HealthVision

Planning for better NHS services across the city The way Swansea patients receive healthcare is changing, with £100millions of pounds earmarked for upgrading hospital buildings, and delivering a more integrated and balanced service.

Over the next few years both and Singleton hospitals will benefit from investment, as will our Mental Health Services. This isn’ t a jam tomorrow pledge, because a major scheme is already underway at Morriston Hospital, (more later) and we also hopetobegin imppgroving facilities for patients at later this year.

But there’s still a lot of planning ahead. And as we start to turn our visions into reality, we are keen to get your ideas and views ... to help us develop healthcare together. HealthVision Swansea ...... is the umbrella title for wide‐ranging projects to modernise Swansea’s health services.

Initially, the plan centred on developing a single SperSuper Hospital for the city, either building on a new site, or expanding Morriston Hospital. Singleton would have virtually closed.

But that idea has been now been revised, because it would have taken too long (a decade or more) for enough funds to proceed.

And also, the Trust and have since joined forces, opening the door for wonderful, cutting edge research‐ led care – with both Morriston, and Singleton, hospitals at the very heart of it. In fact, we are now a Teaching Trust with an undergraduate schlhool whic h will attract the best staff and create jbjobs. In recent Government research assessment exercise, the School of Medicine received a 5* rating ‐ the highest possible ‐ which is a fantastic achievement. Balancing health care between our hospitals Back in the early 1990s, Swansea had quite separate NHS Trusts managing our hospitals, and one unfortunate legacy of that era is a dlduplication of some services on bhboth sites. Splitting resources this way isn’t very efficient, and we think hihaving hitlhospitalswhic h compltlement each other itdinstead, isa much better way forward. The way ahead? Morriston Hospital

• Planned surgery, diagnostics • Emergency care and rehabilitation • Tertiary (l)(specialist) and • Strong links with GPs and regional treatment primary (community‐based) health care • SWW Cancer Centre This isthe general direct ion of travel we think our hospitals should be going. But there is still much debate; engagement with patients, staff and the public; and detailed planning and design ahead.

Oneideawe’rearekeenonisan Ambulatory Care Centre at Singleton Hospital.Workingin partnership with Swansea University and GPs, we believe we can develop a service which will beafirs t in WlWales. Patients should be able to get better diagnostic services, including access to new “hot clinics” within days of seeing their GP. But it’s still early days, and exactly what the new Ambulatory Care Centre could potentially offer in all, is currently bibeing thoug ht throug h and discusse d. Singl eton could also have themajor role in future for elective (planned) care, and helping people get back on their feet.

Sometimes patients who arrive as emergencies need the beds booked for elective patients, and scheduled operations are then dldelaye d.

Evidence shows that keeping most elective and emergency treatment apart ‐ on different sites ‐ canhelpavoidthis. Singleton is an ideal centre to focus on elective treatment. Wealsobelieveit’sgoodpracticetohavemost of our rehabilitation services in one pp,lace, like Singleton Hospital, because patients will get a better service, and it uses staff skills and resources to the full. MiMorriston HilHospital isaldlready home to excellent speciliialist services like cardiac; burns and plastic surgery, and renal services, and has one of the busiest A&E Departments in Wales.

We want to build on those specialist services, and identify Morriston as the hospital for patients with an unexpected serious illness or injury which needs emergency surgery or tttreatment . While these ideas still need much discussion before any firm plans can be made, you may recall we mentioned earlier that major building work has just started at Morriston.

This d’tdoesn’t mean we’re jijumping the gun. In ftfact,we’re jtjust getting prepared for the future. Anyone who’s been to Morriston Hospital knows that access isn’ t great and parking can be a real nightmare. The City and County of Swansea granted planning permission in December to improve access to the hospital and around the site itself. We are also providing better car parks, ildiincluding a multi storey.

This is the first phase of a huge overhaul for Morriston Hospital, which, with continued Welsh Assembly Government support, willseeveryoldpartsofthe hitlhospital (da ting bkback to the 1940s) demolished, and brand new buildings in their place. This is an artist’s impression of the new car parks for Morriston Hospital. December, 2008, Health Minister Edwina Hart AM, and Trust Chairman, Win Griffiths, cut the turf at the start of the Morriston Hospital redevelopment scheme. Over the coming months we will start to shape further plans for the ppyhysical redevelopment of Morriston Hospital.

Already we are favouring, for example, building a brand‐ new out‐patients’ department and a better main entrance with a selection of shops and other patient, staff and visitor‐friendly facilities.

We also want to develop a range of modern accommodation for essential behind‐the‐scenes hospital services like Medical Records. You may wonder just where we could build on Morriston’s site, because it already seems pretty cramped.

Actually, because Morriston Hospital is built on a slope, there’s an opportunity to build up, rather than out, and still keep the new roof at the same level as the main roof of the hospital, so it won’t be an eyesore.

The new multi‐storey will also take advantage of the hill, and be stepped into theslope. The benefit of this natural land slope was not recognised when the hospital was first built, which is why older parts of the hospital have sloping corridors like this one, and youhavetowalkdownahill to access the out‐patient department.

By building up, it means we won’t need to shoehorn new buildings into the existing site. Mental Health As well as our two acute hospitals, we are also looking at ways to improve our Mental Health Services.

We are fav ou ring a tintwin‐tracked approach, inv esting in buildings, but also in improving our community services. Mental Health care has changed a lot over the years, and Cefn Coed Hospital is one of the last remaining examples of alargeVictorian‐style in‐patient mental health hospital.

One of the issues we are looking at is how best to provide in‐patient care in future, and whether the aging Cefn Coed remains the best building, or if a new build is needed.

In the meantime, we are planning to build in the grounds of the hospital to replace some parts of the hospital and other Trust Mental Health accommodation which is no longer suitable. These include a new step‐down unit for patients who are almost ready to live back in the community, but need support to re‐build their daily living skills confidence. We also want to build new accommodation in the grounds for elderly mental health patients.

But some of our building work won’t benefit any patients at all – just special members of the animal kingdom!

We need to knock down old disused wards, but first we must provide a new home – a wooden bat house – for some of these endangered nocturnal creatures who have taken up residence there. Bricks and mortar, important though they are, are just a part of improving Mental Health Services.

Mental illnesses, like depression, are very common, but the vast majority of these patients, need care and support at home, not as an in‐patient in a hospital.

We are looking at ways to improve the community support we provide, so patients can stay in their own homes, with their family and loved ones around them, as they recover. Singleton Minor Injury Unit

One of the reasons we’ re here today, is to talk about developments at Singleton Hospital’s Minor Injury Unit. (MIU)

It isn’t, strictly speaking, part of HealthVision Swansea at all, but changes to the way it is now being run will actually help to support the Ambulatory Care Centre we mentioned earlier. Since the start of January, GPs now man the MIU, supported by a specialist emergency care nurse. The changewasdrivenby the urgent need to find a safe and reliable alternative to the old system, which was badly affected by staff shortages, and was often being forced to shut at little or no notice. Swansea’s GP Out of Hours Service is already based at Singleton, so it made sense to have GPs man the MIU as well.

PtiPatien tswill see very littlechange when they use thenew‐ look MIU – other than it will always be open now! A small number may need to go to Morriston for tests or more specialised treatment, but the majority will be unaffected.

We are asking patients to ring 08458 501 362 first between 10pm and 8am to help doctors manage their workload and shthorten patien t waiting times. BtBut no‐one will be tdturned away if they haven’t phoned first. This new way of working is being phased in through January, and so far GPs are giving positive reports. Monitoring will continue in the months ahead, so we can resolve any problems quiklickly.

Working closely with GPs like this is really helping to lay a strong foundation for our vision of improving NHS care at all levels in Swansea. It’s cutting through artific ia l NHS bdiboundaries and putting the focus on the patient, instead of the system. This is a very positive beginning as we move forward to develop plans like the Ambulatory Care Centre at Singleton Hospital.

One of its key aims will be to provide seamless, easy‐to‐ access patient care, with hospital and primary care staff working in partnership, just like we are beginning to now. We hope this presentation has given you a brief overview of some of the ideas we have and the overall direction we’re taking to improve NHS care in Swansea.

As plans develop, we’ll do all we can to publicise them ‐ ahead of any formal consultation process – to encourage further suggestions and viewpoints. We’re more than happy to answer any questions you may have now, and welcome your views and comments.

As well as the Question and Answer sessions which will follow, feedback forms are also available if anything occurs to you later – just send them on to us and we’ll get back to you as soon as we can.

Thanks for listening.