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