Hywel Dda Health Board agrees to temporary hours cut for Withybush paediatric unit
Hywel Dda University Health Board has agreed on the grounds of safety issues, to temporarily reduce the opening hours of the Paediatric Ambulatory Care Unit (PACU) at Withybush Hospital, but has not agreed to any longer term changes to services for children.
At a meeting of full health board on Thursday November 24, the Board agreed the recommendation to temporarily reduce the opening hours from 10am-10pm by four hours a day to 10am-6pm in light of the reduced availability of consultant paediatricians.
However, they did not agree to the recommendation to permanently merge the consultant overnight rota with Carmarthenshire. They did accept this was necessary temporarily due to reduced availability of consultant level staff.
This will mean if there is a paediatric emergency out-of-hours at Withybush Hospital, the on-call paediatric consultants in Glangwili Hospital will offer remote advice to emergency and anaesthetic staff at Withybush.
Whilst board members agreed the commitment to return to a 12 hour PACU model at Withybush Hospital as soon as workforce issues improved, the Board was not willing to accept any detail about what that future model would look like without first engaging more fully with clinicians, other staff, the Community Health Council and the wider public.
Chairman Bernardine Rees and other Independent Members of the Board expressed, along with the Community Health Council, disappointment that the Health Board had to take this decision, but agreed it was necessary to maintain a safe service.
Chief Executive Steve Moore explained: “I am disappointed that we are here today discussing this and it is not something we wanted for the people in Pembrokeshire. This shouldn’t be read in any shape or form as a lack of commitment to Withybush Hospital as we remain determined to secure the future of this hospital for our population, indeed we are making improvements at the hospital and providing more services locally, and this includes a commitment to providing services for children.
“We had to take action today to avoid ad hoc closures of the service, which carries greater risk. Whist there are challenges across the UK in recruiting consultant paediatricians that we must consider and tackle, we have a particular and temporary problem in Pembrokeshire due to the coinciding of a retirement, maternity leave and sickness. We will work with determination to resolve this situation. We want to continue to work with our clinicians, staff and the CHC and public on the challenges the NHS in the UK is facing.”
Medical Director Dr Philip Kloer added: “We have during recent months had to close the PACU in an unplanned way, which is of concern to clinicians and the public. As medical director I believe we need to provide a more stable service and be clear with the public about that service and when it is available.”
The temporary model which will now be put in place, reflects the 10am-10pm model that has been in place and providing safe care since service change two years ago, but from the new times of 10am-6pm and with remote consultant paediatric support from Glangwili Hospital at night.
Parents should continue to access healthcare services for children in the usual ways. If your child is unwell, you can do a number of things:
Call NHS Direct Wales – 0845 46 47 – they can advise you if you are unsure what to do, as well as provide health information on a wide range of conditions, treatment and local health services
Use your community pharmacy if open
Make an appointment with your GP as usual, including out-of- hours GP services, which are contacted through your normal GP telephone number
For a paediatric minor injury, go to Withybush Emergency and Urgent Care Centre (EUCC) 24 hours a day
In an emergency, if your child is very sick, you should dial 999 for assistance. Children who present at Withybush Hospital out-of-hours will usually be transferred to Glanwgili Hospital for paediatric input. In the exceptional circumstance where emergency resuscitation is required, emergency and anaesthetic staff will resuscitate, stabilise, and arrange transfer onto another hospital.
In the meantime, the health board continues to reduce the impact on families as much as possible. This includes provision of the dedicated ambulance vehicle for transfers between Withybush and Glangwili hospitals, provision of funded transport schemes such as that provided by Action for Children, help under the NHS Travel Costs scheme and, in exceptional circumstances where no alternatives are available, vulnerable families will be provided with a paid for taxi to return home.
Recruitment efforts will continue, both for substantive, permanent posts and locum (temporary) paediatric consultants. The health board has secured an agency consultant for an extended period of three months and is interviewing a potential candidate for a role at either Withybush or Bronglais hospitals in January. Adverts for Advanced Paediatric Nurse Practitioners will also be placed.
The situation will be closely monitored by Board and the quality and safely committee and regular updates will be provided to staff, the CHC and the public. The health board will also work will all parties to engage on a longer term model to return Withybush PACU to a 12-hour service. This will include a quality impact assessment to ensure families are not disadvantaged and are supported as much as possible.
At a meeting of full health board on Thursday November 24, the Board agreed the recommendation to temporarily reduce the opening hours from 10am-10pm by four hours a day to 10am-6pm in light of the reduced availability of consultant paediatricians.
However, they did not agree to the recommendation to permanently merge the consultant overnight rota with Carmarthenshire. They did accept this was necessary temporarily due to reduced availability of consultant level staff.
This will mean if there is a paediatric emergency out-of-hours at Withybush Hospital, the on-call paediatric consultants in Glangwili Hospital will offer remote advice to emergency and anaesthetic staff at Withybush.
Whilst board members agreed the commitment to return to a 12 hour PACU model at Withybush Hospital as soon as workforce issues improved, the Board was not willing to accept any detail about what that future model would look like without first engaging more fully with clinicians, other staff, the Community Health Council and the wider public.
Chairman Bernardine Rees and other Independent Members of the Board expressed, along with the Community Health Council, disappointment that the Health Board had to take this decision, but agreed it was necessary to maintain a safe service.
Chief Executive Steve Moore explained: “I am disappointed that we are here today discussing this and it is not something we wanted for the people in Pembrokeshire. This shouldn’t be read in any shape or form as a lack of commitment to Withybush Hospital as we remain determined to secure the future of this hospital for our population, indeed we are making improvements at the hospital and providing more services locally, and this includes a commitment to providing services for children.
“We had to take action today to avoid ad hoc closures of the service, which carries greater risk. Whist there are challenges across the UK in recruiting consultant paediatricians that we must consider and tackle, we have a particular and temporary problem in Pembrokeshire due to the coinciding of a retirement, maternity leave and sickness. We will work with determination to resolve this situation. We want to continue to work with our clinicians, staff and the CHC and public on the challenges the NHS in the UK is facing.”
Medical Director Dr Philip Kloer added: “We have during recent months had to close the PACU in an unplanned way, which is of concern to clinicians and the public. As medical director I believe we need to provide a more stable service and be clear with the public about that service and when it is available.”
The temporary model which will now be put in place, reflects the 10am-10pm model that has been in place and providing safe care since service change two years ago, but from the new times of 10am-6pm and with remote consultant paediatric support from Glangwili Hospital at night.
Parents should continue to access healthcare services for children in the usual ways. If your child is unwell, you can do a number of things:
Call NHS Direct Wales – 0845 46 47 – they can advise you if you are unsure what to do, as well as provide health information on a wide range of conditions, treatment and local health services
Use your community pharmacy if open
Make an appointment with your GP as usual, including out-of- hours GP services, which are contacted through your normal GP telephone number
For a paediatric minor injury, go to Withybush Emergency and Urgent Care Centre (EUCC) 24 hours a day
In an emergency, if your child is very sick, you should dial 999 for assistance. Children who present at Withybush Hospital out-of-hours will usually be transferred to Glanwgili Hospital for paediatric input. In the exceptional circumstance where emergency resuscitation is required, emergency and anaesthetic staff will resuscitate, stabilise, and arrange transfer onto another hospital.
In the meantime, the health board continues to reduce the impact on families as much as possible. This includes provision of the dedicated ambulance vehicle for transfers between Withybush and Glangwili hospitals, provision of funded transport schemes such as that provided by Action for Children, help under the NHS Travel Costs scheme and, in exceptional circumstances where no alternatives are available, vulnerable families will be provided with a paid for taxi to return home.
Recruitment efforts will continue, both for substantive, permanent posts and locum (temporary) paediatric consultants. The health board has secured an agency consultant for an extended period of three months and is interviewing a potential candidate for a role at either Withybush or Bronglais hospitals in January. Adverts for Advanced Paediatric Nurse Practitioners will also be placed.
The situation will be closely monitored by Board and the quality and safely committee and regular updates will be provided to staff, the CHC and the public. The health board will also work will all parties to engage on a longer term model to return Withybush PACU to a 12-hour service. This will include a quality impact assessment to ensure families are not disadvantaged and are supported as much as possible.
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