Latest 'Stakeholder Briefing' from the Hywel Dda Health Board

Latest 'Stakeholder Briefing' from the Hywel Dda University Health Board -

Clinical Services Strategy Update

A meeting of Hywel Dda University Health Board’s Clinical Services Strategy Implementation Board was held on Monday 17 February 2014.
Here are some latest updates for your information…
Maternity, Paediatric and Neonatal Services
On 21 January 2014, the Minister for Health and Social Care announced his decision following the recommendations of an expert panel set up to scrutinise the University Health Board’s decision to reconfigure neonatal services to ensure safe and sustainable services in the future.
The expert panel endorsed the decision, with some additional comments regarding the provision of interim safety measures. The Minister’s statement to the Assembly on this matter can be viewed in full here www.assemblywales.org/docs/rop_xml/140121_plenary_bilingual.xml#123432
Since this announcement, a Programme Board has been established to provide assurance to the University Health Board around the reconfiguration of maternity, neonates, paediatrics and gynaecology services. The Programme Board will meet monthly and following each meeting a briefing paper will be issued to keep staff, stakeholders, patients and the public updated of our progress.

The Maternity, Neonates, Paediatrics and Gynaecology Services Programme Board (the Programme Board) held its first meeting on 18 February 2014 and approved its terms of reference.
The Programme Board will:
• Identify the future model for provision of maternity, neonates, paediatrics and gynaecology services at Glangwili and Withybush Hospitals and in line with the Board’s decision
• Ensure that all elements of the programme come together into a delivery plan
• Approve the programme of work and oversee delivery to the agreed timescales
• Monitor the project plan
• Consider and resolve any cross-sector implications of the programme
• Ensure stakeholder and partner involvement
• Ensure compliance with relevant standards

• Recommend plans including the business case for submission to the Strategy and Planning 

Committee and Welsh Government for the release of capital funds 

• Ensure that a briefing is provided following each meeting for distribution to staff, patients, partners and the public 

There will be sub groups for paediatrics and neonatal services and obstetric, maternity and gynaecology services, both of which will have a clinical chair and will report into the Programme Board. 

 The Programme Board will sign off operational policies, workforce plans, estates and financial plans. The Programme Board will also be required to ensure that the provisos placed on making the change by the Minister are in place in particular the safety net requirement for the next 12 months. The programme Board will prepare the gateway review for consideration by the Implementation Board. 

Membership of the Programme Board and the sub groups will include the Hywel Dda Community Health Council and Welsh Ambulance Services NHS Trust (WAST). 

A staff briefing was issued following the Programme Board’s meeting on 17 February and can be 

accessed here: www.hywelddahb.wales.nhs.uk/yourfutureservices. 

Reprovision of Inpatient Services in Cardigan 

The planned reprovision of Cardigan Hospital inpatient beds into the community and closer to home begins on 28 February 2014. Cardigan Hospital will not close and will continue to deliver outpatient services for the community until the new integrated resource centre development is completed. 

Click here to read the full press release: http://www.wales.nhs.uk/sitesplus/862/news/31497 

The investment in a new and modern healthcare service in Cardigan is progressing well and will provide a wider range of health and social care for people of all ages. 

 Our new service model and the new build at the Bath House site at Cardigan is our flagship development and we believe the design of this service has the potential to be the model for future 

community services. 

New Strategy and Planning Committee 

The University Health Board has agreed the establishment of a new Strategy and Planning Committee responsible for the University Health Board’s three year planning cycle. A review of the Board’s governance structure has been undertaken and there is a need to separate in year delivery and monitoring from strategy, planning, and service reconfiguration. 

Welsh Government’s revised planning framework requires Health Boards to have both an Annual 

Plan and a three year Integrated Medium Term Plan setting out the strategic direction of the organisation. 

As a result of this, from April 2014, the Implementation Board and Strategy and Planning Sub Committee will cease to exist with their responsibilities taken over by the new Strategy and Planning Committee. 

This committee will also be responsible for ensuring robust gateway processes continue to be in place to ensure service change is delivered in a transparent and systematic way. 

Population Health Programme 

The Population Health Programme Management Group (PHPMG) was set up in 2013 to manage Hywel Dda University Health Board’s Population Health Programme (PHP) and assure the Implementation Board and Strategy and Planning Committee of its progress. 

The PHP supports the strategic aims of the University Health Board by providing a systematic 

approach to the future delivery of services dependent on the health needs of our population, with 

partnership representation from groups including the third sector. The PHP is delivered through 

eight Population Health Groups (PHGs) and progress is outlined below: 

• Cardiovascular and Metabolic Health 

The group has met for its inaugural meeting. Delivery plans for heart disease and diabetes have been drafted for approval. 

• Digestive Health and Urological Health 

This group’s first meeting to consider work programmes is planned shortly and will include acute surgical services. 

• Elderly and Neurological Health 

This group has met and identified key priority areas, including dementia management in acute hospital settings, primary care led dementia care, implementation of the frailty model, establishment of a co-ordinated neurological service and drafting the neurological delivery plan. 

• Head, Neck, Eye and Skin Health 

The key priority areas for this group have been identified including telemedicine, skin cancer, inflammatory skin disease, head and neck, oral health, sensory impairment and eye health with national plans already in place. 

• Mental Health 

This group has also met and work is underway to look at evidence based co-design and 

identified priority areas as: reducing stigma and discrimination, reducing self harm and 

suicide, autonomy and safety better management of psychosis and better management of 

depression. 

• Musculoskeletal Health 

The group has met and held a workshop with a wide range of stakeholders to define the programme of work. These include: community muscoloskeletal (MSK) provision, bone health, specific care pathways for spinal, shoulder, hip and knee, and lifestyle intervention advice of patients with a BMI over 40. 

• Respiratory and Haematological Health 

Work is ongoing to appoint a chair to this group. 

• Women and Children’s Health 

The work of this group is entirely focused on establishing the new models of care in neonates, paediatrics, obstetrics and gynaecology as outlined earlier in this briefing. 

The PHGs report to the PHP Management Group which is chaired by Dr Phil Kloer, Director of 

Clinical Services, and vice-chaired by Kathryn Davies, Director of Planning and Service Integration / Therapies and Health Science. 

Monitoring the impact of service change 

 The University Health Board’s Implementation Board has approved a process to monitor the impact of ‘Your Health, Your Future’ consultation service changes and to ensure that the planned benefits are realised, risks mitigated and equality impact analysed. This will demonstrate a transparent process and there will be continued engagement in the monitoring of service change decisions. 

Urgent care access at Prince Philip Hospital 

Plans to improve urgent care access at Prince Philip Hospital are moving forward, led by doctors working in the Llanelli hospital. Work has been focusing on six different areas: substance misuse (drugs and alcohol); frailty; mental health; acute medicine; minor illnesses; and minor injuries to develop a service that improves the care for those currently accessing emergency care at Prince Philip Hospital. 

A number of actions have been identified for the next phase of the programme, including further engagement with GPs, development of staffing and financial models, analysis of baseline data for future service assessment and benefits realisation, review of estates, potential to improve patient flow, and consultation and engagement with all key stakeholders. 

The Minister’s statement set a two year timescale giving a target date of early 2015. Staff training 

and competency building would be in line with this timescale.  

The Implementation Board endorsed the current work programme and the progress to date in delivering the unscheduled care model for Prince Philip Hospital. This work is progressing through the six clinically led workstreams. 

Chris Martin, chairman, Professor Trevor Purt, Chief Executive.