Hywel Dda Health Board reveals changes to health service

Hywel Dda Health Board has approved a series of recommendations – amended in light of consultation feedback and evidence received - to provide first class healthcare services to the local population, now and into the future.
At an Extraordinary Board Meeting on Tuesday January 15, board members agreed a number of changes to healthcare services that will support delivery of more care closer to people’s own homes and communities, ensuring hospitals are equipped to deal with the most seriously ill
Consultation proposals have been amended following engagement and consultation exercises*:

• Mynydd Mawr Hospital services, currently delivered from the hospital, will be delivered within the community and a new service at Prince Philip Hospital. The original proposal was broadened following consultation feedback and evidence, so that the new service will provide multi-specialty care to the frailest of inpatients, including geriatric medicine and psychiatry for the elderly. 
• we will provide minor injury services from community based services, closing the Minor Injury Units at Tenby and South Pembrokeshire and redeploying nursing staff to support Withybush emergency services. Following consultation feedback and evidence, we will commission a one-year pilot for an additional eight week minor injury service in Tenby (from mid-July to September,including weekends and Bank Holidays) during the peak tourist season. 
• Orthopaedic day-case and short stay, as well as planned surgery including hip and knee replacements, will be retained in all three counties, following consultation feedback and evidence. For the south of the Hywel Dda Health Board area, revisions and complex orthopaedic procedures will be carried out at an Orthopaedic Centre at Prince Philip Hospital. 
• 24/7 Emergency Departments co-located with purpose-built clinical decision and assessment facilities will be provided at Bronglais, Glangwili and Withybush Hospitals. Following consultation feedback and evidence, the Health Board has broadened its proposal for Prince Philip Hospital so that a clinically led group will explore unscheduled care services and re-shaping of front-door services. This will deliver an integrated service, doctor supported and primarily nurse-delivered but sitting within a model of GPs, pharmacists, paramedical and community service teams. Alongside this, Prince Philip Hospital will deliver a 24/7 emergency medical assessment and admissions service. 
• Services for women and children, support the original proposal to retain obstetric and paediatric services in each county with a complex obstetric unit, neonatal unit and high dependency paediatric unit on the Glangwili Hospital site, subject to recruitment. Following consultation feedback and evidence, the recommendation is broader and approves a clinically led group to design services and pathways for these. 

Chief Executive Trevor Purt said: “There has been a long process of debate, engagement and consultation during the past two years and we have been extremely encouraged by the passion our staff, stakeholders and public have for the NHS. Careful consideration has been given throughout the whole process, not only to the depth and breadth of feedback we received, but also to other evidence including healthcare standards and the context the NHS is operating in. This includes the very real challenges faced by the NHS across the UK such as recruitment difficulties and finance, as well as unique challenges such as our geographical location.
“The changes the Board has supported today will help us to improve the services we offer and should result in safe, sustainable services, and a shift in the balance of care, with more care provided closer to home.”
Chairman Chris Martin said the Board had taken due consideration of all public feedback and that as a result a number of amendments had been made to the original proposals.
“We have listened to our local population, and where we can, we have made adjustments to our original proposals. For example, hip and knee operations will now continue in each county with only revisions and complex procedures being sent to an orthopaedic centre in Llanelli. We have committed to setting up an additional service for the peak tourist period in Tenby. At Prince Philip Hospital, we have approved a clinically led group to re-design unscheduled care services, which will deliver doctor supported, primarily nurse delivered care within an integrated model of GPs, pharmacists and community service teams. This will be alongside a consultant-led Emergency Medical Admissions Unit.”
The Board said it was committed to continuing to work alongside the Community Health Council during implementation.
Mr Purt said: “On behalf of the Board I would like to thank our staff for their patience during this long process, and thank our stakeholder and general public for the invaluable feedback they have given.”
An Implementation Board will be set up to ensure that there are robust arrangements in place, and clinicians are satisfied, before any changes are made. The Board will consider all risks and potential impacts on equality and diversity and will mitigate against these.
Anyone who would like continued involvement in the shaping and planning of local healthcare services is encouraged to join the health board’s membership scheme.
Contact us by visiting www.talkinghealth.wales.nhs.uk; phone 01554 779510; write to FREEPOST HYWEL DDA HEALTH BOARD or email talkinghealth@wales.nhs.uk
The full recommendation report, and other resources, can be found at www.hywelddahb.wales.nhs.uk/Consultation
* Individual press release on each service change will be posted here as soon as possible.