Spring 2019
Mid Wales Matters The official newsletter of the Mid Wales Joint Committee for Health and Care Welcome…
In this edition you will find an update on our work over the past 3 months as well as lots of useful and important information about what is going on in your area.
In January we held a Mid Wales Joint Committee meeting, kindly hosted by Gwynedd Council in their area offices in Dolgellau. Updates were received detailing the ongoing work, which is explained further on in this newsletter as well as news of a new lead Chief Executive for the Joint Committee and plans for an All Wales Rural Alliance.
1 Joint Committee Groups
The sub-groups of the Joint Committee are now up and running and these are known as the Planning and Delivery Executive Group, Clinical Advisory Group and Public and Patient Engagement and Involvement Forum. Planning and Delivery Executive Group The Mid Wales Planning and Delivery Executive Group chaired by Carol Shillabeer, Lead Chief Executive for the Joint Committee, met on 13th December 2018. Representatives from Health Boards and Local Authorities were in attendance to discuss the development of the Mid Wales Ophthalmology Plan. Following detailed discussions it was agreed that this work be split into phases. The first phase is focusing on Mid Wales Community Primary Care Ophthalmology services for which two workshops have been held. These two workshops have brought colleagues together to share the current position, discuss how a Mid Wales approach could improve services and start the work on developing a draft plan for a Mid Wales approach which will be presented to the next Joint Committee meeting. Clinical Advisory Group The Mid Wales Clinical Advisory Group chaired by Dr Wyn Parry, the Joint Committee Lead Clinical Director, has met on two occasions since the group was formed. Updates on the Mid Wales perspective were received from those members representing Betsi Cadwaladr University Health Board, Hywel Dda University Health Board, Powys Teaching Health Board, Welsh Ambulance Service NHS Trust and Shrewsbury and Telford NHS Trust. It was noted that each organisation covered a huge geographical area for which there were significant challenges. However, there were significant opportunities for developing services across Mid Wales and working across boundaries which could be influenced by the group. Key enablers include making more use of telemedicine and sharing of records for all aspects of care including social, primary and community services. Public and Patient Engagement and Involvement Forum A small group of Engagement and Involvement Leads for partner healthcare organisations, Local Authorities and Community Health Council representatives has been established, known as the Mid Wales Public and Patient Engagement and Involvement Steering Group. The main role of this group is to discuss and agree how best to engage and involve the public and patients in the work of the Joint Committee using existing organisational mechanisms.
The first “people’s” event coincided with the Rural Health Conference held in November 2018. This was an information sharing and engagement event for people and frontline staff on the Joint Committee’s strategic intent and priorities, proposed patient success measures and an opportunity to feedback on any other areas of work which need to be considered in the long term. Although there was good attendance for the Rural Health and Care element of this event the numbers of public who attended the event was disappointingly low.
As a result the Steering Group has considered the format of future events in order to better attract a public audience and ‘drop in’ events will be held in late Spring 2019 at local cafés at locations across Mid Wales for late afternoon / early evening. These events will showcase projects undertaken across Mid Wales which include patient experience and staff experience stories. Individual health and care organisations will also be offered the opportunity to use these events as vehicle for their own respective engagement and involvement activities.
Also running alongside these events is a piece of work being undertaken to collate individual organisational engagement and involvement mechanisms in order to identify those opportunities where the Joint Committee can engage and involve the public and patients in its work. 2 Chair of Mid Wales Public and Patient Engagement and Involvement Forum
A process of nomination has been held in order to find a Chair for the Mid Wales Public and Patient Engagement and Involvement Forum for the period from April 2019 to March 2020. Details of the new Chair will be released in due course.
Next meeting of the Mid MWJC Leadership Roles Wales Joint Committee At our recent Joint Committee, Carol Shillabeer Our next meeting was due to be held on Monday 11th announced that she was stepping down as Lead March. Unfortunately due to the announcements of a Chief Executive after two years in post. Lead Chair, new Lead Chair and Chief Executive coming in to place Bernardine Rees, thanked Carol for all her hard work it has been decided to postpone this meeting. The on the Committee. The new Lead Chief Executive for meeting will now be held on Monday 15th April at 11am the next year has not yet been confirmed but will be in the Council Chamber, Ceredigion County Council, announced as soon as discussions have taken place. Penmorfa, Aberaeron, Ceredigion, SA46 0PA . Papers will be available to download from our website a We are saddened to share the news that Bernardine week prior to the meeting and a live webcast will also Rees, Lead Chair MWJC and Chair, Hywel Dda be available if you wish to watch the meeting as it University Health Board has announced her happens but can not retirement with immediate effect. We wish Bernie all attend in person. the best for the future and thank her for her Details of the leadership over the last few years. A replacement webcast will be Lead Chair will be announced in due course. published a week prior to the meeting.
Rural Health and Care Wales
Rural Health and Care Wales was established in response to the twelfth recommendation of the Mid Wales Healthcare Study that a centre be developed to focus on research, development and dissemination of evidence in health service research that addresses the particular challenges of Mid Wales.
The second Rural Health and Care Wales Annual Conference was held in November 2018 for which the theme was “Improving the Health, Well-being and Care of Rural Populations”. The event was opened by Dr Chris Jones, Chair of Health Education and Improvement Wales, and chaired by Bernardine Rees, Mid Wales Joint Committee Lead Chair. The event was well attended by approximately 150 delegates and feedback received was overall very positive, with considerable interest in continuing to stage a rural conference in Mid Wales as an ongoing annual event.
A presentation was received by the Mid Wales Joint Committee at its meeting on 14th January 2019 outlining the proposed future governance arrangements for Rural Health and Care Wales through the establishment of an All Wales Rural Alliance for which Rural Health and Care Wales would be a part of. Members supported the proposal to develop an All Wales Rural Alliance to be hosted by Powys Teaching Health Board and agreed that further work would be undertaken to develop this proposal. A paper will be presented at the next Joint Committee meeting.
Rural Health and Care Wales continues to provide administrative support for the Green Health in Practice Network (Mid Wales) which has developed quality assurance frameworks for social / green prescribing 3 providers for which the public facing ‘tree’ is described in the illustration on the next page. Green Health in Mid Wales
4 Dyfi Valley Health
Dyfi Valley Health, the provider of GP Primary Care Services for around 7,000 people in north west Powys and surrounding areas, is facing a number of challenges in maintaining local services in their current form. They have submitted a formal application to Powys Teaching Health Board to merge their services onto their Forge Road premises in Machynlleth and close their premises at Cemmaes Road by June 2019.
In order to help PTHB consider the application from the practice and make decisions on the future of local services, they are consulting with patients of Dyfi Valley Health and the wider communities around Cemmaes Road and Machynlleth.
Consultation is taking place from 11 February to 28 March 2019.
Local patients and communities value their local services and a consultation document has been published which sets out the history, current situation and options for the future. This is being sent to patients registered with Dyfi Valley Health to seek their views, and is also being shared with local organisations and stakeholders. The consultation document can be found at this link: http://www.powysthb.wales.nhs.uk/sitesplus/documents/1145/broddyfivalley-dogfendocument-EN-Web.pdf
Your views are essential to this process.
PTHB need to understand how any change would affect you and your community and what steps they could take to reduce any negative impact of any change. We encourage you to express your views by completing and returning the consultation questionnaire: Consultation Questionnaire: https://www.smartsurvey.co.uk/s/broddyfivalley/ You don’t need to give your name and any feedback or comments will be entirely confidential.
PTHB plan to hold a number of public meetings and drop in sessions where you can talk to the health board and other members of the community about this consultation. To find details of these event please see the PTHB website.
The questionnaire will be analysed by the health board’s engagement team. Responses may also be shared with the Powys Community Health Council who are the independent statutory body to represent the interests of patients and the public in the NHS.
Your views will contribute to a report which will inform a recommendation on the way forward, which will be debated in public at a meeting of the Powys Teaching Health Board later this spring.
The Health Board is not prejudging the outcome of this consultation, however in the event that the application from Dyfi Valley Health is accepted, then their premises at Cemmaes Road would close by June 2019.
Thank you for taking the time to consider this proposal and share your views.
Find out more on the website at www.powysthb.wales.nhs.uk/dyfi-valley-health or by emailing 5 [email protected] or by phone to 01874 712489. Dyfi Ward, Bronglais General Hospital
Patients in Mid Wales have been given a boost following the reopening and renaming of a Bronglais Hospital ward which underwent a series of improvement works over the summer.
The new Dyfi Ward – formerly Iorwerth, which Canolfan Goffa Ffestiniog historically managed patients with cardiac and respiratory conditions – opened in December Over the coming weeks, a new series on S4C will open the following its temporary closure over the summer. doors of one of north Wales’ largest rural health and wellbeing centres. Over a course of a year, cameras have been Following a staff ballot, the ward was renamed recording the busy everyday life of Canolfan Goffa Ffestiniog. with two designations - Dyfi East, which now has From the daily challenges facing the healthcare staff, to all the a newly-modelled Non Invasive Ventilation (NIV) reasons, big and small, that bring people to the centre. The area for patients with complex respiratory series will give a glimpse of Blaenau Ffestiniog’s lively conditions, and Dyfi West, which has modernised community - a community full of characters, who all take their cardiac monitoring equipment for its patients. own unique approach to deal with life’s trials and tribulations.
The ward staff will work as a single team and this Canolfan Goffa Ffestiniog opened in November 2017. Today, offers opportunities for skills exchange in the there are over 30 services offered at the centre, which vary management of two distinct patient groups. The from Dementia care to Midwifery, Physiotherapy to Audiology, ward has also been redecorated and improved to name only a few. with dementia-friendly colours. The fly on a wall series, Helo Syrjeri, began on Monday, 18 Joe Teape, Director of Operations and Deputy February and offered the viewers the chance to see the Chief Executive at Hywel Dda University Health healthcare staff at work, treating and helping every patient Board, said: “I’m delighted to be able to announce that walk through the centre’s doors. the opening of the new Dyfi Ward following a period of improvement and refurbishment works Dr Rachel Davies worked as an inner-city GP in Nottingham, over the summer. before moving back to Wales three years ago to work at Canolfan Goffa Ffestiniog. Donogh McKeogh, Consultant Cardiologist at Bronglais General Hospital, added: “I am excited “I was raised in Prestatyn, before heading to Manchester to about the improvements to the ward and the study Medicine after my school days in Ysgol Glan Clwyd," positive impact this will have for our patients and added Dr Rachel, "I thinks it’s important for me to come back staff. I see it as a clear sign of the Health Board’s to Wales to work and to give something back to a Welsh commitment to the development of cardiology community like Blaenau." services in Bronglais which will benefit the patients of Mid Wales, more of whom will be able "After working in England for such a long time, I lost the to have their health care needs met by their local Welsh language, but by now, it’s come back to me. It’s so hospital”. important, if possible, for the patients to have the ability to speak in their first language under our care," said Dr Rachel.
In the series, we come face to face with the patients experience as they share their troubles with the nurses, doctors and other experts of the health service. Depression, dementia, drug addiction – the series will touch on each patient’s different complex situations, who all have their own stories to share within the four walls of Canolfan Goffa Ffestiniog. From taking blood pressure to hearing a baby’s heartbeat for the very first time, there’s plenty to see, and hear, at the local surgery. 6 NHS Future Fit
A critical decision point for the NHS Future Fit Programme was reached at a meeting of the Joint Committee of Shropshire Clinical Commissioning Group and Telford & Wrekin Clinical Commissioning Group
Members of the Joint Committee unanimously approved NHS Future Fit Option 1. This means that the Princess Royal Hospital in Telford will become a dedicated Planned Care site and the Royal Shrewsbury Hospital in Shrewsbury will become a specialist Emergency Care site. This will allow specialist doctors to treat the most serious cases on the Emergency Care site, which is proven to be safer, provide better results for patients and reduce the amount of time people have to stay in hospital. By having a separate Planned Care site, beds will be protected for planned operations, meaning that is highly unlikely operations will be cancelled due to emergency admissions.
This decision follows many years of planning, as well as last year’s formal public consultation which saw thousands of people from Powys take part and share their views.
This will be a major and exciting development that will benefit so many of our residents – and is much needed to help SaTH address the challenges they have faced in recent years to sustain safe and high quality services. Engagement in Mid Wales Integrated Health and Care in Ceredigion Over the last few years there has been a great number of consultations about the future design of care services Residents in north and south Ceredigion are invited across Mid Wales. To see the complexity of strategic to take part in two public drop-in events in planning in the area take a look at this link which details Aberaeron and Cardigan to share their thoughts on in a paper all that is going on in the area local capital development projects and health and http://www.midwalescollaborative.wales.nhs.uk/sitesplus care provision. /documents/1158/Ag%20Item%207%20Strategic%20Se As part of Hywel Dda University Health Board’s rvice%20Change%20Prog%20update.pdf commitment to continuous engagement with local communities residents will have the opportunity to In some cases the strategic direction has been decided speak to health officials about Aberaeron and so what services and resources available across Mid Cardigan’s new Integrated Care Centres on the Wales is becoming clearer. In this context we are trying following dates: to keep in contact with people in a less formalised way. In the spring we have decided to try a “drop in surgery” Aberaeron Memorial Hall between 3pm and 6pm series of events. We are hoping to use local cafes and on Wednesday, 6th March 2019 be available to anyone who wishes to drop in to discuss whatever they wish. We do need further feedback on the Bethania Chapel Vestry, Williams Street, plans and work of the Mid Wales Joint Committee so we Cardigan between 3pm and 6pm on Wednesday, will provide an easy way to comment on this as well. At 20th March 2019 earlier public meetings there were requests for a user friendly on line comprehensive source of information Peter Skitt, MWJC Lead/County Director about services and facilities across the patch. We will Ceredigion, said: “We’re pleased to invite local also be seeking some help with the design of this residents to come and speak with us about the resource. The Mid Wales Strategic Intent and Work healthcare issues that matter the most to them, Programme can be found here particularly in relation to our ongoing capital http://www.midwalescollaborative.wales.nhs.uk/mid- development projects in Aberaeron and Cardigan. wales-strategic-intent We are happy to receive comments on these or any “The public are again invited to provide feedback on other matters in any of the usual ways. Jack Evershed progress and our adherence to the plans they have has given talks to groups on subjects of interest to them helped us to develop following the previous drop-in and will try to accommodate any other requests. If you session, as well as commenting on our proposed would like Jack to meet with or talk to your group please colour schemes and other details.” 7 contact the Mid Wales Joint Committee Team. Herefordshire and Worcestershire STP Stroke Review
A review of Stroke Services is currently being undertaken by the Herefordshire and Worcestershire Stroke Programme Board, which was established in July 2017. The Board is made up of commissioners, clinical and operational staff from Herefordshire CCG, South Worcestershire CCG, Wye Valley NHS Trust, Worcestershire Acute Hospitals NHS Trust, Worcestershire Health and Care NHS Trust, Herefordshire Council (Public Health), NHSE Strategic Clinical Network lead, third sector and patient representation.
Welsh Ambulance Service Trust (WAST) and Powys Teaching Health Board (PTHB) attend to understand and assess the impact of the options for residents in Mid Wales, particularly those in mid Powys, who use these services. Both organisations can then develop actions in response to the decisions made.
The review is considering Hyper Acute Stroke Unit and Acute Stroke Unit (HASU AND ASU) services currently provided at Wye Valley Hospital in Hereford and Worcestershire Royal Hospital in Worcester. These services do not consistently meet key national clinical standards as they are currently set up, particularly in relation to 7 day provision.
The Programme Board has recently carried out a period of engagement, to facilitate conversations around the stroke pathway with interested parties, stakeholders and workforce. This is taking place ahead of the development of a pre-consultation business case. Further engagement is planned in the summer of 2019, after the local elections which take place in Herefordshire and Worcestershire in the spring of 2019.
A table-top session on Stroke pathways for South Powys was held on 8th November 2019 with key clinicians and stakeholders including the Community Health Council, WAST and the Stroke Association. This considered the models for stroke services being explored by Herefordshire and Worcestershire, as well as looking at the Powys pathways more generally in the mid and south of the County, of which the Hereford hospital pathway is just one component.
It was agreed at this session that the modelling work already carried out by WAST and PTHB on Stroke pathways would be refreshed with the most up to date data. Further scenario planning using this data is being carried out to inform an update to be provided to the Executive Committee Strategic Planning and Commissioning Group in March 2019.
We will keep you update on this work as more information is published.
Ways in which to contact us To follow the most recent news, updates and information from partner organisations please follow their social media pages
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