We would like to bring to your attention some planned temporary changes starting imminently by Powys Teaching Health Board that we are concerned would be detrimental to the care of some of our most vulnerable patients. In this post we have shared a link to the ‘have your say page’ which explains the changes in more detail.
We were asked to attend an urgent meeting on the 17th July, which was the first time we were made aware of these proposals. This meeting generated many questions, and we did not receive clear answers at the time. We have since written to the Health Board for further clarity about these concerns.
These concerns included:
1. A lack of appreciation as to how our virtual ward service interacts with the ward. The virtual ward allows us to look after our most vulnerable frail patients and admit them to Llewellyn Ward for therapeutic intervention with continuity of care. This helps prevent admissions to main Hospitals outside of Powys, a key goal for the Health Board. We were unable to establish if this would be still possible.
2. A lack of appreciation that the journey of a patient once deemed ‘clinically optimised’ may fluctuate with mild illnesses and patients often need ‘top up’ interventions from therapists. Under these new proposals, as no ‘outreach’ therapists have been proposed this would require transfers back to Brecon War Memorial Hospital or Montgomery County Infirmary, Newtown, 47 miles away a 1 hour and 22-minute journey by car.
3. That families and friends are key to motivating and caring for patients when they are admitted to the community hospitals, but these plans will increase their travel burden. In a worst-case scenario this could mean instead of being in Bronllys, a patient may be transferred to Llanidloes hospital from Brecon, 48 miles away and just over an hour journey by car, with very limited public transport options.
4. A lack of consultation with the providers of medical cover to the wards involved
5. This downgrading of Llewellyn ward to a ‘ready to go home’ unit, will lead to a deskilling of nursing staff, this could lead to the job roles becoming less appealing and further increase in reliance on agency/locum staff. This directly contradicts one of the key reasons for the implementation of these changes.
6. A lack of information around consultation with the ambulance services as these plans would require more transfers
7. A lack of information around infection control procedures with more transfers planned in this service
8. No impact assessment has been provided as part of the proposed documentation
We have focused our concerns on the changes to the ward, but the changes to the Minor Injury Units will also have an impact on you. We acknowledge that these changes are being made because the Health Board is facing extreme financial pressures from Welsh Government and that they have had to make tough decisions, but we are concerned that patient centred care is being deprioritised.
The most powerful voice about the care you receive is yours and therefore we wanted to make sure you are informed about the changes, our concerns and how you can have your say on the proposals.
https://pthb.nhs.wales/news/health-board-news/temporary/
Thank you
Haygarth Doctors