Withybush changes ARE temporary insist health board

In a bid to keep Withybush open 24/7 despite a lack of doctors Hywel Dda University Health Board (UHB) announced last week that its solution to continue admitting patients and keep the Emergency and Urgent Care Centre included reducing the number of patients admitted to the Haverfordwest hospital.

This would be achieved “by temporarily changing the catchment area of Withybush Hospital, diverting GP admissions and ambulance transfers from Cardigan, Narberth, Kilgetty, Saundersfoot and Tenby to Glangwili Hospital, Carmarthen”.

The health board claim that the road network from these areas is “good and travel times similar to Glangwili Hospital as Withybush Hospital so patients are not disadvantaged and the impact on the Welsh Ambulance Services Trust is also lessened”.

It adds that “more beds will be provided at Glangwili and Prince Philip Hospital to care for these patients, supported by medical and nursing staff allocated to the hospital and agency staff where necessary”.

Chief executive Steve Moore said: “Absolutely it is temporary; we are really clear what we have a situation that will probably last August to Christmas. From August it will be a rebuilding picture with new doctors coming in. What’s important is this model allows 24/7 to continue to be delivered.”

He added that the hospital would have been at much greater risk if the health board had to go down the route of closing medical services in the day.

“The public should be reassured the model is a safe one and one we can build from.”

When asked about fears this move will be a step towards making Withybush a cottage hospital, Mr Moore said: “I think the opposite. We’ve been clear we are 100% behind this hospital, the continuation of 24/7 A&E and all that entails.”

He, and medical director Dr Iain Robertson-Steele said that 11 doctors were lined up to start in the next few months who were either awaiting visas or ready for induction before starting work in a “staggered group”.

The numbers of beds will then be gradually increased back up, said Mr Moore.

“I know people will be genuinely worried but this is a temporary measure, we will push on all fronts to make this work. It is an opportunity to think differently about how to deliver care,” he added.

“Withybush Hospital facilities are worth fighting for, what we’ve seen here in the last six weeks and the staff are up for that fight. There is a sense of rallying round, they’ve been fantastic. The people of Pembrokeshire ought to be very proud of local staff and what they are doing.”

New beds at Glangwili will be opened up in areas not currently used and will be fully staffed said Mr Moore and the health board would be working with care homes in Pembrokeshire and Carmarthenshire to gain greater access to community beds.

“We weren’t simply going to send patients to a system already under pressure,” he said adding that there were still details to “work out”.

Mr Moore said there were currently 36 beds at Withybush used for medical patients – that is people admitted to hospital in an emergency or illness not those having elected surgery – there would be a reduction of 16 with the remaining beds used for elected treatments and reducing surgery waiting lists.

Dr Robertson-Steele added: “It’s equally important to continue to provide care for people on waiting lists, there is an element of ring fencing to avoid medical overspill. It’s a net reduction of 16 beds.”

Twenty-two beds, possible 28, will be opened up at Glangwili and Prince Philip hospitals, said the health board.

Transport arrangements for those in the east of the county and Cardigan area will be looked at said Mr Moore, particularly frail and elderly patients, as well as support for relatives but admitted that parking issues at Glangwili cannot be solved in the short term.

He said that use of the park and ride was improving and work continuing to ensure adequate parking on a constrained site in the long term.

In reference to distances from the east to Glangwili or Withybush Mr Moore said the health board had been talking to local GPs and the Welsh Ambulance Service Trust “who know the roads”, adding it was “almost equivalent to go from these areas”.

Following the announcement of the plan to staff last week Mr Moore said there had been a lot of questions relating to “worries” such as what’s the future of the hospital.

The plan is “both a demonstration of our commitment and an opportunity to look at building strong foundation in this hospital,” he added.

Despite assurances there have been strong objections to the plan in public and from politicians.

Those on the frontline also voiced concerns, such as a paramedic commented on a public Facebook forum, but later asked to remain anonymous, who said: “Sorry all, but this is an absolute disgrace. As a paramedic I'm waiting outside Glangwili because they can't cope with the demand now and often divert patients to Prince Phillip or Morriston now. There is NO way they will be able to absorb more patients from this area. Also we are spending vast portion of our shift now travelling to Carmarthen and waiting to offload, this is going to reduce the counties ambulance cover further and we're on the bones of our bum now. There has been no increase in the amount of operational vehicles since I started 17 years ago and our workload has quadrupled. Patients are suffering now and it's going to get worse. We are all wondering if these are the beginning of plans to shut Withybush, because they are not putting up much of a fight to retain services!”

Concern over the temporary arrangements has been expressed by members of health watchdog SEPCHN.

(South East Pembrokeshire Community Health Network).

The group is now asking if the local health service is receiving adequate provision, notably in Tenby where there is no NHS dentist or optician, the Minor Injury Service has been closed and the GP service is understaffed.

SEPCHN chairman Mansel Thomas said this week: "Has the effect on the local population structure been analysed? The new arrangements could involve additional transport problems for hospital visits.

"In one Tenby political ward, 40.5 per cent of homes are without a car. What would be the additional cost of transport to Llanelli or Carmarthen?"

Mr Thomas asked the health board to describe what particular efforts have been made to attract doctors to the area and if its current efforts had been evaluated. He also wondered if it had sought advice from areas with similar problems, and if it had any new strategies planned.

He added: "Whilst the appointment of doctos is a national problem, Pembrokeshire appears to be having more problems than most."

Preseli Pembrokeshire MP Stephen Crabb said he met with Mr Moore and clinical director Dr Phil Kloer last Friday.

“We had a frank and honest discussion about the state of recruitment across the Hywel Dda area and I am very aware of the challenges at Withybush especially in terms of keeping A&E open. The staff there are doing an amazing job and they deserve our full support and commitment.

"I have already had urgent discussions this week with my Ministerial colleagues about recruitment in the NHS and the particular challenges that we have here in Wales. I am awaiting details from the Health Board about the specific visa cases and will be working with the Home Office team to get these much needed medical staff in post as soon as possible."

Local Assembly Member Paul Davies has expressed his ‘fearfulness’ regarding Hywel Dda University Health Board’s announcement.

Mr Davies said: “I’m extremely disillusioned with the health board’s latest announcement, which will result in people across Pembrokeshire having to travel further to receive treatment. Sadly, this latest news is yet another blow to Withybush hospital, which has already seen some services downgraded and others centralised further afield.

“My constituents have no confidence in the health board’s announcement that the plans will be temporary as we’ve heard this before. Recruitment issues have been a significant problem for a long time now and so the health board and the Welsh Government must get to grips with them as a matter of urgency. I’m meeting the Chief Executive of the local health board to voice my concerns and to find out what the health board will be doing to ensure we do not see a repeat of the situation in the future.”

A lack of confidence in the health board was reiterated by regional AM Simon Thomas, who said: “People are given assurances of a better service but the reality we all know is different.

"I am very concerned that the A&E service at Withybush is tottering and about to collapse.”