children, covering everything from pre-birth to late teens.

“To get access users just need to visit www.inourplace.co.uk and use the code ‘NWSOL’ if you live in North Wales, and ‘SWSOL’ if you live in Mid, West or South Wales.

“Public Health Wales is also continuing working to address the negative impact of Novel Coronavirus (Covid-19) on the social, mental and physical wellbeing of people in Wales. Our latest campaign, ‘How are you doing?’ is now live and offering practical advice from phw.nhs.wales/howareyoudoing.

“Anyone with a suspected coronavirus illness should not go to a GP surgery, pharmacy or hospital. They should only contact NHS 111 if they feel they cannot cope with their symptoms at home, their condition gets worse, or their symptoms do not get better after seven days.

“Only call 999 if you are experiencing a life-threatening emergency, do not call 999 just because you are on hold to 111. We appreciate that 111 lines are busy, but you will get through after a wait.

“We also want to reinforce the message from NHS Wales that urgent and emergency care services for physical and mental health are still open and accessible.

“For parents, if your child is unwell and you are concerned you should seek help. If you have urgent dental pain you should still call your dentist. If you have a health complaint that is worrying you and won’t go away you should call your GP practice. If you or a family member are seriously ill or injured you should dial 999 or attend your nearest Emergency Department.”

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