THE WELSH AMBULANCE SERVICE has revealed the most inappropriate calls made to 999 in the past year.
Among them was someone who had eaten a mouldy tomato and someone who had got their plaster cast wet.
One person with an earring lodged inside their ear asked for a “lift” to the Emergency Department, while another dialled 999 for a papercut.
Of the 470,653 incidents recorded by the service in the last 12 months, nearly a quarter were non-essential, including someone with diarrhoea and someone enquiring about their medication.
In the face of unprecedented demand, the ambulance service is reminding people only to call 999 in a serious or life-threatening emergency.
Chief Executive Jason Killens said: “Our ambulance service exists to help people who are seriously ill or injured, or where there is an immediate threat to their life.
“That’s people who’ve stopped breathing, people with chest pain or breathing difficulties, loss of consciousness, choking, severe allergic reactions, catastrophic bleeding or someone who is having a stroke.
“People with something stuck in their ear still have a clinical need, but calling 999 for that is ill-judged when there are so many other ways to access more appropriate help.
“Non-essential calls represent nearly a quarter of our total 999 calls, and time spent dealing with these could be time spent helping someone in a life or death situation.”
As Covid-19 tightens is grip, the Trust is asking the public to think about the many alternatives to 999.
Director of Operations Lee Brooks said: “Winter is traditionally our busiest period, and we also have a global pandemic to contend with.
“It’s easy to make fun of the people who call 999 foolishly, but actually, these people do have a legitimate clinical need – they just don’t know where to turn for it.
“We’re asking the public to educate themselves on the NHS services available in their area, of which there are many.
“The symptom checkers on the NHS 111 Wales website are a good place to start for advice and information, or you could phone 111 to speak to a nurse or health information advisor.
“Also think about your local pharmacist, dentist and optician, as well as your minor injuries unit and GP.
“Also ensure you have a well-stocked medicine cabinet for things which can be treated at home, like coughs and colds, sore throats and grazed knees.
“Every single one of us has a responsibility to use NHS services wisely and protect them for those who need them most.
“Help us to help you, and think twice before you call 999.”
The following are real 999 calls made to the Welsh Ambulance Service in the past year –
Caller: Basically, I had a piercing a few weeks ago in my ear. Everything’s been fine but last night I woke up and the piercing had gone. I can’t find the piercing and it feels like it might be in my ear drum.
Operator: Right, OK.
Caller: Normally I would go to A&E myself but I don’t actually have any money. A lift to A&E would be amazing.
Caller: My neighbour came here and she gave me a sandwich, cheese and tomato. Anyway, I feel quite sick now. I looked at the tomatoes and there’s mildew on them.
Operator: OK, is that why you’re requiring an ambulance?
Caller: I was mucking about with my plaster cast and it’s coming apart. I don’t know whether to get a taxi or an ambulance.
Operator: From the information you’ve given, you require a more detailed assessment by a nurse. An ambulance will not be sent at this time.
Caller: Oh, you’re joking. Are you being serious?
Operator: We’re extremely busy at the moment.
Caller: I’ll get a taxi.
Caller: I cut my arm, my arm’s cut.
Operator: How did you do that?
Caller: I sliced it on a piece of paper.
Operator: When did this happen?
Caller: About half an hour ago.
Operator: Is there any serious bleeding?
Operator: Tell me exactly what’s happened.
Caller: Basically, my mum drank apple vinegar but mixed it with water and lemon. Now she has diarrhoea.
Caller: Oh, hi there. Basically, I’ve got my hand in a cast. It’s been in there for three weeks and I’ve got it wet.
Caller: It’s not an actual emergency, I just need to get to hospital.
Caller: What it is, right, I’ve got different medication and I don’t know whether I can take these or not now.
Operator: What’s your telephone number?
Caller: I don’t want an ambulance, I just don’t know if I can take my meds or not.
Self-isolation period cut to five days in Wales
PEOPLE who test positive for Covid-19 will be able to leave self-isolation after five full days if they have two negative lateral flow tests, Health Minister Eluned Morgan confirmed today,
The two consecutive negative lateral flow tests must be taken on days five and six of the isolation period.
The changes are being made after a thorough examination of the evidence from Public Health Wales and bring Wales into line with changes made elsewhere in the UK.
They will come into effect from 28 January, at the same time as Wales is expected to complete the move to alert level zero.
A shorter self-isolation period will support public services and businesses by reducing pressures on the workforce through Covid-related staff absences.
Financial support through the Self-Isolation Support Scheme will return to the original payment rate of £500 in recognition of the shorter isolation period. People who need support with essentials such as shopping and pharmacy goods will be able to access help through their local authority and voluntary organisations.
Minister for Health and Social Services Eluned Morgan said:
“Self-isolation is one of the most effective ways of preventing the onward spread of this virus and disrupting its transmission. But self-isolating for long periods can have a negative impact on our mental health and can be damaging for our public services and the wider economy.
“After carefully reviewing all the available evidence, we believe that testing on days five and six together with five full days of isolation will have the same protective effect as a 10-day isolation period.
“But it is really important everyone self-isolates and uses lateral flow tests in the way advised to ensure they protect others from the risk of infection.
“The response from the public has been outstanding in Wales throughout the pandemic and we want to thank everyone for working with us to keep Wales safe.
“The booster jab has lessened the likelihood of severe cases of the virus and hospitalisation, so I encourage anyone who is yet to have their vaccine to take up the offer.”
If a person is currently self-isolating as a positive case, or tests positive for Covid-19, they must self-isolate for five full days and should take a lateral flow test on day five and another test 24 hours later on day six.
If both results are negative, it is likely they are not infectious and can stop isolating.
But anyone who tests positive on either day five or day six must continue to self-isolate until they have two negative tests taken 24 hours apart or until day 10, whichever comes first.
This change reflects the latest evidence from Public Health Wales. Guidance on self-isolation for those working in more sensitive areas such as health and care will issue shortly.
Rhun ap Iorwerth MS, Plaid Cymru spokesperson on health and care, said: “This is undoubtedly good news, but it’s now important to understand what needs to happen to bring this self-isolation period down to zero days – how is Welsh Government assessing this, what conversations are happening, and what criteria will need to be met for this important milestone to be reached?
“In the meantime, we must continue to see effective measures to push down community transmission further and to create more long-term resilience, including more action on clean air in schools, encouraging greater vaccine take-up, and ensuring our health and care services are given the support and resources they need.”
Shadow Health Minister Russell George MS said: “With the booster jab rollout so advanced, the need to keep public services staffed, and the increasing desire to move to a point where we live with the virus, the time for cutting the self-isolation has undoubtedly come.
“Sadly, as has been the case throughout the pandemic with the Labour administration in Cardiff Bay, they replicate decisions taken by the UK Conservative Government but only after playing politics, questioning and undermining such changes days earlier.
“As we move from the pandemic to endemic these political games have to stop as Labour’s response to Omicron harmed Wales, not through mass hospitalisations and deaths, but through thousands having to isolate, leaving public services understaffed, consumers short-changed, and businesses losing out.”
‘Once in a lifetime bid’ for health and care investment in mid and west Wales
HYWEL DDA University Health Board will discuss and agree the submission of an ambitious plan to improve health outcomes and well-being of our population.
A Programme Business Case (PBC) for the Welsh Government, will be discussed at the Health Board meeting at 9.30am on Thursday 27 January 2022, available to watch live here.
It’s a milestone in the Board’s journey to achieve its long-term strategy and improvement in population health – A Healthier Mid and West Wales, which followed extensive engagement and consultation in 2018.
It is also the means by which the Board will address long standing challenges, including fragile services, unsustainable workforce and financial challenges, and an aging hospital estate (some of the oldest hospital buildings in Wales).
The PBC offers hope following the pandemic, that health and care can shift from an illness service with a focus on hospital buildings and intervention, to a service that works across boundaries to prevent ill health or deterioration of health, providing help earlier, and wherever possible closer to home.
Steve Moore, Chief Executive of Hywel Dda UHB, said: “This is the first but important stage of producing a business case to Welsh Government to try to secure a scale of investment never seen before in this area of Wales.
“The COVID-19 pandemic has re-enforced the need for change, and we believe this is our once in a lifetime opportunity to improve the health outcomes and wellbeing of our population and create a healthier mid and west Wales and hope for the future.”
The PBC is the first stage of business planning to secure support from Welsh Government in order to proceed to far more detailed planning, analysis and recommendations on the detail of how to proceed.
Included at this stage is a prospectus of investment opportunities, which could be realised over the next decade, to fundamentally improve the way in which health and care services are provided, as well as the environments they are provided from. If supported, investment could exceed £1.3billion, which is a level never seen before in west Wales. This is a significant bid but reflects the enormity of the change and improvement being sought for the benefit of our communities.
Proposals within the plan include;
- the enablement of closer integration and joint working between health and social care, spanning community, primary care (such as GPs, community pharmacists) and hospital services
- investment in existing or new community hubs (such as integrated care centres) across Carmarthenshire, Ceredigion and Pembrokeshire to bring more care closer to home
- a new Urgent and Planned Care Hospital, somewhere between Narberth and St Clears, providing a design separation between planned and urgent care that will protect the ability to deliver both types of care and reduce waiting times; and inclusive of mental health services
- re-purposing or re-build of Withybush Hospital, Haverfordwest; and Glangwili Hospital, Carmarthen, inclusive of GP-led minor injury units, the ability to provide same-day care, and beds for patients who do not need to be in an acute setting but need support
- improvements and modernisation of Bronglais Hospital, in Aberystwyth, and Prince Philip Hospital, in Llanelli. Bronglais Hospital will continue to provide acute emergency and planned care and Prince Philip Hospital will continue to provide a GP-led minor injuries unit as well as acute adult medical care, consultant-led overnight beds and diagnostic support
Changing the way services are delivered and improving the environments will improve patient outcomes, quality of care and patient experience. By bringing together some services onto fewer sites, such as trauma, emergency surgery and A&E, the health board will also be able to improve standards.
To properly appraise all options, as required by Welsh Government business case process, the next stage would look in more detail at how we re-purpose Glangwili and Withybush Hospitals. This would include options to use the current buildings and location, but also potential to re-build them on site.
Another fundamental aspect of the PBC is a focus on providing better conditions and opportunities for staff, to retain and attract the workforce needed. One of the board’s biggest challenges has been workforce shortages and over-reliance, and cost of, temporary staff.
The health board also wants to maximise the social benefit from the way it works and anticipates the proposed investment would bring significant economic benefits for our communities. For example, the procurement (purchasing) strategy is to increase the proportion of spending with local suppliers or providers that support job opportunities for more vulnerable citizens or local employment, training and apprenticeship opportunities.
The PBC recognises the need to create a digital infrastructure that will enable the health board to connect with patients and service users in all settings, creating a health system ‘without walls’. This would include innovations, such as wearables, more advanced electronic health records, and greater use of technology to simplify processes including admission and discharge.
It is through this transformation that the health board believes its buildings and infrastructure can support NHS Wales decarbonisation strategy.
Mr Moore added: “I understand the strength of feeling and passion for our NHS that our staff and public have and we want to continue to harness that and keep engaging with our communities as we build more detail around these plans.
“To enable a generational shift to a wellness system we need the whole package of prevention and early intervention, at all stages of life. That includes the backbone of strong and sustainable primary and community services; proper provision of rehabilitation and therapies; acute hospital services that are able to provide the standard of provision our communities deserve; and a supported workforce.”
Following a formal endorsement from the Welsh Government, the health board will then move to the next stage of individual outline and final business cases for elements of the programme. There will be a need for regular engagement, and possibly consultation on parts of the programme, with patients, public, staff, and partners.
In the meantime, the health board will continue with the process around site selection and preparation for the new urgent and planned care hospital. We are working with the Consultation Institute to ensure public involvement in the criteria and final scoring of options. We will share progress on this as more information is available. It is hoped a preferred site will be identified in the summer.
Same Day Urgent Care at Cardigan Integrated Care Centre
CARDIGAN’S Minor Injuries Unit (MIU) and Same Day Urgent Care service (SDUC) will once again open for walk-in appointments this weekend (22/23 January 2022) after providing care and treatment for nearly 30 patients who would otherwise have gone to A&E or their GP.
As part of a new trial to help relieve pressures on our hospital A&E departments, the nurse-led services – which are based in Cardigan Integrated Care Centre – opened for weekend walk-ins without prior appointment between 15 and 16 January, with our staff seeing and treating a number of patients over the two days.
The services are led by Advanced Nurse Practitioners who can assess, diagnose and treat walk-in patients who are then able to return home the same day, with a plan of care involving referrals to other services if necessary.
Our hospitals are currently dealing with unprecedented demand, which is leading to significant delays in care provision and long waits in A&E. If you have a condition which could be seen and treated at Cardigan’s Integrated Care Centre, we would strongly encourage you to attend as you can be seen more quickly, as well as helping to relieve pressure on the hospital system.
The type of conditions our Advanced Nurse Practitioners can see and treat include:
- Chest Infections
- Wound Infections
- Urinary Tract Infections
- Tonsillitis / sore throat
- Ear Infections
- Minor Chest/Hip/Pelvic/Back injuries – Patient must be able to mobilise
- Minor Head Injury
- Non-cardiac chest pain
- Skin complaints including rashes, infections, and sunburn
- Sprains, strains & soft tissue injuries
- Hay fever, Mild allergic reactions
- Minor injuries – cuts, wounds
- Minor eye injuries, complaints and irritations requiring irrigation, and Chemical eye injury
- Emergency contraception
- Suspected fractures and injuries to knee, lower leg, ankle, and feet
- Suspected fractures and injuries to arms
- Animal, insect, or human bites
- Minor burns & scalds
- Removal of foreign bodies from eyes, ears, nose & skin
In patient feedback given to our nurses over the weekend of 15 and 16 January, all patients agreed or strongly agreed that staff had explained the service; that they were satisfied with their treatment plan, and that they had the opportunity to raise questions or concerns.
Patients also reported feeling more confident about managing their symptoms and being satisfied with the service to the point of recommending it to others.
Sian Lewis, Clinical Lead Nurse for Ceredigion Community, said: “Our Advanced Nurses were really pleased to be able to see and treat so many patients last weekend – particularly given that many of them would have otherwise faced long waits in A&E for the type of conditions that our teams here are well equipped to deal with.
“Please give us a call, or come down to the Integrated Care Centre in Cardigan if you need care and you think we can help – you don’t need an appointment, we can provide a quick service and you can be on your way home on the same day with a care plan if you need it.”
Cardigan Integrated Care Centre is located at Rhodfa’r Felin, Cardigan SA43 1JX. If you would like to speak with a triage nurse at the centre first to discuss your condition, please call 01239 803 075.
If you have a more urgent care need or in a medical emergency, please dial 999.
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