Save Princess of Wales Hospital

Thursday, 23 May 2013

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

South Wales Evening Post

May 23rd, 2013

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

22 May 2013 14:00

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.

“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.

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

Wednesday, 15 May 2013

Glamorgan Gazette - Thursday 16th May 2013

The Princess of Wales Hospital will NOT be recommended for downgrading under controversial hospital service shake-up plans, the Gazette understands.

The rumour was firmed up by a senior NHS source yesterday – days before health bosses’ preferred options for frontline service reconfiguration are publicly released.

The Gazette has learned the Coity Road hospital will likely be named as a preferred option to retain its key services – including its 60,000-patient-a-year specialist A&E department – when the South Wales Programme (SWP) board unveil their public consultation document next week.

It is understood Prince Charles Hospital in Merthyr Tydfil will also be named as a preferred choice for a “regional centre” hospital – along with the already confirmed choices of University Hospital of Wales, Cardiff, Morriston Hospital, Swansea, and the new Critical Care Centre, near Cwmbran.

That means the Royal Glamorgan Hospital, Llantrisant, would miss out.

Leaders from the five health boards involved in the SWP process will meet to formally sign off a consultation document next week before another round of public consultation follows.

But it is understood PoW scored highly in the criteria and will be mooted as a preferred hub hospital.

“It is recognition that PoW has, for many years, had a very good reputation and a high level of care for the people in its area,” said the NHS source.

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.

The news is likely to buoy campaigners in Bridgend, thousands of whom have voiced concerns about possible service reductions.

But they have been warned no final decision has yet been made and were urged to keep up the fight during the upcoming consultation period.

“As you can well imagine, people in the Rhondda are going to be pretty disappointed,” said the NHS source.

“There is no room for complacency in Bridgend about this.

“People have to attend the next round of consultation events and keep on fighting until the final decision is made.”

Clinicians and health bosses have been working for months on the plans to centralise A&E, consultant-led maternity and neonatal care and children’s inpatient services at fewer South Wales hospitals, arguing these services are currently spread too thinly to be run safely.

It is understood the consultation document will include various hospital configuration options, with the “best fit” option of regional centre hospitals in Cardiff, Swansea, Bridgend, Merthyr Tydfil and the Cwmbran centre.

Health board bosses behind the SWP said the consultation document is still being finalised.

A joint statement from the chairmen and chief executives of Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff and Vale, Cwm Taf and Powys health boards said: “The formal consultation process will commence in line with the agreed timetable.

“The consultation documentation is currently being finalised and will incorporate all the options to be consulted upon.

“It will also identify the option that best fits the assessment criteria, which has been used in the process so far.

“Following agreement by all the boards to proceed to consultation, there will be a full and open process to listen to and consider the public’s views about all the options.”

Cardiff lawyer Michael Imperato, who is involved in a judicial review of Hywel Dda Health Board’s bid to downgrade the A&E service at Prince Philip Hospital in Llanelli, said he “feared” for Llantrisant’s Royal Glamorgan Hospital.

“Put it this way, I have had concerns put to me about the Royal Glamorgan and none from anyone in Bridgend or Merthyr,” he said yesterday.

“I fear for the Royal Glamorgan and would urge people to be ready with their arguments during the public consultation stage.”

No hospitals will close under the plans and clinicians leading the SWP process insist the “vast majority” of patients currently accessing care at their nearest hospital will continue to do so even if it does not become a regional centre.

Meanwhile, the Welsh Conservatives’ health spokesman Darren Millar AM this week called on the NHS in Wales to abandon the reorganisation plans altogether.

He said any move to reduce the number of emergency units in the region at a time of swelling demand would be “just crazy” and would “fly in the face of common sense”.

But Bridgend AM Carwyn Jones told AMs at First Minister’s Questions that Mr Millar’s comments represented a “do nothing” approach, which was “exceptionally lazy”.

Clinicians behind the SWP changes said doctor shortages and other pressures mean change is vital. Dr Grant Robinson, medical director of Aneurin Bevan Health Board, said: “We want to ensure that patients get the right care for their illness or injury and are seen by the right clinicians who can help them return to full health.

“Care for the most seriously injured and sick patients would be concentrated on fewer hospital sites across South Wales, ensuring senior experienced clinicians are available when patients need them.”

More than 4,000 people signed a “Bridgend Princess Of Wales – Save Our Services – Stop the Downgrade” petition before it was handed into the National Assembly last year.

Thursday, 2 May 2013

NHS neglect 'contributed to death'

A man with severe learning difficulties died from natural causes contributed to by neglect at a Swansea hospital, a coroner has ruled.

An inquest in the city heard that Paul Ridd's nursing care at Morriston Hospital was substantially below the expected standard.

Mr Ridd, 53, from Baglan, near Port Talbot, died after an operation on his bowel in January 2009.

Abertawe Bo Morgannwg Health Board said its care quality had since improved.

Mr Ridd, who was described by his family as a gentle giant, could not communicate beyond a few words.

He died from respiratory problems after being transferred from intensive care to a general ward. The inquest was told that there were omissions in a number of areas in his care.

Linda Bevan, head of nursing for the surgical unit, told the hearing that staffing levels among nurses on Mr Ridd's ward had not been high enough, but they had since improved.

She also said his nursing notes did not follow set guidelines and were not good enough.

She conceded that suction to Mr Ridd's lungs, which doctors had said should have happened every two to four hours, occurred only three times in total during a stay of nearly three days in the ward.

She added that if he had been in the hospital now, his care would have been immensely different.

At the end of the two-day hearing, Mr Ridd's sister Jane Nicholls wept as Swansea coroner Philip Rogers ruled that the hospital's neglect had contributed to his death.

He told the coroner's court that there had been catalogue of errors in Mr Ridd's treatment, a gross failure to provide adequate medical care and a clear connection in the way he was treated and the cause of his death.

'Third World country'
Following the inquest, Mr Ridd's brother Jonathan said he was pleased with the verdict and felt the family had been given "some justice".

His sister said they hoped the case would lead to "major change" and that what they had been through would not happen to anybody else.

"I'm satisfied with the outcome [of the inquest] because we have been listened to," she said. "I'm still heartbroken because he actually died from neglect and there was a chance he could still be here."

The family is now working with the hospital to provide better training for staff to meet the needs of disabled people.

The health board offered its "sincere condolences and apologies" to Mr Ridd's family.

"We are truly sorry that whilst he was a patient on one of our wards, Mr Ridd received care which fell well below acceptable standards," it said.

"Following this tragic event a thorough investigation was carried out and improvement actions identified. We have worked hard to address the shortcomings identified and have taken action to improve the quality of care we provide across the health board.

"We appreciate that these improvements in care can be of little comfort to the family of Mr Ridd. The health board would like to acknowledge that the concerns raised in this case have improved care for others."

In 2011, the public services ombudsman for Wales said in a report into concerns surrounding his death that Mr Ridd's nursing care was "abject" and "dire".

BBC © 2013

Only 52% NHS staff happy with care

The survey is the first to be carried out in six years
Only 52% of NHS employees in Wales would be happy with the standard of care provided by the health service if a friend or relative needed treatment.

The findings of an NHS staff survey also show that a third of workers have been ill with stress in the past year.

But it also found staff are highly dedicated, with more than four in five saying they would be willing "to go the extra mile" for the organisation.

Health Minister Mark Drakeford said the survey showed a "mixed" picture.

"It isn't satisfactory that just over half of people working in our NHS positively think that what they provide would be good for somebody in their family," he said.

"It's a finding that's consistent with other parts of the NHS across the United Kingdom and I think it does reflect the sense of a service which it knows it is under pressure and not able to do a job that people would like to be done."

Mr Drakeford said some staff felt under strain and that the survey showed a "disconnect" between managers and employees on the front line. He was also concerned about scepticism among staff that their views will be acted on.

He said: "My job is to make sure this survey is used and pursued, and that local managements take it seriously and respond to it."

The survey is the first to be carried out in six years with 22,392 staff working in the Welsh NHS filling it out, representing 27% of the workforce.

It found 64% of NHS staff who responded said they were satisfied with their current job but fewer than half would recommend the NHS as an place to work.

Not enough time
A third of staff said they had been injured or felt unwell because of stress in the last 12 months and just under half (48%) felt they did not have enough time to complete their work.

Work related stress was highest amongst ambulance technicians (65%), paramedics (62%) and ambulance control staff (45%).

The survey responses also suggested that issues of bullying harassment and violence affected a small but notable minority of health service staff.

The Royal College of Nursing (RCN) in Wales and Unison - the union that represents many NHS staff - welcomed the survey's publication but called for action to address some of the concerns.

Peter Meredith-Smith of RCN Wales said the survey would only be beneficial if concerns were addressed.

He added: "Although the headline findings are in many respects positive, close reading of the national report indicates an NHS in Wales that is under significant pressure. It is apparent that frontline clinical staff are bearing the burden of that pressure.

Dawn Bowden, head of health at Unison Cymru Wales, said it was important to gauge how morale and workload pressures are among NHS staff.

'Matter of concern'

She said: "There are some very clear positives coming out of the survey results, showing that the workforce are committed and want to deliver a quality service.

"However, there are some concerning elements of the survey and it is essential that these elements are addressed in order to ensure that this staff survey is a meaningful exercise for the workforce and patients."

Dr Richard Lewis, Welsh secretary of the British Medical Association, added: "While this survey reflects much that is good in NHS Wales from the perspective of the frontline staff who work in it, clearly there is much to be done to change some of the unacceptable cultural norms."

The survey also indicated significant problems within the Welsh Ambulance Service.

Ambulance staff reported the lowest level of job satisfaction of any group in the NHS and a relatively high level of concerns in several categories.

They include the lowest levels of job engagement, the highest levels of stress, and higher levels of dissatisfaction with managers. Paramedics were also least happy about the standard of care being delivered.

Mr Drakeford called it "a matter of concern".

Last week a wide ranging review into the ambulance service highlighted problems with staff morale and recommended big changes to the way it is run.

The review will be debated by Welsh assembly members on Tuesday.

BBC © 2013

Figures released for A&E department at the Princess of Wales Hospital in Bridgend MAY 2, 2013

THE ACCIDENT and emergency department at the Princess of Wales Hospital in Bridgend dealt with more than 60,000 patients in 2012.

The under-threat department saw 25,000 people with major health problems and a further 35,000 with minor issues.

The figures were released as a result of a Freedom of information request submitted by Welsh Conservative regional AM’s Byron Davies and Suzy Davies and Vale MP Alun Cairns.

Concerns about the future of the A&E department have been mounting since it was revealed that POW could be downgraded under the South Wales Programme.

Unless it is designated as a regional centre, it will lose its A&E department, its children’s ward, its neonatal baby unit and its obstetrician-led maternity unit.

Instead the hospital will have a minor injuries unit, a paediatric assessment unit but no overnight facilities for children and a midwife-led maternity unit. No gynaecological procedures would take place at the hospital either.

The three also asked for figures relating to the other departments facing closure.

They were told that 4730 children were admitted to the children’s ward during the year while 316 babies were treated in the neo-natal unit.

The maternity department saw 2317 births of which 885 required intervention from an obstetrician. 490 women received epidural anaesthesia. In addition, the gynaecological ward dealt with 1,720 women.

Byron Davies said that the figures were truly terrifying.

“In all, 70,000 people ranging from mothers in labour and newborn babies through to children and adults of all ages received treatment in 2012 in departments, especially A&E, that are now under threat.

“What will happen to the many thousands of others like them in the future if these cut backs go ahead?

“This is an alarming scenario and these figures only show how right it is that the people of Bridgend and the Vale fight to keep all facilities at this district general hospital.

“The most frightening prospect involves A&E. How on earth would the other accident and emergency departments in hospitals like the Royal Glamorgan and Morriston manage if 60,000 extra patients land on their doorsteps?

“Despite a £6m revamp of A&E at Morriston, they are failing to cope with existing demand – and that’s while POW is still functioning normally.

“ I urge the Welsh Labour government to re-think its plans to axe £534m from the health budget over three years. It is not do-able and will decimate the health service.”

Suzy Davies said that while there was an issue with people with minor injuries clogging up A&E, that should not obscure the fact that 25,000 people with serious health problems attended last year.

She also said that closing the obstetrician-led maternity unit would put mothers and babies at risk.

She added:

“Complications can arise very quickly and without prior warning in both pregnancy and during labour with women suddenly needing an emergency c-section.

“If they are in a midwife-led unit with no doctors available, what will happen? There will certainly be no time to put someone in an ambulance and send them to Swansea or Cardiff. Quite simply, they will be dead in the back when they arrive.”

Mr Cairns said that the Western Vale, including Cowbridge, Llantwit Major and other communities would be badly hit by any downgrading at POW.

He said:

“It is important that people from the Vale get behind the fight that’s already taking place in Bridgend to keep these services at the hospital.

“Bridgend is much more accessible than other hospitals like Llantrisant and Llandough. People suffering a heart attack or stroke need to be treated very quickly and I am worried about delays in getting the urgent treatment that’s required if people are having to be taken much longer distances.

“There is also the issue of capacity at the other hospitals and also whether the ambulance service will cope. We already have dire problems with ambulance response times in the Vale and the increased pressure caused by closing these departments at Bridgend will make a bad situation worse.”

No decisions have been made yet under the South Wales Programme and definite proposals are expected in May.

Pages

Thursday, 23 May 2013

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

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Wednesday, 15 May 2013

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Thursday, 2 May 2013

NHS neglect 'contributed to death'

Only 52% NHS staff happy with care

Figures released for A&E department at the Princess of Wales Hospital in Bridgend MAY 2, 2013