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27 care failings before baby’s stillbirth

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A DOCTOR whose conduct of a difficult birth was heavily criticised by the General Medical Council remains on the GMC register as a member of staff at Hywel Dda UHB.

Alan Treharne qualified for appointment to the specialist register as a consultant obstetrician in October 2016.

On March 12, 2017, was responsible for the management of the delivery of a child following a complex and difficult pregnancy.

Arthur Wyn Jones was stillborn and Dr Treharne’s conduct of the birthing process was panned by a subsequent investigation.

Kara Jones and her partner Sam Penfold from Tre’r Ddol originally attended Bronglais Hospital. However, due to Ms Jones’ Type 1 diabetes, the pregnancy was complicated and Ms Jones was directed to the notionally safer consultant-led facility at Glangwili, almost three hours’ drive from her home.

In a report on S4C’s Newyddion Nawr on Tuesday (Aug 13), the couple said during the pregnancy became increasingly concerned over both the consistency and standard of care they received at Glangwili’s Ante-Natal Unit.

“We didn’t have a clue. Had no idea what was going to happen. Every time we went back there [Glangwili], they told us ‘we’re not sure about this, we’re not sure’,” she said.

Their baby, Arthur Wyn Jones, died 24 minutes after being delivered on March 12, 2017.

Ms Jones said that her reports that the baby had stopped moving were brushed aside and that her concerns about the course of her pregnancy as she approached the delivery date were similarly ignored.
Newyddion Nawr, which had a copy of an internal Hywel Dda UHB investigation, reported that medical staff ‘missed [numerous] opportunities to acknowledge the complexity of the pregnancy”

The failings in the care given to Kara Jones and her unborn child included several failings to act on abnormal scan results and not acting quickly enough to deliver Arthur when there were clear indicators the birth was going badly wrong.

Newyddion Nawr reported that the Board identified 27 separate indicators which should have raised the alarm were missed or ignored by medical staff during the pregnancy.

The consultant obstetrician responsible for overseeing the delivery received a formal warning from the General Medical Council in June last year. That warning expired just over six weeks ago, on June 29.

No restriction was placed upon Dr Treharne’s practice despite the content of the warning, which reads: “Dr Treharne failed to obtain an adequate clinical history for the patient; failed to adequately assess readings of foetal heartbeat and contractions; did not arrange continuous monitoring; did not appreciate the full significance of the clinical risks; and wrongly concluded that there was no immediate urgency to deliver the patient’s baby. The baby was stillborn.

“This conduct does not meet with the standards required of a doctor. It risks bringing the profession into disrepute and it must not be repeated. … Whilst these failings in themselves are not so serious as to require any restriction on Dr Treharne’s registration, it is necessary to issue [a] formal warning.”

Dr Treharne is shown on GMC records as a member of staff awaiting revalidation by Hywel Dda Health
Board. The responsible officer for revalidation is shown as Dr Philip Kloer, Executive Medical Director and Director of Clinical Strategy for the Health Board.

Responding to the Newyddion Nawr report, the Director of Nursing, Quality and Patient Experience for the Board, Mandy Rayani, said: “On behalf of Hywel Dda I wish to offer our sincere condolences and apologies for the distress experienced by Ms Jones and her family.

“A thorough investigation was undertaken by the health board as well as the GMC. This resulted in a number of recommendations to change procedures and clinical pathways.

“Additional learning and training for the whole multidisciplinary team have taken place across the health board area. We wish to provide assurance that all of these recommendations have been implemented.”

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The county’s play areas to close

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ALL THOSE who manage Ceredigion Play Areas have been asked to close their play areas as of Monday, 23 March 2020.

This decision doesn’t come lightly as they are wonderful places to enjoy. However, you may have noticed people are still meeting in outdoor parks and communal areas outside. We must protect our communities and strive to ensure that people stay away from places where they can come together, especially children and young people who are not currently attending school. It is also important to note, it is reported that Coronavirus can remain on surfaces, including metals and plastics.

The Council requires all playground owners / managers in Ceredigion to ensure that the community keep away from the play spaces. These include community spaces, parks and skate parks.

If there is a gate or fence around the play area, it will be locked and a poster placed on the entrance. For those areas without a fence or gate, the poster will be put in a suitable place so that the public can understand that it is not safe for them to use the play area at present.

We thank all who are helping to deal with the Coronavirus outbreak responsibly.

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Community

The latest on plastic free Ceredigion

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At its meeting held on 17 March, the Council’s Cabinet received an activity update from the Plastic Free Ceredigion Task and Finish Group, which was set up after full Council approved a motion on 22 February 2018.

Full Council approved the ‘Plastic Free campaigns throughout the County, including Plastic Free Aberporth and Plastic Free Aberystwyth’ motion to ensure that the Council helps to reduce the amount of single use plastics used in our day to day operations.

The motion involved a number of factors including; reducing single-use plastics within Council facilities and offices and encouraging local businesses, organisations, schools and communities to move away from single-use plastics and use sustainable alternatives. Promoting the use of sustainable alternatives to single-use plastics at all Council supported events, supporting beach cleans and any other events which aim to raise awareness of the issues of single-use plastics.

Since 22 February 2018, the Council have removed 5 single-use plastic that were used across the local authority, implemented projects in conjunction with NRW with local primary schools, worked closely with communities throughout Ceredigion and commenced the provision of Water bottle re-fills on request to all visitors to our public facing buildings.

In January 2020, the Schools Service were successful in bidding for funding from the Circular Economy Capital Fund, which allows for the purchasing of milk dispensers which will remove the need for the provision of plastic milk bottles and straws by 1,979 pupils at Foundation and Key Stage 2. This is equivalent to a reduction of 376,010 plastic milk bottles per school year.

Councillor Alun Williams, Member Champion for Sustainability said, “These are initiatives which, together, make a real difference to the amount of single-use plastics going into the waste stream from Council activities. Whilst it’s important that everyone seeks to minimise their use of single-use plastics, it’s particularly important that large organisations like councils take these kinds of actions because they can have a wider effect which, in turn, can lead to industry changing to more sustainable practices. Ceredigion Council is trying to lead the way in showing what’s possible within an organisation.”

This supports one of the Council’s corporate priority of Promoting Environmental and Community Resilience.

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Community

Cabinet decision on former care home still stands

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The Council’s Cabinet met on Tuesday 17 March to discuss the recommendation put forward by the Corporate Resources Overview and Scrutiny Committee on Monday 16 March, regarding the future of the former care home, Penparcau.

Following the discussion at Cabinet, it was decided not to support the recommendation put forward by the Committee. The Cabinet’s original decision made on 25 February will now be implemented.

The Committee recommended that Cabinet postpone progressing the sale of the former care home for 6 months, given the current situation regarding coronavirus, and following that period, both the Corporate Resources and Healthier Communities Overview and Scrutiny Committees reconsider the matter of future EMI Nursing in Ceredigion. The recommendation was made after councillors used the Councils’ call in process to review the Cabinet’s decision on 25 February 2020.

Councillor Rhodri Evans is the Cabinet member for Economy and Regeneration. He said, “The Council has actively sought the appropriate re-use of the former care home over a lengthy period of time. The Council initially undertook a procurement exercise to identify a provider between 2015 and 2017 and since 2018 sought to sell the property for a preferred use since. Both approaches have been unsuccessful. After careful consideration, it’s now time to consider alternative options for disposing of this asset and attract investment in the property. The money raised from the sale can then be used towards supporting service providing care elsewhere in the County.

The Council will continue to discuss options with Hywel Dda University Health Board for providing improved EMI provision in the County.”

The Council will liaise with Registered Social Landlords in the hope that a purchase can be agreed within 3 months. This is due to the continued need for affordable housing in the County. If this cannot be achieved, the land will be sold on the open market without identifying any preferred uses.

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