Friday 24 May 2013

URGENT

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PRINCESS OF WALES NEEDS YOU!

Save Our Services - Stop the Downgrade!

Thursday 23 May 2013

Jabs and 999 calls in NHS priorities


nurse
The framework outlines the priorities for the NHS in Wales

Immediate action is needed by the NHS in Wales to increase vaccinations of young children, reduce A&E waiting times and to get to grips with bed blocking, health chiefs say.

The NHS Delivery Framework priorities for 2013/14 also include spot-checks relating to patients' dignity of care.

NHS Wales chief executive David Sissling said the focus was "quality, patient experience and outcome".

Opposition parties say cancer care and doctor training also needs to improve.

The priorities outlined are:

spot checks and patient surveys to see if dignity in care is improving

ensuring improvements in ambulance response times, patient waiting times in A&E departments and access to planned care

vaccinating 95% of children up to the age of four with scheduled jabs such as the triple vaccine MMR

closer working with social care agencies to reduce emergency hospital admissions

Mr Sissling said: "It will ensure the NHS can drive up standards in key areas. During the course of the next few months we will be looking to further improve our targets.

"We will be working with our staff, stakeholders and service users to ensure we are monitoring and measuring the things which will really make a difference."

In a move to ease pressure on hospitals, Health Minister Mark Drakeford last month said patients should leave as soon as they can and not continue to occupy a ward bed.

Measles crackdown

This month a review of the ambulance service ordered by former Health Minister Lesley Griffiths recommended a revamp of its performance targets and said crews should concentrate on emergency patients with routine transfers to hospitals becoming the responsibility of local health boards.

The focus on vaccination rates comes as Wales is tackling its largest measles outbreak in a generation, with 1,136 suspected cases since November 2012.

An MMR drop-in clinic at Neath Port Talbot Hospital
MMR drop-in clinics finish this weekend, but jabs will be available from GPs

More than 60,000 unscheduled MMR vaccinations have been given aimed at reducing the length and severity of the outbreak but Public Health Wales says another 33,000 youngsters between 10 and 18 still have not had the jab.

A spokesman said: "Our MMR uptake in small children has been rising over the last few years but we are still short of hitting the 95% target for both doses of MMR that would eradicate measles in Wales."

The issue of dignity in care follows concerns highlighted by the public inquiry into Stafford Hospital which uncovered neglect and abuse of patients leading to hundreds of unnecessary deaths between 2005 and 2008.

It was also raised in December by Cynon Valley MP Ann Clwyd who complained that her husband Owen Roberts had died "like a battery hen" at the University Hospital of Wales in Cardiff.

She is now advising Prime Minister David Cameron on how NHS hospitals handle complaints.

Opposition parties in Wales have responded to the publication of the priorities by highlighting other issues they want tackled.

Welsh Conservatives health spokesman Darren Millar said: "There is nothing here to suggest the cancer delivery plan will be dusted off and implemented, no guarantees on abysmal cancer waiting times, and nothing to address the unfair divide in access to cancer drugs."

Plaid Cymru health spokesperson Elin Jones said there was a need to "train more doctors in Wales, and ensure that more doctors that train in Wales stay in Wales to work".

Welsh Lib Dem leader Kirsty Williams said the priorities were "hardly surprising" and the party would use them to ensure "the Welsh Labour government learns from its mistakes and starts to actually improve our health service, rather than sitting back and continuing to allow our NHS to deteriorate".

BBC © 2013

Campaigners warn against complacency - Glamorgan Gazette (23/5/13)

CAMPAIGNERS warned there is “no room for complacency” after health chiefs endorsed a plan not to downgrade services at the Princess of Wales Hospital.
Bosses behind controversial shake-up plans for hospitals in South Wales yesterday formally recommended that the PoW retain key services, as the Gazette exclusively revealed last week.
 
The hospital was named by the South Wales Programme’s board as a “best fit” to become one of five “regional centres” along with University Hospital of Wales, Cardiff, Morriston Hospital, Swansea, and the new Critical Care Centre, near Cwmbran.
Merthyr Tydfil’s Prince Charles Hospital is also among the health board’s preferred sites, meaning specialist services at the Royal Glamorgan Hospital in Llantrisant could be downgraded.
 
Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff and Vale, Cwm Taf and Powys health boards agreed to adopt the South Wales Programme’s recommendation on Wednesday. The plans will now be subject to an eight-week public consultation, which starts today.
If it does become a regional centre, PoW will treat more
patients from a wider catchment area but would retain its 24/7 specialist A&E department, consultant-led baby care service and inpatient children’s ward.
 
Campaigners said they were encouraged by the news that PoW could become a regional centre – but urged caution.
 
The three other options would all see PoW lose consultant-led accident and emergency, maternity and children’s services.
 
Mel Hughes, of Carmen Street, Caerau, organised a march in February against the possible loss of specialist services.
“It’s imperative that the people of Bridgend are aware that this is only a recommendation and this decision can be changed,” he said.
“I’m very encouraged about the proposal that Bridgend becomes a regional centre because at the beginning of our campaign it looked like Bridgend was not getting anything.”
He added: “I’m really delighted at the proposal we remain a regional centre but we still have to be careful.”
 
Ian Spiller – the driving force behind the Bridgend Princess Of Wales – Save Our Services – Stop the Downgrade campaign – said: “The fight is far from over – that is the view that I would like to get across.
“In Bridgend we cannot afford to be complacent.”
 
Health chiefs argue staff shortages are being compounded by recruitment problems, making safe standards of clinical care more difficult to sustain.
Dr Graham Shortland, medical director of Cardiff and Vale University health board, said: “We cannot continue to provide consultant-led maternity and neonatal care, inpatient children’s services and emergency medicine for the most seriously-injured and sickest patients in all hospitals – we are not providing the highest quality care for patients all the time and our doctors are spread too thinly.
“Concentrating these services in fewer hospitals in South Wales will mean that patients with life-threatening injuries and illnesses will get faster access to senior clinicians when they come to hospital.
“The changes will help improve the standard of care we are able to give to all patients when they come to hospital in the future.”
Health board bosses said if the proposal goes ahead, some services – such as planned surgery – could be transferred to the Royal Glamorgan from the Princess of Wales and the University Hospital of Wales, Cardiff.
 
Bethan Jenkins, Plaid Cymru AM for South Wales West, said: “Once again, I find myself disappointed by how a health service consultation is being framed.
“The proposals raise a considerable number of questions on how they will be delivered.
“These four options could well force people into turf wars over saving services at their local hospital. It’s important to remember this consultation has come about through a failure of management, not a failure of services.
“People pay their taxes because they believe in investing in the health service. Instead, we are being told that not enough doctors can be recruited by health board directors who were appointed to do just that – and paid very handsomely for it.”
 
Liberal Democrat AM Peter Black said: “These proposals are not set in stone. We need to remain vigilant, continue to make the case for our hospitals to keep these services locally and above all, ensure that the new consultation reflects the views of residents in Swansea, Neath Port Talbot and Bridgend.”
 
Tory AMs Byron Davies and Suzy Davies challenged the
Labour-led Welsh Government to tackle the root of the problem.
“I accept there is a recruitment crisis in Wales in attracting more doctors especially in emergency medicine but the Welsh Labour Government needs to tackle the causes rather than seek to centralise emergency medicine in too few centres,” said Mr Davies.
Suzy Davies said: “The fight put up by the people of Bridgend and the Vale to keep all services at PoW has been critical. But there is no room for complacency.
“This is only a recommendation so it is essential we keep up the pressure to ensure we retain a viable hospital in Bridgend.”
 
Labour’s Ogmore AM Janice Gregory AM said: “I am pleased that the public will now get their say on definite proposals, including the recommended option of five centres including the Princess of Wales. Nothing is yet decided so I would urge everyone to respond to the consultation.”
 
Bridgend AM and First Minister for Wales Carwyn Jones told the Gazette: “It’s important that the Princess of Wales is a regional centre as a preferred option.
“It’s important still of course that people make their views known as part of the consultation process but it shows the strength of the hospital in terms of its staff and training facilities.”
He added: “As far as Bridgend is concerned it’s a preferred
option and that is something I will continue to advocate.”

Consultation over big South Wales health service shake-up due to start


Consultation over big South Wales health service shake-up due to start tomorrow

CONSULTATION over the biggest shake-up of health services in South Wales for decades is due to start today.

THE five health boards providing care for people in South Wales and South Powys have been asked to launch a formal public consultation about the future of four hospital services.

Abertawe Bro Morgannwg University Health Board members agreed to the move at a special board meeting on Wednesday.

Aneurin Bevan, Cardiff and Vale, Cwm Taf and Powys health boards also held meetings during which they were asked to agree an eight-week consultation about the future of consultant-led maternity and neonatal care, inpatient children’s services and emergency medicine (A&E).

Frontline doctors, nurses, midwives, therapists and paramedics have been working together over the last 18 months to look at the challenges facing these services – including problems recruiting sufficient doctors - and ideas for their future to ensure they meet standards and are clinically safe and sustainable.

This is called the South Wales Programme – a partnership of the five health boards and the Welsh Ambulance Services NHS Trust.

These ideas, including where they could be based, were shared with the public during a three-month engagement last year.

This revealed widespread understanding about why these services can no longer be provided in all hospitals and significant support for the ideas to concentrate them in four or five hospitals.

Dr Graham Shortland, medical director of Cardiff and Vale University Health Board, said: “We cannot continue to provide consultant-led maternity and neonatal care, inpatient children’s services and emergency medicine (A&E) for the most seriously-injured and sickest patients in all hospitals – we are not providing the highest quality care for patients all the time and our doctors are spread too thinly.

“Concentrating these services in fewer hospitals in South Wales will mean that patients with life-threatening injuries and illnesses will get faster access to senior clinicians when they come to hospital, which will mean they get faster treatment and get better more quickly.

“The changes will help improve the standard of care we are able to give to all patients when they come to hospital in the future because patients will be getting care from the most appropriate clinician for their needs.”

There are four options being proposed, all of which see these services being provided at Morriston Hospital, University Hospital of Wales in Cardiff, and the Specialist and Critical Care Centre due to be built near Cwmbran.

The favoured option would see the services also provided at Princess of Wales Hospital in Bridgend and Prince Charles Hospital in Merthyr Tydfil.

The South Wales Programme says each option has been assessed against a wide range of factors, including their impact on travel times, especially for people living in the most deprived communities; the number of doctors needed; the impact on the Welsh Ambulance Service, and; a high-level assessment of how much they will cost.

Finance is an important factor but the South Wales Programme is said not to be about saving money or cutting costs – but about improving care for patients and achieving clinical standards.

Dr Andrew Goodall, chief executive of Aneurin Bevan Health Board and the lead chief executive for the South Wales Programme, said: “Whatever the outcome of the South Wales Programme, all our hospitals have a vital role to play in the future of healthcare for people in South Wales and South Powys.

“No hospitals will be ‘downgraded’ as a result of this process; no A&E departments will be closed – the majority of patients will continue to get their care from their local hospital, exactly as they do now.

“It is only the small number of patients who are seriously injured or ill who will have their care provided at a different hospital. For these patients, travelling a little further – in an emergency ambulance with highly-skilled paramedics – will mean they get better care, which will hopefully increase their chances of surviving their illness or injury.

“If these patients need ongoing care, we are committed to getting them to their local hospital closer to home as soon as clinically appropriate.”

He added: “We look forward to working with community health councils during the consultation period and we would encourage everyone to get involved and let us know what they think of the options for the future of these services.”

The consultation document, the supporting technical documents, the draft equality impact assessment and full details of all the public meetings to support the public consultation will be available on the South Wales Programme website: www.wales.nhs.uk/swp and www.wales.nhs.uk/swp/hafan (Welsh) from tomorrow.

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Royal Glamorgan faces losing key services under overhaul of hospital care in South Wales


Health bosses involved in South Wales Programme outline four proposals - but say cutting service from Royal Glamorgan is 'best fit'

The Royal Glamorgan Hospital in Llantrisant could face losing key services
The Royal Glamorgan Hospital in Llantrisant could face losing key services
Richard Williams

The future of A&E provision for the sickest and most seriously injured patients at the Royal Glamorgan Hospital could be under threat following proposals to shake-up hospital care in South Wales.

Health bosses involved in the South Wales Programme have outlined four options for the future of consultant-led A&E, neonatal, maternity and inpatient children’s services in the region as part of NHS reconfiguration plans.

The options, which follow a three-month engagement period and will now go to an eight-week public consultation, will see at least one hospital from Bridgend’s Princess of Wales, Llantrisant’s Royal Glamorgan or Merthyr Tydfil’s Prince Charles, lose these four services.

But health bosses from the five health boards involved in the Programme said the ‘best fit’ option which scored most highly on issues such as safety, quality and access, would be to remove these services from the Royal Glamorgan site.

This would mean that emergency care at the hospital would move from level two to level three, with no A&E consultants based at the hospital.

Non-serious injuries and uncomplicated fractures would be treated at the hospital but patients with more serious injuries will have to go another site, likely to be the University Hospital of Wales in Cardiff.

Under this option, consultant led A&E, neonatal, maternity and inpatient children’s services would instead be provided for patients across South Wales in five hospitals -  University Hospital of Wales,  Morriston, Prince Charles, Princess of Wales and a new Specialist and Critical Care Centre (SCCC) in Cwmbran.

Health bosses said the proposals had been designed to tackle the issues of doctor shortages and concerns over standards of patient care.

They insisted the options did not amount to a downgrade and said care would remain the same for the majority of patients, with around one in five having to travel to another site.

Dr Andrew Goodall, chief executive of Aneurin Bevan Health Board and the lead chief executive for the South Wales Programme, said: “Whatever the outcome of the South Wales Programme, all our hospitals have a vital role  to play in the future of healthcare for people in South Wales and Powys.

“No hospitals will be ‘downgraded’ as a result of this process, no A&E departments will be closed - the majority of patients will continue to get their care from their local hospital, exactly as they do now.

“It is only the small number of patients who are seriously injured or ill who will have their care provided at a different hospital.”

Dr Graham Shortland, medical director of Cardiff and Vale University Health Board, said: “We cannot continue to provide consultant-led maternity and neonatal care, inpatient children’s services and emergency medicine for the most seriously-injured and sickest patients in all hospitals – we are not providing the highest quality care for patients all the time and our doctors are spread too thinly.

“Concentrating these services in fewer hospitals in South Wales will mean that patients with life-threatening injuries and illnesses will get faster access to senior clinicians when they come to hospital, which will mean they get faster treatment and get better more quickly.

“The changes will help improve the standard of care we are able to give to all patients when they come to hospital in the future because patients will be getting care from the most appropriate clinician for their needs.”

But the proposals came under fire from critics who accused health officials of moving services away from the communities who need them the most.

Concerns were also raised about moving this level of care further away from an area with transport difficulties and where ambulance response times for the most serious calls are at their worst.

Last month, just 42.1% of ambulances responded to Category A calls in the eight minute target.

Plaid Cymru Leader and South Wales Central AM Leanne Wood said: “The people of Rhondda Cynon Taf will be very concerned to discover that critical services could be taken from the Royal Glamorgan hospital in Llantrisant.

“RCT is an area where many of the residents have chronic health problems, the road network is poor and the local ambulance service has the worst performance in Wales for responding to life-threatening emergency calls.

“People will be rightly concerned that the health boards’ preferred option would involve people from RCT travelling further in life-threatening emergencies.

“There was an admission today from health chiefs that the ambulance service is ‘struggling’ and would need ‘strengthening’ to cope with the new proposed five-site model for South Wales hospital services.

“The term ‘strengthening’ doesn’t come close to what is needed to ensure people in life-threatening emergencies in RCT can be taken to an A&E department in time if they cannot be taken to the Royal Glamorgan. 

“This is still a consultation exercise and we can change these plans.  Anyone concerned about the preferred option to take acute A&E services away from the Royal Glamorgan hospital, or any other hospital in south Wales, should make their views known to the consultation process.”

Eluned Parrott, Liberal Democrat AM for South Wales Central, said: “I’m sure the proposals outlined today will come as a shock and a worry to people across South Wales, particularly those who rely on services such as A&E at the Royal Glamorgan Hospital in Llantrisant.

“Patients using emergency services at the University Hospital in Cardiff already experience long waiting times and crowded and uncomfortable conditions. 

“We need to carefully assess whether a better-staffed and resourced University Hospital could deliver a better quality of care for patients than the existing two currently do, or whether the pressure of numbers would have a detrimental impact.

“The reforms planned are very radical, but some of our health services in South Wales have been failing to provide the kind of care that local people deserve for some time now. 

“Clearly some action is needed, but the safety of patients should be the key factor in deciding how our services are organised.

"Now is not the time for knee-jerk reactions, but for careful considered discussion.”

Health officials insisted that by travelling further patients would receive a higher standard of care which would actually improve their chances of survival. They also said the Welsh Ambulance Service Trust had been a partner in developing the four options.

Dr Goodall added: “For these patients, travelling a little further - in an emergency ambulance with highly-skilled paramedics - will mean they get better care, which will hopefully increase their chances of surviving their illness or injury.

“If these patients need ongoing care, we are committed to getting them to their local hospital closer to home as soon as clinically appropriate.”

Helen Birtwhistle, director of the Welsh NHS Confederation, said: “The need for change in the way we provide care in hospitals is clearly evident and the challenges faced by the NHS service in Wales cannot de disputed and are widely understood.

“The result of the changes will be that seriously ill and injured patients will have better and faster access to care from senior and expert doctors, which will have an immediate and direct effect on their recovery.

“This progressive reshaping of services will create a different but more sustainable network of hospitals throughout South Wales and will have the direct result of delivering better quality care to patients.”

The public consultation will start tomorrow and end on July 19.

The four options for the provision of consultant-led services for A&E, neonatal, maternity and inpatient children’s services are:

Option 1: 

* University Hospital of Wales (UHW), Cardiff

* Morriston Hospital, Swansea

* Specialist and Critical Care Centre (SCCC), a new hospital which is planned to be built near Cwmbran

* Prince Charles Hospital in Merthyr Tydfil

Option 2:

* UHW

* Morriston

* SCCC

* Royal Glamorgan Hospital in Llantrisant

Option 3 (‘best fit’ option)

* UHW

* Morriston

* SCCC

* Prince Charles Hospital

* Princess of Wales Hospital in Bridgend

Option 4: 

* UHW

* Morriston

* SCCC

* Prince Charles

* Royal Glamorgan