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GP shortage ‘caused by Withybush downgrades’

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docsPEMBROKE residents have expressed concerns about reduced opening hours in the town’s doctors surgery as a result of a shortage of doctors. Since September 1, the surgery at St Oswald’s has closed at 1pm on weekdays. Until then, it had been open until 6.30pm on Monday, Wednesday and Friday. The surgery, a member of the Argyle Medical Group which also has practices in Pembroke Dock and Neyland, serves Pembroke, Monkton, and a number of outlying communities in the area. The surgery in Pembroke Dock will remain open from 8am – 6.30pm.

However, concerns have been raised about how the reduction of provision in Pembroke will affect elderly patients, or those with reduced mobility. Speaking to The Herald, Practice Manager for the Argyle Medical Group Juliet Goldsworthy confirmed that the reduction in surgery hours was a deirect result of staff shortages: “We’re two doctors down at the moment – its a common problem across Wales,” she said.

Safety was apparently a major consideration for the shorter opening hours. The practice was unwilling to let one doctor work at the surgery alone. “Its about managing the surgery safely andwe can’t do that at the moment,” Ms Goldsworthy added.

When we asked how long the staff shortage had been a problem for, she said that the staffing shortages were ‘relatively recent,’ though admitted that they had ‘struggled on’ over recent months. However, staff holiday time had meant that they were unable to keep the current provision. “The first doctor left about 18 months ago, and we lost another one 12 months ago,” she added.

“We have been advertising in national publications, but haven’t had any response. Accepting that the situation for patients was ‘far from ideal,’ she said that the problem was an all-Wales issue. Ms Goldsworthy confirmed that the practice had 10.75 FTE (full-time equivalent) doctors.

There are around 25,000 patients registered with the practice, which equates to 2325 patients per GP. Several years ago, the average number of patients per GP in Wales was 1640, and while Ms Goldsworthy said that this had risen to around 1900-2000, she still acknowledged that Argyle Street still did not meet these levels.

“Its not ideal – it puts a lot of pressure on both patients and doctors,” she added. Ms Goldsworthy pointed out that Argyle Street employed full-time nurse practitioners, who worked supporting GPs, as well as a full-time pharmacist who could ease the burden on doctors with work related to medication. “We were one of the first practices to take on a full-time pharmacist,”she added. “The health board seems to be looking more at approaches like this now. I understand that patients hanker for days gone by, but times have changed.”

With regards to the opening hours at St Oswalds, Ms Goldsworthy told us that if two new doctors could be recruited the situation would be reviewed after six months. At present, she said that the practice has been advertising ways for those unable to drive to attend the Argyle Street Surgery to travel there more cheaply.

“Services like country cars, and public transport can save people money on taxis,” she pointed out. Ms Goldsworthy emphasised that the surgery would still be open in mornings, and that hopefully people who would struggle to get to Pembroke Dock would be able to attend then. “We do visit a lot of people at home, if they are unable to get out. Our visiting rates are quite high,” she added. She pointed out that a shortage of GPs could lead to a continuing problem, because constant staff-shortages would lead to an increased workload, and the job becoming less attractive for medical trainees.

“There is talk of a ‘Golden Hello’ in Wales, but I’m not sure what is going to become of that,” she said. Concerningly, Ms Goldsworthy agreed with other commentators, including Simon Hart MP, who has previously said that a reduction in service provision at Withybush will lead to a knock-on effect on the county’s medical community.

“As Withybush downgrades and less doctors come to work there, their partners, who often used to work in surgeries won’t come here either, leading to the health community shrinking. We had a doctor who worked with us who was fantastic, but his wife worked in paediatric care, and when the department in Withybush downsized she had to move to Swansea to find work.

“There may also be issues with GP training at the hospital.” Speaking to The Herald, MP Simon Hart agreed that Issues faced by Withybush Hospital were a definite contributing factor in staffing problems across the medical community in the area: “From what I can discover there is a definite connection between recruitment and uncertainty over Withybush. For once the problem is not entirely about money,” he said.

“For the County to be able to attract Doctors and their families, they need to assure them that the services have a future and that there is certainty as far as their jobs are concerned. The Welsh Labour Government continues to fail in this regard and our county suffers accordingly.” We asked Hywel Dda University Health Board whether this was a fair reflection, and what if anything could be done to attract more GPs to the county.

At the time of going to press The Herald had received no reply. A spokesperson for Hywel Dda UHB said: “We would strongly urge caution when drawing ‘definite’ links between recruitment issues at a hospital and GP level as there is no absolute or clear evidence for this. GP recruitment is challenging across Wales, this is well documented, and we are experiencing this in areas across Carmarthenshire and Ceredigion as well as Pembrokeshire.

“Whilst we are taking clear actions to address recruitment at our hospitals, we have numerous responses to recruitment challenges at a GP level. For example, we are in the process of developing a Primary Care Support Team to offer support to Practices with workforce issues to which we have successfully appointed a GP clinical lead and three Advanced Practitioners, due to start shortly.

“We are also supporting the development of other roles that can provide patient care in General Practice working alongside GPs. For example, Argyle Surgery have employed a practice based pharmacist to support the GPs on a day to basis. This is alongside developing portfolio GP roles to increase the appeal of working in the Hywel Dda area to those wanting diversity within their role.”

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Judge dismisses appeal in ‘truly disturbing’ animal neglect case

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A CROWN court judge has upheld a judgement of a case which saw the neglect and death of 58 cows. In his judgement, the judge described the offence as ‘truly disturbing’. The west Wales case related to the conviction of David Davies, and Evan Meirion Davies of Penffynnon Farm, Bangor Teifi, near Newcastle Emlyn.

They had both pleaded guilty to 13 charges of animal neglect in February 2019. They later appealed the Magistrates Court’s sentence banning them from keeping animals for five years. The brothers had frustrated the appeals process by securing adjournments in seven appeal hearings. Another request to adjourn the eighth hearing on Monday 2 December was not granted.

They also sought to appeal the guilty verdict despite pleading guilty to the charges earlier in the year.

The prosecution followed a visit by Animal Health Officers and Animal and Plant Health Agency vet to the farm in April 2018. Officers found 58 cattle carcasses in various states of decay in the cattle sheds and surrounding fields. The remaining cattle were housed in terrible conditions with no food, water or dry lying area.

The vet confirmed that the cattle were being caused unnecessary suffering, and that the dead cattle had succumbed to the horrendous conditions found in the sheds, and died of neglect.

The vet had to euthanize two cows to stop further suffering during visits to the premises. This is one of the worst cases of animal welfare neglect seen by the Animal Health team of Ceredigion County Council. Alun Williams is Ceredigion County Council’s Corporate Lead Officer responsible for Policy and Performance. He said, “We had no doubt that the judge would uphold the judgement of the Aberystwyth Magistrates Court.

Although we have been frustrated by the delay caused by the appellants, we are satisfied with the result. “The vast majority of Ceredigion farmers take excellent care of their animals and uphold high standards of animal welfare. We will make sure we pursue the small minority who do not.

We will not hesitate to prosecute in such devastating cases of animal neglect.” Their initial sentences were upheld.

They were sentenced to 16 weeks imprisonment suspended for 12 months, and were disqualified from keeping any animals for five years. The brothers will be allowed 28 days to dispose of the herd.

They were ordered to pay costs to the council of £420.

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New Integrated Care Centre opens

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Services together in one place: The Cardigan Integrated Care Centre

CARDIGAN’s brand new Integrated Care Centre will open its doors to the public on Monday, December 9.
Hywel Dda University Health Board says the new Centre will bring joined-up care to local communities for the first time.
The opening of the centre follows hot on the heels of the launch of a similar initiative in Aberaeron. It represents a decisive change of direction in the way the Board delivers health and social care services to a largely rural area.
The new centre was developed with £23.8m of Welsh Government funding
The centre will provide a modern, fit for purpose healthcare service – including a GP practice, dental service, and pharmacy. It will also host a range of other clinics and services delivered by Hywel Dda, the third sector, local authority. and partner organisations.
Those services include:
• A nurse-led minor injuries walk-in service with telemedicine links to the emergency department
• Radiology and diagnostics
• Phlebotomy service
• Outpatient suite with consulting rooms and clinical treatment facilities for pre-assessment and outpatient consultations by visiting clinicians and social workers
• Disease-specific services for heart failure, motor neurone disease clinics, and Chronic Obstructive Pulmonary Disease services
• Enhanced telemedicine equipment in clinical areas, providing remote access to specialists from across the professions
• Rehabilitation services, providing opportunities for intensive and slow stream rehabilitation to restore function and improve independence, supported by therapists, nurses and social care staff within the Community Resource Team
• Mental health and learning disabilities services
• A base for the local Community Resource Team in south Ceredigion, including the Acute Response and District Nursing teams
Steve Moore, Chief Executive of Hywel Dda University Health Board, said: “This is an ambitious step forward for our health board, which embodies the strategy we agreed last year to shift our focus to community and primary care. It has taken many years of planning and there have been challenges along the way. We’ve had to work very hard to make sure that we’ve got it right the first time.
“In particular, the hard work and commitment from our staff, and the support of many stakeholders – particularly our local communities – has been a critical part of our journey. It is with these groups in mind that we begin delivering on our ambition of providing safe, sustainable, integrated care for our local population.”

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Ceredigion success at Welsh Indoor Rowing Championships

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THERE was success for Ceredigion at the Welsh Indoor Rowing Championships bringing home nine medals.

Held on Friday and Saturday, 22 and 23 November at the Channel View Leisure Centre in Cardiff, this was the 20th anniversary of the event. The aim in Ceredigion is to grow indoor rowing and to promote the local Sea Rowing Clubs.

On the Friday, 14 children from Aberaeron Comprehensive School and Ysgol Bro Teifi, Llandysul took part in the school event. Some had competed last year for the first time, while others were rowing in the competition for the first time. The standard was exceptionally high, with schools from both Wales and England, with 9 records being broken within the 20 races that were held on the day.

Three medals were won in the school event. Beri Tomkins, Ysgol Bro Teifi; Finley Tarling and Dylan Gwynne Jones, Ysgol Gyfun Aberaeron each won a gold medal. 10 of the children achieved their own personal best times with Beri and Finley even broke national records.

On the Saturday, the club races were held where two junior medals and four senior medals were won. Dylan Gwynne Jones won a gold medal for 4min row under 16. Beri Tomkins won a gold medal with a new personal best of 543 metres rowed in two minutes. Beri now holds four records – year 6 school and Welsh record; and year 7 school and Welsh record.

In the adult event, Leo O’Connor won a bronze medal for 60+years 500m; Hannah Lodder won two gold medals for Ladies 40+ years 500m and Ladies 40+years 2km; and Sam Owen won silver medal for Ladies 40+years 2km.

There are weekly Indoor Rowing sessions held at Ysgol Bro Teifi, Llandysul; Aberaeron Comprehensive School; and Bro Pedr School, Lampeter. These sessions are supported by CRIW which are the indoor rowing group within Ceredigion. CRIW also run sessions on a Monday evening at Aberaeron Leisure Centre.

Rhidian Harries, Active Young People Officer, said, “The Young Rowers from Ceredigion have done fantastically well at this national competition. The event was very well organised, and many English schools that are recognised as rowing schools attended. However, the children from Ceredigion showed that they could compete against anyone. It’s a great credit for them and also for CRIW, who have been working tirelessly to grow the sport in the area. Their support and enthusiasm has been crucial, and they should take great pleasure in the success and the performances of these young rowers.”

CRIW will be running their own Indoor Rowing Competition at Teifi Leisure Centre, Cardigan on Saturday, 28 March 2020. Search them on Facebook for more information.

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