Plans for Prince Philip Hospital’s 'Front of House' moving forward

Plans to improve urgent care access at Llanelli’s Prince Philip Hospital have been discussed at a meeting between doctors and local councillors.
Following the Health Minister’s statement to the National Assembly for Wales in September 2013 regarding changes to A&E services in Llanelli, work has been progressing to develop a service that improves the care for those currently accessing emergency care at Prince Philip Hospital.
Representatives from Carmarthenshire County Council, Llanelli Rural Council and Hywel Dda Community Health Council (CHC) were invited to meet with Dr Sian Lewis, Dr Granville Morris, Dr Robin Ghosal and Dr Dai Samuel to hear about the progress of the last few months that has focused on six different areas: 
  • substance misuse (drugs and alcohol)
  • frailty
  • mental health
  • acute medicine
  • minor illnesses
  • and minor injuries. 
Dr Sian Lewis, Associate Director of Clinical Services and Chair of the Prince Philip Hospital Front of House project group said: “This is our big opportunity to do things differently and develop a service that improves the care we offer Llanelli residents. We are extremely heartened by the response from the meeting and we received valuable feedback that will help us greatly in moving this project forward.
“We know that traditional A&E departments throughout the UK are struggling and these changes mean that Llanelli can be at the fore front of developing a new approach to urgent care. This isn’t about doing less; this is about doing things differently. This will be achieved by having a team of hospital doctors, Emergency Nurse Practioners (ENPs) and GPs working closely together and with social services and third sector colleagues.”
Consultant Physician Dr Robin Ghosal summarised the feeling of all doctors involved with this project: “We have worked extremely hard and will continue to do so to develop a Front of House service that is second to none and which the population of Llanelli deserve.”
Dr Dai Samuel, Gastroenterology registrar and Welsh Clinical Leadership fellow, said: “The meeting provided the perfect platform to discuss the concerns of councillors, and our patients and all parties agreed that a different way of working could enhance, not diminish our local patients' care. I look forward to working with our colleagues in the local authority who acknowledged the importance of tackling difficult issues such as alcohol and substance misuse, to not only improve treatment, but prevent harm in the first place."
Tony Wales, Chairman of Hywel Dda CHC said “I am pleased that the University Health Board has taken such positive steps to engage with both local councillors and the Community Health Council in the plans for Prince Philip Hospital. I am especially pleased that local clinicians at Prince Philip are leading the project and identifying local service need.”
Dr Sian Lewis concluded: “We must now build on the positivity of this meeting and will work with our partners and stakeholders to ensure that Llanelli residents receive accurate and timely information about the changes, changes which are being taken forward by an extremely talented and dedicated team of doctors.”

The meeting was held at Prince Philip Hospital on Monday 10 February 2014.
In attendance from the University Health Board were Mrs Sian-Marie James, Vice-Chair, Dr Sian Lewis, Associate Medical Director, Dr Granville Morris, Consultant Gerontologist, Dr Robin Ghosal, Consultant Physician, Dr David Samuel, Gastroenterology registrar and Welsh Clinical Leadership fellow and Mr Mansell Bennett, Project Management Lead..
In attendance from Llanelli Rural Council were Cllr Derek Cundy, Cllr Tegwen Devichand and Mr Mark Galbraith, Llanelli Rural Council Clerk. County Councillor Louvain Roberts attended from Carmarthenshire County Council. In attendance from the Hywel Dda Community Health Council were Mr Tony Wales, Chair, Mrs Helen Williams, Interim Deputy Chief Officer, CHC member John Philip and Donna Coleman, Interim Deputy Chief Officer

* Hywel Dda University Health Board consulted extensively on its clinical services strategy; Your Health Your Future, culminating in the Board’s decision on 15 January 2013.
In May 2013, Welsh Ministers confirmed that they proposed to make a determination on the proposals which Hywel Dda Community Health Council had stated that it could not support– this included A&E services at Prince Philip Hospital.
Welsh Ministers convened a Service Change Scrutiny Panel to consider the issues referred and provide detailed advice and recommendations on the specific services in question.
The panel consisted of Mr Jim Wardrope, consultant in emergency medicine at the Northern General Hospital in Sheffield; Professor Neena Modi, professor of neonatal medicine at Imperial College London and honorary consultant at the Chelsea and Westminster Hospital NHS Foundation Trust; and Dr David Salter, the retired former deputy chief medical officer for Wales with extensive knowledge of the Welsh NHS.
The Minister considered the advice and recommendations of the Scrutiny Panel and announced his decision on the appropriate model of emergency care at Prince Philip Hospital, in a statement to the National Assembly on the 24 September 2013.
The panel strongly supported the case for replacement of accident and emergency services at Prince Philip Hospital. It unanimously proposed that an emergency nurse practitioner unit, supported by general practitioners, should form the future model of care at that hospital.
Hywel Dda University Health Board established an Implementation Board to oversee changes made to services following consultation. The Prince Philip Hospital Front of House project is subject to a gateway process managed by the clinical service strategy ' Implementation Board', to ensure that all reasonable preparations are in place prior to change.

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