A HISTORY OF H.M. STANLEY HOSPITAL
St. Asaph
Denbighshire
1838 – 2012 A site record
A HISTORY OF H.M. STANLEY HOSPITAL
St. Asaph
Denbighshire
A site record from 1838 - 2012
Produced by editorial team from Betsi Cadwaladr University Local Health Board
Dawn Davies, Communications Officer (Editor) Eryl Smith, Library Services Manager, Ysbyty Glan Clwyd Julie Jackson, Higher Clerical Officer Anne Hughes, Higher Clerical Officer Mike Jones, Medical Photographer
With grateful thanks to all the contributors who have made this booklet possible.
June 2012
For further copies contact: Mrs Eryl Smith, Library Services Manager, Betsi Cadwaladr University Local Health Board, Ysbyty Glan Clwyd, Bodelwyddan, Denbighshire, LL18 5UJ
CONTENTS
Page
Chapter 1 Portrait of Sir Henry Morton Stanley (1841 – 1904) 1
Chapter 2 History of the workhouse 5
Chapter 3 The Hospital 1948 – 2012 13
Chapter 4 Services delivered at the Hospital
4.1 Care of the Elderly 21 4.2 ENT and Oral Surgery 29 4.3 General Outpatients 33 4.4 Maternity (up until 1993) 35 4.5 Gynaecology (up until 1993) 49 4.6 Ophthalmology 53 4.7 Stroke Rehabilitation 65 4.8 Other Services 73
Chapter 5 Supporting the Hospital 81
Chapter 6 Reprovision of the services 87
Preface
“History is the essence of innumerable biographies” Thomas Carlyle 1795-1881
I have enjoyed meandering down memory lane through the pages of this booklet on H. M. Stanley Hospital. This is a place I have known and loved since 1955 when I arrived as a locum for Dr. Nancie Faux, Mr. Ivor Lewis‟s wife. Internationally known medical men and women are associated with it as well as Henry Morton Stanley. Within you will read of history and the many people who helped to create the happy atmosphere associated with it latterly, but from which Stanley was happy to escape. The incident which epitomises this hospital for me was of Alf Jones, an early theatre attendant, being asked by Edward Parry-Jones if he would mind tying up his shoe lace, unless it was too menial a task for him. Quick as a flash Alf replied “no task is too menial if it serves a useful purpose”.
I commend the Editorial Team and the photographer for amassing this treat for the reader and I congratulate them.
Buddug Owen Retired Consultant Anaesthetist Author of several books on Welsh medical history
~~~~~~~~~~~~~~~~~~
Acknowledgements
When the H.M. Stanley Project Board asked me to “record the closure of the Hospital”, I did not fully appreciate the task that lay ahead of me. Indeed, without the tireless efforts and personal knowledge of the small editorial team that joined me in this work, this publication may never have been completed. My thanks to all of you, and especially to Eryl Smith, Library Services Manager at Ysbyty Glan Clwyd, who co-wrote many of the chapters and whose research skills were used to the full.
During the course of writing I have been fortunate to meet many knowledgeable and interesting people who had a wealth of experience to impart about their time at H.M. Stanley. These include current and retired staff, volunteers, patients, support groups, and even relations of a Master and Matron of the former Workhouse. Thank you all.
This book has been a joy to produce. Whilst it only provides a snapshot, the Editorial team hope that it goes someway to recording the history of the site from 1838 and the hospital itself from its inception in 1948 through to its closure in 2012.
Dawn Davies (Editor) Communications Officer Betsi Cadwaladr University Local Health Board
Chapter 1
Portrait of Sir Henry Morton Stanley (1841 – 1904)
Born on the 28th January 1841 at a cottage near Denbigh Castle, he was the illegitimate son of John Rowlands and Elisabeth Parry. He was christened John Rowlands at nearby St Hilary‟s Church. His aged grandfather, Moses Parry, brought John up, but when the old man died in 1846, an uncle paid 2/6d weekly for Mr and Mrs Price of Bowling Green Cottage to look after the boy. This sum was not enough to keep a growing boy and on the 24th February 1847 he was taken to St Asaph Workhouse – which became H.M. Stanley Hospital.
There he was treated harshly, but received a good education. It was said he was excellent at drawing maps. When he was 15 years old he was flogged by one of the masters for an offence of which he was not guilty. Young John Rowlands and his friend Moses Roberts ran away from the workhouse. They visited relatives in Denbigh, Llanrhaeadr and Tremeirchion, but received little help. John tried to work as a pupil teacher at Brynford, but after 2 years left for Liverpool where he obtained work in a butcher‟s shop. After a few weeks he decided to make a new life for himself, and signed on as one of a crew of a ship bound for New Orleans in the United States of America.
There, a lonely man, he was fortunate to find work with a cotton merchant, Mr Henry Morton Stanley. Mr Stanley treated him as a son and took him to live in his home. This was the happiest time John had ever known and as if to blot out his unhappy early life, he gave up his own name and from that time took on the name of his kind employer.
Young Henry led an adventurous life. He fought on both sides during the American Civil War and travelled all over North America. After the war he became a newspaper reporter and went to Turkey and Abyssinia to seek interesting stories. In 1869, he was employed by the New York Herald to go to Africa to look for David Livingstone, the famous explorer of whom nothing had been heard for some time. After many months of patient and dangerous search through the African Jungles, Stanley found Livingstone at a place called Ujiji, near present day Kigoma on Lake Tanganyika in Tanzania. It was there he spoke the famous words, “Dr Livingstone I presume?”
For the next few years Stanley travelled across Africa discovering new lands and tracing the course of the river Congo. He was the first man to cross from East to West Africa, starting at Dar es Salaam in Tanzania and arriving four years later at the Atlantic Ocean near Kinshea in Congo. On this trip he circumnavigated both Lakes Victoria and Tanganyika, proving once and for all that Victoria and not Tanganyika was the source of the Nile, and then travelled the length of the Congo River. He wrote several interesting books about his journeys and was often asked to give talks about the places he had visited. In 1890, H.M. Stanley was elected MP for North Lambeth in London. Nine years later he was knighted by Queen Victoria.
Sir Henry never forgot Denbigh or his family. He frequently returned to the Vale of Clwyd to visit his mother and his cousins. He also visited the workhouse despite having many sad memories of his childhood. H.M. Stanley died in 1904 aged 63 and was buried in Pirbright, Surrey.
When St Asaph workhouse was converted into an NHS hospital – the St. Asaph General Hospital – and renamed in 1959, it was very fitting that the Hospital should become the H.M. Stanley Hospital.
In April 2012, as the hospital was nearing closure, the plaque and photograph featured below were removed and donated to the exhibition at Denbigh Library to ensure that the association of Henry Morton Stanley with the Hospital will never be forgotten. The safe and artefacts have been given to the Denbigh Museum Group.
1
Portrait of Henry Morton Stanley
Situated in main reception of hospital
Commemorative plaque to Henry Morton Stanley
Situated on exterior wall at front of main hospital building.
2
Reproduced by kind permission of the Rhyl Journal
A letter was received at the Hospital from The Rhyl Journal which said “Mrs. E.N. Lewis of Bury, and her sisters, Misses B.E. and L. Lewis, of Longacre, Dyserth, would like you to have this souvenir picture of H.M. Stanley. The story surrounding this picture will appear in the „Rhyl Journal‟ this week, 20th November 1959.” Sadly we no longer have the photograph, but above is the article that appeared in the Rhyl Journal.
3 4 Chapter 2
HISTORY OF THE WORKHOUSE
The site which now houses H.M. Stanley Hospital was purchased in April 1838. It was a three acre area of land called Ysgubor-y-Coed (Barn in the Woods) which formed part of a farm called Bryn Polyn, the property of Lord Dinorben. Later excavations at the hospital revealed ancient foundations, thought to be the remains of a hospice run by monks. Thomas Penson the Younger produced designs in November 1838 but the work was carried out and completed in 1839 by John Welch, surveyor to the Guardians; Edward Knowles, Salter and Plasterers of Denbigh and Maurice Roberts, painter of Denbigh, at a cost of £6,500.00.
The building was designed to hold 300 people and was opened in 1839 as the „St Asaph Union Workhouse’. It was built to relieve poor people in the area, covering Prestatyn to Llanfair Talhaiarn, taking in Rhyl, St Asaph, Denbigh and the surrounding villages.
The original building was constructed in a cruciform shape with four courtyards. The front elevation was to have been made out of red brick, but instead dressed stone - Anglesey “Marble” - was used, being transported by sea to Rhuddlan harbour.
St. Asaph Union Workhouse/H.M. Stanley Hospital
Front of the workhouse from due south showing characteristic arches. 5
Front Elevation/main entrance
Diagram of the St. Asaph Union Workhouse, circa 1926. (ground floor plan). Courtesy of Denbighshire County Council.
Central part showing nursery from the south
South-east wing taken from the east Photographs courtesy of Peter Higginbotham – workhouses.org.uk
6
Chapel and male vagrants' cells taken from north - Windows bricked up Photograph courtesy of Peter Higginbotham – workhouses.org.uk
. Chapel View underneath the arches
The Boardroom which was the „Masters‟ Dining Room‟ in the days of the workhouse
7
Accommodation for inmates when the building first opened was somewhat basic; candlelight throughout (although paraffin lamps were used in the dining room). No carpets on the floors, no curtains at the windows, fires were lit only on the coldest days (if lucky) and the only toilet facilities available for the inmates were privies and wash houses across the courtyards (although chamber pots were provided for night time use).
Many poor men, women and children lived at the workhouse, including the able bodied, sick and the lame, the old and infirm, with schooling being provided for the children. The kitchen not only catered for the inmates, but also provided soup and bread for the poor of the surrounding area.
The workhouse dining room, date unknown. Photograph courtesy of Mr. David Hughes and Mrs Margaret Berridge, great-great grandchildren of Robert and Ellen Jones.
In 1841, beds and a nursery were made available for unmarried mothers. The majority of births (approx 400) at the workhouse between 1840 and 1921 were illegitimate. In the 1920s, married women were first admitted to have their babies and, from then on, the Maternity Services continued to develop.
Between 1855 and 1906, the chapel was built and laundry extended.
H.M. Stanley Hospital Chapel Inside the chapel (used latterly as storage for medical records!) 8
Main Chapel entrance
Original candle holder, converted to electricity Hymn Books
Plaque situated outside Chapel. It reads This sign is all that is left to tell us that the “This Chapel was renovated by public chapel had its own organ. subscription and re-opened on 21st May 1966 by Mrs Denzil Morton Stanley. The organ was installed in the same year.” 9
In March 2012, the Author was contacted by Mr. Robert Davies, a native of Denbigh, now living in Reading. Robert is the great grandson of Mr. Robert Jones, who was Master of the Workhouse from February 1878 – April 1911. Mr. Robert Jones was a railway locomotive engineer by trade but came to be Master of the Workhouse on the death of his father, Mr. Evan Jones who was Master from May 1871 to January 1878. Until her death his mother, Mrs Eliza Jones, continued to serve as Matron. She in turn was succeeded by Robert Jones‟ wife, Ellen. Robert and Ellen had four children; two sons, Evan and Charles, and two daughters, Seprina and Eliza. Prior to her marriage in June 1892, Eliza acted as Assistant Matron to her mother. It is assumed that up to the establishment of the NHS, the Matron was usually the wife of the Master.
There were two further „Jones‟ as Masters immediately prior to this – Ishmael Jones (1859- 1866) and Peter Jones (1866-1871). Robert, and great-great grandchildren David Hughes and Margaret Berridge, have confirmed that these Masters were not members of the same family.
Photograph courtesy of Mr. Robert Davies
Robert Jones – Master of the Workhouse February 1878 – April 1911
Photograph taken some time between 1878 - 1911
Photograph courtesy of Mr.David Hughes
Workhouse staff showing Master Robert Jones and his wife Ellen as Matron. 10
Robert Davies (right), great grandson of Robert Jones with Nigel Parry (Porter at HMS) during a visit in May 2012. Robert stands in front of the fireplace where his great-grandfather would have whiled away many hours.
Workhouse Masters
Mar 1840 - Apr 1850 Mr. Robert Ivey May 1850 - May 1850 Sergeant Daniel Evans acted pro tem May 1850 - May 1859 Mr. John Williams May 1859 - Apr 1866 Mr. Ishmael Jones Apr 1866 - May 1871 Mr. Peter Jones May 1871 - Jan 1878 Mr. Evan Jones Feb 1878 - Apr 1911 Mr. Robert Jones Jun 1911 - Mar 1915 Mr. E. Hughes Jun 1915 - 1948 Mr. William Frederick Morris
Workhouse Matrons
It is assumed that up to the establishment of the NHS the Matron was usually the wife of the Master. Matron Alice Morris 1915 – 1946
11
In 1906 a 2-storey infirmary was built at the rear of the Workhouse (north east) to house the sick inmates and members of the public, and in 1924 it was joined to the workhouse. The isolation hospital was built in 1910 on the East side of the site. This was known as the St. Asaph Infectious Diseases Hospital where diphtheria and scarlet fever patients were nursed (1937-49). Doris Roberts, Retired Senior Administrator with the Conwy & Denbighshire NHS Trust remembers the Isolation Hospital – “I was very young then and the only time I saw it, from a distance, was when we as children travelled to Rhyl by train on the annual day trip from Denbigh Town. Nurses and patients used to wave to us as we went past.” The buildings have far outlasted the railway which closed in 1967!
12
Chapter 3
The Hospital 1948 - 2012
Entrance to H.M. Stanley Hospital – 1980s.
Entrance to H.M. Stanley Hospital - 2012
With the advent of the National Health Service in 1948, the Infirmary beds were developed and utilised for Medical, Surgical, Gynaecological, Obstetrics, Ophthalmic, Dental and Ear Nose and Throat (ENT) treatment. The building gradually developed into a Hospital, and was given the name H. M. Stanley Hospital in 1959, in memory of Henry Morton Stanley.
Vagrant wards were adapted for use as pathological laboratories, pharmacy, store rooms and work offices. Provision was made for additional Ear, Nose & Throat and Ophthalmology (eyes) beds and a dental unit was added. 13 A twin theatre suite was erected on the site of the old theatre and the laundry was adapted for use as a central supply department and linen store.
Poor Law patients remained in the building until 1960 when they were re-housed in old people‟s homes.
After the Health Service reorganisation in 1974, the Health Authority provided 50 acute beds, a new department for Ophthalmology, a through-care Delivery ward and improved facilities for both the Department of Obstetrics and Special Care Babies.
Matrons recorded at the hospital included: Matron Blodwen Evans 1946 – 1955 Matron Ada Thomas 1956 – 1958 (Acting) Matron Lucy M. Jones 1958 – 1971 Matron Alexa M. Jones 1971 – 1973
Diagram of Workhouse and Infirmary, and subsequent additions.
Aerial shot showing divisions of the site as shown on the above diagram. Photograph believed taken in the 1970s. 14
Changes in management
In 1948 the Clwyd and Deeside Management Committee oversaw H.M. Stanley, along with 14 other hospitals. Primary and Community services were administered separately by Executive councils and local authorities respectively.
In 1974 hospital and community services were brought together under one organisational umbrella – Clwyd Area Health Authority, which was split into North and South districts, run by district management teams, working on a consensus basis.
In 1982 the 8 Area Health Authorities in Wales became 9 District Health Authorities and district management teams were replaced with a system of unit management. In 1986 consensus management was discontinued (following a review by Sir Roy Griffiths) and a Unit General Manager was introduced.
In the 1990s, District Health Authorities became purchasers of health care and hospitals the providers. Hospitals were allowed to apply for specific statutory status. On 1st April 1993 the hospitals of Glan Clwyd, H.M. Stanley, Abergele and Lluesty (Holywell) jointly became the Glan Clwyd District General Hospital NHS Trust. Clwydian Community Care Trust was responsible for all hospitals and services in the community including mental health.
From 1 April 1996 Clwyd Health Authority merged with the 3 other authorities in North Wales to become the North Wales Health Authority until it was abolished in March 2003.
In 1998 the Welsh Office, now the Welsh Government, reduced the number of Trusts. The Glan Clwyd NHS Trust was dismantled and the Conwy & Denbighshire NHS Trust was formed on 1 April 1999, with responsibility for all acute, community and mental health services within Conwy and Denbighshire.
On 25th June 2008, the Trust merged with North East Wales NHS Trust to become the North Wales NHS Trust.
On 1st October 2009, the North West Wales and North Wales NHS Trusts merged and became the Betsi Cadwaladr University Local Health Board, the managing body at the time of closure of H.M. Stanley.
15
Decision to reprovide services and close H.M. Stanley
Following extensive stakeholder engagement and the subsequent formal consultation, the Secondary Care Review “Designed for North Wales” concluded in 2007 that Ophthalmology and Stroke Rehabilitation services should be relocated from H.M. Stanley. Apart from General Outpatient clinics that still operated on the site, other clinical services had already relocated over a period of years.
In 2010, the Health Board agreed, as set out within the „5 Year Service, Workforce and Financial Strategic Framework‟, to put these plans into action. It then set an ambitious target completion date for transferring services to more appropriate accommodation, and vacating the HM Stanley site.
The reasons for this decision were mainly focussed around the poor fabric of the buildings, with clinical services frequently interrupted whilst repairs were made. The cost of backlog maintenance amounted to approximately £3.4m, of which some £2.3m would be needed to address the high and significant risk issues. This included work on the electrical systems, heating and structural repairs and replacement operating theatres.
The main issues that affected the site were the conditions of the mechanical engineering services and the presence of asbestos. £1.8 million would be required to restore these services to a maintainable and reliable condition. The main boiler house had been decommissioned as a direct consequence of the dilapidated condition of the services. Heat was provided by a temporary boiler which was being leased. The additional unavoidable costs of running the site, which in many cases were linked to its poor condition and traditional construction, were circa £0.9m.
The reprovision of the services took place during 2011 and 2012. (See Chapter 6). The Health Board worked closely with other users of the site – including St Kentigern‟s Hospice and the Wales Ambulance Service – to ensure that their services could be maintained and could remain and continue to operate from the H.M. Stanley site after the hospital‟s closure.
The hospital finally closed its doors on Friday, 13th April, 2012.
16
General Photographs of the Hospital
The front of the main building, looking towards Finance building, which was the original Residences the Finance building. (Outpatients in distance) for the hospital. (looking west)
Finance building/courtyard. (looking east) Front of Finance building
Dining Room interior 1965 (looking west) Dining Room Interior 2011 (looking east)
17
Looking down into the old Laundry building View of Corridor to Stroke Unit looking down from old Flint Ward
Corridor from main building to Stroke Unit Safe in General Office - dated 1857
Laundry. Background doors led to Workhouse Nursery. Corridor between Gynaecology and X-ray
18
The original front door. Unused for many years.
Two very familiar faces at the hospital. – photograph taken 2011. Left – Porter of 20 years Brian Phillips. Right – Domestic of 30 years Sid Davies
19
Photograph courtesy of Rhyl Journal.
Long Service Awards at the hospital as reported in the Rhyl Journal, November 6th, 1991.
20 Chapter 4.1
Care of the Elderly Services
Reproduced by kind permission of the Rhyl Journal. Workhouse Wards transformed into modern Geriatric Unit – February 2nd, 1966 21
Adapted from Ysbyty Glan Clwyd Birth and Life of a Hospital: The Geriatric Service, Clwyd North by JP Arnold & BK Bhowmick
The new specialty of Geriatrics began in North Wales in 1961 when 45 beds were opened at H.M. Stanley hospital. At that time outpatients services were provided at Lluesty Hospital, Holywell which had 192 beds.
The facilities in the old workhouse accommodation were not really appropriate as only two wards were on the ground floor; the other two were up narrow winding staircases. The old workhouse also carried a stigma; people who were admitted were expected to remain in hospital until they died and discharges were rare. However there were other acute services at the H.M. Stanley site, and local general practitioners soon realised the advantages of referring patients over 65, whom they considered required specialist care. Thus, perceptions and prejudices gradually changed as patients returned home, coped and lived for many more years. This resulted in a sharp increase in admission rates; in 1965 there were 400 admissions and this had risen to 4,000 in 1986.
In 1961, medical cover was largely the responsibility of general practitioners with some support from a junior medical hospital officer. In 1961, Dr June Arnold was appointed Geriatrician and she felt that “if only elderly people could be treated at the start of their illness, age was not a bar to recovery; beds had to be always available. Transfers from other departments needed to be rapid and home visits carried out quickly; the waiting list and waiting times had to be short for both inpatients and outpatients”. At times the local GPs slept in the hospital to enable emergency cover to be provided.
In 1964 a lift was installed at a cost of £7,500. This improved access for patients and relatives and meant nurses no longer had to carry up individual meals or trays from the kitchen.
In 1966 the wards were totally refurbished and improved for the benefit of the patients and staff, as recorded in the newspaper cutting from the Rhyl Journal at the start of this chapter.
In the 1970s a Psychogeriatric Assessment ward was set up at the North Wales hospital to take Geriatric patients with mental disturbance not obviously related to physical illness, who could not be cared for properly at H.M. Stanley.
During this time H.M. Stanley hospital also provided respite care for carers looking after disabled elderly people at home. This holiday care was available in periods to suit the patient and carer, but could be as long as six weeks in hospital alternating with six weeks out. Six weeks was chosen as this was the length of time somebody could remain in hospital without a reduction in pension.
Dr Arnold was very happy to welcome Dr Bimal Bhowmick as a Senior Registrar in 1974. In 1975 he became locum Consultant and substantive Consultant in 1976.
As acute services were centralised on the H.M. Stanley site the workload increased and there was a need for more acute beds. In 1975 a prefabricated unit with 20 beds was built and named Stanley A (for Arnold). The existing Geriatric ward on the first floor previously just called Stanley, (which had two wings to it one for males and one for females) was named Stanley B (for Bhowmick). Also on the first floor was a Medical ward, which later became Flint Ward (circa 1986).
In the early 1980s a new ward was built - Stanley C, which took long stay elderly patients from Llangwyfan Hospital; many staff also transferred. It then became an acute ward under the third consultant, Dr Wyn Greenway in1984, and later as Conwy Ward - the Stroke unit. 22
In 1980 Ysbyty Glan Clwyd, Bodelwyddan opened, so all Medical wards from H.M. Stanley were transferred, but it was not until May 1982 that a 30 bed Care of the Elderly acute admission ward (Ward 14) and a multidisciplinary Day Hospital (adjacent) were opened at Ysbyty Glan Clwyd.
The transfer of Medicine to Glan Clwyd left vacant space at H.M. Stanley. Initially it was used for haematology - 6 beds under Dr Edwards - and surgical convalescence. Then in 1986 the old medical ward was refurbished and acute elderly patients from Lluesty were transferred to it. It was at this time that they decided to rename all the wards at H.M. Stanley after local castles and the old medical ward became Flint Ward, Stanley B became Rhuddlan Ward, and Stanley C became Conwy. However as St Asaph did not have a castle Stanley A was named Elwy after the river. At this time there were about 100 beds in the four wards.
In 1986 Dr June Arnold retired and Dr Jane Wood was appointed Consultant in her place. Elwy Ward (previously Stanley A) became the new home for the Stroke ward from Lluesty.
Ward Geography - Care of the Elderly Wards
Table showing Ward names
Code on 1961 1974 Early c1986 1994 2011 above 1980s plan 1 Stanley Stanley B Stanley B Rhuddlan Moved to (1st floor) Glan Clwyd 2 Stanley A Stanley A Elwy Day Unit Moved to Glan Clwyd 3 Stanley C Conwy Stroke Moved to Rehabilitation Glan Clwyd 4 Medical Medical Flint Moved to (1st floor) Ward Ward Glan Clwyd
23
In 1989 a Stroke Rehabilitation Centre was established at H.M. Stanley. See separate chapter.
During the 1990s the term „geriatric medicine‟ lost favour and the term “Care of the Elderly” came into use as it conveyed a more caring image. In 1993 a Care of the Elderly Academic Unit was established at Glan Clwyd and a fourth Consultant/Senior Lecturer Dr Jolyon Meara, a specialist in movement disorder and Parkinsons Disease, was appointed.
In July 1994 the three acute wards at H.M. Stanley were transferred to the vacated and refurbished Paediatric wards (Wards 1 and 2) at Ysbyty Glan Clwyd. This left space for the refurbishment of a ward at H.M. Stanley, at the cost of almost a quarter of a million pounds, to provide better fit-for-purpose accommodation for the Stroke Rehabilitation Centre.
In 1980 there were 271 Geriatric beds in North Clwyd spread across H.M. Stanley, Lluesty, Royal Alexandra Rhyl, and Llangwyfan Hospitals. By 1997 this had been rationalised to 169 beds, comprising 90 acute admission beds (Ysbyty Glan Clwyd), 20 stroke rehabilitation (H.M. Stanley hospital), 30 rehabilitation/respite/continuing care beds (Lluesty hospital) and 29 beds for respite/continuing care at Royal Alexandra hospital.
By 2010 this picture has evolved again and Lluesty Hospital has shut, as have the Elderly Care beds at Royal Alexandra. Community outreach teams now operate to keep the elderly in their own homes with the appropriate health support – this is called the Home Enhanced Care Service.
The closure of H.M. Stanley and the relocation of the Stroke Rehabilitation Unit to Glan Clwyd means all acute and rehabilitation services for the elderly are located on the Glan Clwyd site in modern purpose-built accommodation.
24
Stanley „Geriatric‟ ward (Photo taken in 2011 when space used for storage)
Communal area outside Stanley „Geriatric‟ Ward used for social gatherings for patients. Dr Jane Wood commissioned the mural to make it a pleasant place to sit.
25
Professor Bhowmick in Stanley B ward. Stanley B cubicles. – male patient section In 2011, Stanley B (male) was the H.R. department
Stanley B – female patient section. Stanley A (pre-fab building)
In 2011, Stanley B (female) was part of Ophthalmology offices.
Flint ward – male section. Flint ward – female section.
In 2011, Flint Ward was Clinical Governance department.
26
On 9th December 2011, a coffee morning was held at HMS to celebrate 58 years of Eye care at H.M. Stanley Hospital. Two retired members of staff who had worked at H.M. Stanley, mainly in Care of the Elderly, before transferring to Ysbyty Glan Clwyd attended the coffee morning and shared their experiences:
Eirlys Marshall became a Health Care Support Worker in HMS 1973 and worked mainly on the Care of the Elderly wards, including Stanley B and Stanley C. “EP” undertook her nurse training in 1972 in HMS and in Colwyn Bay before settling at H.M. Stanley. Both moved to Glan Clwyd when the wards closed at HMS and transferred to Glan Clwyd. They both retired in 2009, having worked under Dr. June Arnold, Dr. Bim Bhowmick and Dr. Wyn Greenway.
In discussing changes they had seen over the years, one practice they were glad to see the back of was the lifting of patients. Of course today this is not allowed and the use of hoists was a welcome change of practice. Another welcome development was the arrival of pre-plated meals for patients instead of having to „dish-out‟ the meals on the wards: this allowed staff to serve the patients their meals single-handedly.
One practice down-side however is the amount of paperwork that has to be undertaken, and whilst not disputing the need for good recording, Eirlys and EP feel it does take staff away from spending time with the patients.
Both were very sorry to see H.M. Stanley closing.
27
28
Chapter 4.2
Ear Nose and Throat and Oral Surgery Departments
Based on information from Mr Zak Hammad, ENT Consultant, Mr F.G. Hardman and Mr Paul Bradley Oral Surgery Consultants, from the book Ysbyty Glan Clwyd : Birth and Life of a Hospital.
Ear Nose and Throat – ENT
In 1956 the first ENT department was established at H.M. Stanley Hospital. Previously patients were treated by visiting surgeons from outside the area, e.g. Liverpool. Miss Catrin Williams was appointed as the sole Consultant, she retired in 1986, but continued to do some locum work. Miss Williams was assisted by one Registrar Dr I Narain (1986 he was appointed a full time Clinical Assistant) and one Senior House Officer. All surgery was carried out at H.M. Stanley, but regular clinics were held at Colwyn Bay, Denbigh and Holywell Community Hospitals, as well as H.M. Stanley. Having these facilities was so important for the patients, who did not have to travel out of the area, particularly in emergency situations. ENT services continued to be provided at H.M. Stanley for 24 years, until it moved to Ysbyty Glan Clwyd in September 1980. The move to new accommodation initiated a growth in the number of staff in the department, (a second consultant Mr Z Hammad was appointed in 1981), introduced new equipment and, in turn, a rapid development in the number and variety of medical and operative treatments available. See ward geography on P23 for location of ENT ward.
Oral Surgery
In 1954, Mr Gordon Hardman, who had completed four years senior registrar training in East Grinstead Hospital, was appointed to 6 sessions per week, to provide oral surgery for the four counties of North Wales. Providing a service across North Wales, with an underdeveloped road system, was difficult. In 1959 he formed the North Wales Postgraduate Dental Education Society (“Y Geg”) to encourage local dental practitioners to maintain a wide range of skills. The Society met twice yearly until 1983.
In 1960 an Orthodontist - Mr DG Huggins was appointed and in 1967 a second consultant, Mr P Worthington, was appointed. He emigrated to America in 1977, and was replaced by Mr Paul Bradley, who had been Senior Lecturer and Consultant in Liverpool. Paul Bradley continued his research on cryosurgery at Liverpool and published a text book entitled „Cryosurgery in the Maxillofacial Region‟. In 1973 Mr Richard Parkhouse, joined as a Consultant Orthodontist.
During the 1970s and early 1980s oral surgery became known as oral and maxillofacial surgery and its scope became better recognised by other specialities. Mr Hardman was becoming world renowned for his work; he was invited to speak at over a dozen international meetings and, on a similar number of occasions, conducted lecture and operating tours in many parts of the world.
The Unit at H.M. Stanley developed and they pioneered the technique of the Temporalis Muscle Flap. This reconstructive technique was used on the first group of human patients in North Wales as a means of repairing the oral cavity, particularly the palate after cancer resection. An article was published in the European Journal of Maxillofacial Surgery in 1982, presaging a technique which is now used in virtually every maxillofacial unit in the world.
Over the years many trainees from the UK and foreign countries came to work and learn at the unit at H.M. Stanley, several of whom, like Tony Pogrel, have continued to have distinguished careers in many different countries. 29
In 1983 Gordon Hardman retired and Paul Bradley became Professor of Oral and Maxillofacial Surgery at the University of Edinburgh. Continuity was provided however by the appointment of Graham Wood, the senior registrar as Consultant of Oral & Maxillofacial surgery at Ysbyty Glan Clwyd where the department was based from 1984.
Murals in Operating Theatre
From 1961 to 1980 the Twin theatres were shared between Ophthalmology and Ear, Nose & Throat (ENT). Animal murals were painted by an ex-patient on ENT (possibly in the late 1960s) for the ENT children undergoing anaesthetic. Most of the operations would have been for tonsils and adenoids. In those days operations were performed only twice a week. In 1980 when ENT moved to Ysbyty Glan Clwyd, Ophthalmology took over the both theatres and decided to leave the murals. They have remained a talking point since.
30
Memories of working on the Ear Nose and Throat and Maxillofacial Surgery Ward by Jenny Joyce, Sister (retired 2007)
I started working at H.M Stanley Hospital in April 1975. Having been interviewed by Mr. Carl Pierce, Senior Nurse in Ophthalmology and Mrs Alexa Jones the Matron, I was allocated a post on the Ear, Nose & Throat/ Maxillofacial ward, doing two nights each week. This ward was known as Sister Hendley Ward. Sister Gertrude Hendley was the first trained nurse to manage the Workhouse Infirmary in 1915.
The Consultants at that time were Miss Catrin Williams for Ear, Nose & Throat and Mr. Gordon Hardman for Maxillofacial. Both were highly renowned in their field. Dr. Narain is also fondly remembered, as is his sidekick for many years Dr.Dwivede. Many more Consultants, Registrars and House Officers came and went during my time on this ward and I remember particularly the American Doctors, who came to learn from Gordon Hardman. Who would have thought a little place like H.M Stanley hospital in St. Asaph being able to teach the United States a thing or two? The Hardman Society still exists today, led by Tony Pogrel a one time Doctor at H.M Stanley, who is today Professor of Oral and Maxillofacial Surgery, University of California, San Francisco. A reunion was held only last year at The Oriel House Hotel, St. Asaph, with a nostalgic visit to H.M Stanley, before it disappeared for ever.
In 1975 the Nursing Staff were led by Senior Sister Pat Williams, assisted by Sister Dilys Parry, Sister Maisie Campbell and Charge Nurse Ramasseur. All were well established and experienced nurses in these specialities. I was told early on that the formidable Sister Williams would like me if I could play the organ in the Chapel and if I spoke Welsh. As I did neither I didn‟t stand much chance, but still we tolerated each other. She did day duty, and I did night duty, thankfully! Other memorable members of the nursing staff in these early days were Olive Roberts, Moira Murray, Linda Ffoulkes, Pauline Pierce, Carys Howatson, Gillian Williams, Eluned Davies and Judy Speakman, to name but a few.
The Ear, Nose & Throat ward was divided into four sections. An area for the children, which had 8 beds, then a male ward for 10 men and down a corridor, quite some distance away, a female ward for 12. Then another long corridor of single rooms, which were occupied by the more seriously ill and private patients, whose privilege was they had their morning tea on a little tray with a silver teapot and china cup. There was also a two-bedded room next to the office which was just off the male ward.
The nights were busy especially after operating days. All those little children post tonsils and adenoids and insertion of grommets. A lot of them were fretful as parents weren‟t allowed to visit on theatre days. (How cruel that sounds now!)
31
Children on the ENT ward - early 1970s. photograph courtesy of Andrew Pritchard
Major surgery was performed by both Ear, Nose & Throat and Maxillofacial. As there was no Intensive Care, these patients were nursed in the side room next to the office and an extra member of staff was allocated to “special” them. Mornings were particularly hectic, with everyone expected to be woken and washed, medicines given, Temperature, Pulse and Respiration (T.P.R) and Blood Pressures (BPs) done and we also did breakfasts, making porridge in the ward kitchen.
We also received casualties related to the ward specialities directly to the ward, requesting the on call Doctor from home to attend to these and any other ward emergencies.
The ward finally closed in 1981, when all staff and patients were transferred to Ward 4 at the big new hospital, Ysbyty Glan Clwyd in Bodelwyddan.
32 Chapter 4.3.
General Outpatients
Adapted from information kindly provided by Sister Jenny Joyce.
General Outpatients Building
In 1992 Jenny Joyce, previously Sister in ENT returned to H.M. Stanley Hospital to take charge of the General Outpatients Department (GOPD). Her predecessor, Sister Rose Holmes had left to manage the new Gynaecology Day Unit at Ysbyty Glan Clwyd, taking the majority of the nursing staff with her, leaving only Staff Nurse Rhiannon Wynne. Another Staff Nurse Wendy Owens and a new Health Care Support Worker Heather Inskip were quickly appointed.
At that time the clinics in place were: Dr. Wyn Greenway - Care of the Elderly, Mr David Hay - General Surgery, Miss Christine Evans - Urology and Dr. David Smith - Neurology and Dr. Gozzard and Dr. Edwards - Haematology. The Midwives took over on Wednesday afternoons for their Ante-Natal clinic and the general staff had a half day.
Dr. Olwen Williams, Consultant in Genito-Urinary Medicine (GUM) started her clinics in general outpatients, assisted by Helen Dunshea and Staff Nurse Mark Andrews, until they moved to their new department at Ysbyty Glan Clwyd. Mr. Banfield commenced his Gynaecology clinic bringing his own nursing staff.
33 As clinic space at Ysbyty Glan Clwyd became scarce, sessions at H.M. Stanley were filled to capacity. Urology became well established with Mr. Srinivasan joining the team and the commencement of nurse-led Erectile Dysfunction and Prostate Assessment Clinics. Clinical trials for Urology were also conducted from the General Outpatient department led by Mr. Islam assisted by Jenny Joyce.
Further nursing staff joined the department as the workload increased, including Kate Fairhurst, Claire Wilson and Karen Morris.
The department had a refurbishment in the 1990s and facilities were greatly improved as the department was well past its best. Vertical blinds replaced the net curtains and a crash trolley and defibrillator were provided.
In 2005 after much discussion and many meetings, it was decided to introduce an Endoscopy service to Outpatients. This would facilitate a better service to patients attending the General Surgery Clinics. Jenny Joyce left the General Outpatient Department at H.M.Stanley in 2005 to become Clinical Leader for General Outpatients at Ysbyty Glan Clwyd/H.M. Stanley and this Endoscopy service was successfully implemented in 2006, by her replacement, Kate Fairhurst. Jenny Joyce retired in March 2007.
Outpatients clinics ceased at H.M. Stanley in June 2011 and moved to Ysbyty Glan Clwyd, with some of the clinics held in the new Ivor Lewis Building on the Ysbyty Glan Clwyd site.
Sister Kate Fairhurst Sister Jenny Joyce with Mr. Islam, Mr. Srinivasan, and the Urology Team
34 Chapter 4.4
Maternity
Midwifery services had a presence on the H.M. Stanley site from 1840 to 1993. The initial “living-in” ward was located in the original workhouse and provided 8 beds. In 1924 the service relocated to the Infirmary and then relocated again to the Isolation/Fever hospital in 1950. It remained in this area until the Unit transferred to Ysbyty Glan Clwyd in 1993.
The first birth took place in the Workhouse on 20 November 1840, although no name is recorded. The last birth recorded was on 19th February, 1993. Needless to say, in the early days of the workhouse there were no trained midwives. It wasn‟t until 1881 that the “Midwives‟ Institute” was set up, which eventually became the „Royal College of Midwives‟ in 1947.
1846-1936 In the late 19th/early 20th century births were facilitated by „untrained‟ nurses and the other inmates of the workhouse. The first trained nurse was appointed in 1915 (Sister Gertrude Hendley) to manage the Infirmary. A Doctor was only „summoned‟ to a birth when things became „desperate‟. Caesareans were only carried out on dead or dying women, since to perform the operation virtually meant her death, due to sepsis. During this period approximately 523 births are recorded, the majority of which (nearly 90%) were illegitimate. (Source C.G. Williams, Liverpool Daily Post, (1963).
In 1906 an Infirmary was built at the rear of the workhouse, and joined to it by a corridor in 1924. A purpose-built labour ward, operating theatre and X-ray room were built off the corridor. The provision of this delivery suite was an act of great foresight and provided the basis for a proper obstetrical unit.
Diagram shows New Labour ward, theatre and X-ray room, built c.1924.
35 1937-1980
Mr. A.H. Holmes, a local GP, who took up Infirmary duties in 1937 extended the midwifery service and introduced gynaecological work into the hospital, and is generally regarded as the founder of the Obstetrical and Gynaecological department at H.M. Stanley. The unit housed 12- 14 maternity beds, shared between the antenatal and postnatal patients, with an additional 3- bedded side ward for complicated cases. The Nursery was at the end of the ward, separated from the main part by a glass partition. All babies were nursed in the same room, with a wooden incubator available for a sick premature baby, and it was not unknown for the incubator to be shared with another baby. In order to avoid infection, the regulations on visiting were strict. Only staff were permitted to enter the Ward or Nursery
The number of births rose significantly during this period. 3,539 births were recorded, with a much smaller percentage (17%) being illegitimate.
For deliveries, the supply of equipment was scanty, and linen threads, boiled and reused, were used as „ties‟ for ligating the umbilical cord. For operative deliveries (for example the use of forceps) the midwife was in charge of monitoring and administering the anaesthetic (usually chloroform on an open mask), while the Doctor undertook the delivery.
Ante-natal clinics were held in the Operating Theatre, with as many as 60 patients. These clinics could last 4-5 hours, particularly if the Theatre was required for emergency deliveries.
In the early 1950s it became obvious that the conditions were no longer adequate for the increasing obstetric practice. Fortunately, in a field adjacent to the Workhouse was an Isolation or Fever Hospital. The first building was erected in 1910 and extended so that by 1948 there were 5 separate bungalow-style buildings. The Welsh Regional Hospital Board decided that this Isolation Hospital was well suited for maternity services, and on Pancake Tuesday 1950, the post-natal patients in the Infirmary were transferred to the former Isolation Hospital. Isolation Hospital patients were sent to either the „Infectious Diseases Hospital‟ at Bron y Nant, Colwyn Bay or to Abergele Sanatorium, which became Abergele Chest Hospital in 1955.
The move wasn‟t without its hazards. The service was split over 5 unconnected „Pavilions‟ (which were renamed „Blocks‟) and women requiring emergency delivery in the Operating Theatre had to travel outside the building to reach it.
The diagram and legend on the following page relates to the Isolation/Fever hospital at the time it was adapted for Obstetrics and Gynaecology.
36
Isolation/Fever hospital adapted for Obstetrics and Gynaecology.
Pavilion 1, B1. Original Isolation hospital built 1910. Rebuilt 1966 and became the Outpatients Department. Pavilion 2. B2. 1929. Converted to Offices 1952. Registrars Flat 1954 Pavilion 3. B3. 1929. Adapted for Gynaecology 1954 Pavilion 4. B4. 1940. Adapted for post-natal work 1951 Pavilion 5. B5. 1940. Adapted for ante-natal work 1953
1. Post-natal wards 2. Nursery, built 1963 3. Nurses‟ changing room 4. Gynaecology ward (G3) 1969 5. Theatre built 1940; used as delivery ward 1951 – 53; then as theatre 6. Corridor linking Pavilions 4 & 5, 1953 7. Waiting Hall, Reception and Main Entrance 8. Corridor linking Pavilions 3 & 4, 1954 9. Gynaecological Wards, taken over 1954 10. Delivery Suite, built 1963 11. Offices 12. Temporary Delivery rooms 1953 – 1963 13. Ante-natal ward, taken over 1953 14. Library built by public subscription 1975 15. Special Care Baby Unit adapted in 1951, first used in 1953 16. Administrative Block 1929, extended in 1940, later Nurses‟ Home and Midwifery School 17. Original Isolation Hospital (tin hut). Rebuilt 1966, now Out-patients‟ Department 18. Oil-fired boiler house 1966 19. Old coal-fired boiler house, in 1980s were engineers‟ offices and work rooms 20. Office block 21. Registrar‟s flat 22. Mortuary and Laundry built 1929; now part of Out-patients‟ department, 1966 23. Records 24. Garage and Storage Shed 37
18 months after the move to the Isolation hospital, the first Consultant appointment was made. One of the first priorities was to redesign the layout, starting with a corridor linking Blocks 4 and 5 in 1954. This allowed the Obstetric department of 52 beds to be housed under one roof.
In 1952 a 24-hour Obstetric „Flying Squad‟ service designed to bring immediate help of Midwives/Doctors to look after the pregnant or labouring women in their own home or nursing home was introduced.
A new Delivery Suite and Nursery was built and opened in 1963 (building no. 10 in above diagram). This allowed plenty of room for the increasing number of births and also released space in the Special Baby Care Unit.
Unveiling the plaque at the opening of the new delivery suite and nursery -1963. From left to right: Professor A.S. Duncan, Mr. E. Parry-Jones, Dr. Huw T. Edwards, Matron Lucy Jones, Mr. E.V. Vaughan, Mrs G.M. Heaton, Dr. Muriel McLean, Mrs Barbara Duncan.
Births at the hospital from 1953-1980 rose steadily from 558 in 1953 to 2,029 in 1980. At the same time infant mortality rates gradually reduced, with 39 mortalities recorded in 1980 against these 2,029 births.
Eluned Jones - „Sister Lyn‟ - worked at the Midwifery Unit in H.M. Stanley for 33 years from 1960-1993. Much of her time was as Sister in charge of the Labour Ward. Here she shares some of the changes in patients care she experienced.
“In the early sixties patients‟ care was very much „routine care‟, i.e. every patient on admission was examined, shaved and given an enema. As labour progressed sedation was given such as chloral hydrate, pethidine and gas & air. Patients were kept in bed for three days after delivery, swabbed 3 times daily and bed bathed daily. Their stay in hospital was between 10-14 days depending on the type of delivery. Care would then be continued at home by the Community Midwife for up to 28 days before the Health Visitor took over.
During the late sixties patients care changed dramatically and continued, and still continues, to improve. Acceleration of labour was introduced. Pain relief in the form of Epidural Analgesia was introduced by Dr. Buddug Owen in 1970 and for some considerable time she was the only one doing this procedure.
38 The new Delivery Suite opened in 1963 brought great advantages. It had 2 spacious Delivery Rooms, Sterilising Room with Autoclave, sluice and bed pan sterilizer, 5 rooms for patients in early labour, as well as a Sister‟s office and changing rooms with toilets and shower. Delivery rooms were fully equipped and included piped oxygen, resuscitative cot for baby, and excellent lighting. Patients still had to be moved from the early labour rooms to the Delivery Rooms, but it was much easier to manoeuvre the trolley that carried the patients. The two post-natal wards and the ante-natal ward were also upgraded and a new nursery built.
Autoclave had replaced the old boiling steriliser for sterilising instruments and the sluicing of linen was stopped as laundry facilities in the Laundry were improved to deal with this task. However the rubber mackintoshes (draw sheets) continued to be scrubbed and dried by the midwives, being replaced in the early seventies with plastic disposable draw sheets when “disposables” were introduced into the unit. The introduction of a central dedicated Sterilising Unit at Glan Clwyd around 1980 was another great step forward.”
1980-1993
Although Glan Clwyd District General Hospital opened in 1980, it would be many years before the second phase of building to include a Maternity Unit was carried out. Therefore plans to build a „through-care facility‟ at H.M. Stanley were put forward, and in 1984 a new unit was opened. This unit, which was opened by Mr. E. Parry Jones, housed 8 spacious Delivery Rooms, a Central Nurses‟ Station, plus changing rooms and bathrooms, Sister‟s Office, and a small kitchen with all facilities.
Sister Lyn explains, “The trends in Midwifery at this time were to be less clinical and patients were given the choice and actual involvement in their pregnancy, delivery and postnatally. All this was taken into consideration when the new Delivery Suite was planned. Each room was pleasantly decorated with matching curtains and bed covers and was comfortable. It included a cardiotocograph machine for recording baby‟s heartbeat, infusion pump, resuscitative cot and all equipment for baby‟s resuscitation had it been required. The delivery bed was one of the latest height-adjustable divan types.
Through-care means that patients were admitted to any one of these rooms and would remain there throughout her labour. Baby would be bathed after delivery and then transferred over to the postnatal ward in the cot. Caesarean sections were still performed in Theatre although one of the rooms was linked to the Theatre, and Caesarean sections could be performed there if the Theatre was in operation. Midwives by this time had been trained for assisting in carrying out these procedures.”
The Antenatal ward was upgraded and now named as “Celyn”, as were the two Post-natal wards, named as “Brenig” and “Tegid”. The postnatal wards each had their own small nursery, releasing the large nursery to become the patients‟ dining room. Babies in the main were kept with mothers on the wards.
The Special Care Baby Unit was also upgraded where premature and ill babies were cared for, with mothers able to visit them whenever they wished.
During this period the birthrate continued to increase to 2,500 pa. Infant mortality rates continued to reduce due to early detection of problems with the help of modern technology including fetal monitoring machines and ultrasound scans etc.
The unit progressed satisfactorily until it finally closed on Saturday, 20th February 1993 when the Unit transferred to new purpose-built facilities in Glan Clwyd, and a new era began.
39 Photos of the Maternity Unit prior to 1993
Entrance leading to the Antenatal Delivery Suite Room Ward, delivery suite and Special Care Baby Unit
Antenatal ward treatment room
Postnatal ward (Tegid) Entrance to Postnatal ward (Brenig) Although the wards were long and open in design they were divided into bays of 4 for more privacy. 40
Converted delivery rooms sometimes used Brenig Nursery – Ann Jones, far right. as the Obstetric Theatre.
Entrance to Special Baby Care Unit corridor Incubator used to transfer babies to other hospitals
41 The Staff
Celyn Ward Office. (left to right) - Celyn Ward Office. (left to right) Midwife Anne Stapleton, Nursing Auxiliary Violet Midwife Ilona Ramsay, Ward sister Jane Hulson and Hughes and Midwife Pauline Evans. Midwife Julie Templeton.
Midwife Ilona Ramsay standing outside Delivery Suite main work desk. Celyn Ward Treatment room. The area where patients‟ Sister Joyce Hawkins and Senior House Officer sat to await admission was dark. To brighten up the space Ingrid Cebertowicz painted the „living room‟ scene in the corner. The dog looked over the bench when it was put in place for the patients to sit on. 42
Student Midwives featured in the hospital‟s „Grapevine‟ staff magazine – January 1990.
43 First triplets born at HMS pictured with Mr. Edward Reproduced by kind permission of „Daily Telegraph‟ Parry Jones. The triplets, all boys, were born in February 1965.
Retirement of Mr. E. Parry Jones, Senior Obstetrician and Gynaecologist. Mr. Parry Jones worked at H.M. Stanley from 1952, retiring in 1980. In 1981 he produced a book “From Workhouse to Hospital” – a story of H.M. Stanley Hospital, St. Asaph 1840-1980, and much material has been taken from his book for this publication.
44
The day of the move to Ysbyty Glan Clwyd. Packing everything away from Celyn Ante-natal Mrs. Dorothy Sutcliffe (H grade midwife) and Dr. Gwilym Ward. Nursing Auxiliary Lyn Jones. Davies (Consultant Anaesthetist).
Photograph courtesy of Eluned Jones
Nursing Officer Dorothy Sutcliffe, Sister Barbara Rust and Staff on moving day 20th February 1993.
45
Maternity moves to Glan Clwyd - first day on Celyn ward/ward 22. 20th February 1993 (Left to right of those faces visible) – Midwife Debbie Hughes and Sister Jane Hulson. Behind Sister Hulson is Midwife Alison Shields.
46
Photograph courtesy of Eluned Jones . The last baby born at HMS was on Saturday, 20th February 1993. Pictured right is Mrs Noorjahan Ali and baby boy, with Senior Midwife Eluned (Lyn) Jones.
The first baby born in the new unit at Glan Clwyd also on Saturday, 20th February 1993. Pictured left Mrs Michelle Roberts and baby girl, with Sister Joyce Hawkins. Dr. George Van Rensburge looks on.
47 48 Chapter 4.5 Gynaecology
The Gynaecological service was retained in the Infirmary when the Obstetric service moved to the Isolation Hospital in 1950.
On 1st May 1952, Miss M. Lloyd Roberts started work at the St. Asaph Hospital and went on to be one of the longest-serving members of the hospital, and was in charge of the gynaecological wards for 28 years. Initially she was attached as Second Sister to the 34-bedded surgical ward (mixed ward) which was also used for dental and gynaecological patients. After a few months she was promoted to First Sister when her senior colleague left to get married. The other nursing staff consisted of two female Enrolled Nurses, (who had never had any formal training), two male Enrolled Nurses, Ward Orderlies and Auxiliaries. Off-duty was 1½ days per week, with split duties. Senior nursing staff lived in the nurses‟ home, called Caledfryn. It was very Spartan, but despite there being very little money, and few cars, the staff organised many parties and small dances.
The medical staff in the hospital at that time consisted of Mr. A.H. Holmes, the Consultant Obstetrician and Gynaecologist E. Parry-Jones, Mr. Spalding who was a General Surgeon from Wrexham visiting twice a week, Dr. Babbington, a GP from Rhyl who acted as one of Mr. Spalding‟s Clinical Assistants, and Dr. Prys-Jones, a GP from St. Asaph. Mr. Win Griffiths, a dentist in Bangor visited once a week for difficult dental extractions. There was no resident Medical Officer until the appointment in 1953 of Dr. Gwyn Parry. His off-duty consisted of one half-day a week!
Sister Lloyd-Roberts was initially unhappy with the conditions at the hospital; she was used to a „training‟ hospital and she found the equipment to be outdated. There was no Pathology Laboratory so every blood test was done by venepuncture and sent to Rhyl by taxi. Blood required for transfusion was also obtained from Rhyl. The pharmacy was attended each evening by a local chemist. Most of the premedications for anaesthesia were ordered by telephone; one consultant anaesthetist for example lived in Penmaenmawr. It was the Ward Sister who assisted the Surgeon in the theatre – a duty that was transferred reluctantly to Dr. Gwyn Parry on his appointment. Conditions were less than adequate, for example the equipment in the Theatre was basic with the Theatre light being a cast-off from the Llangwyfan chest hospital, which offered very poor lighting. Also the Theatre could not function in the early hours of morning due to the boiler being allowed to run out of steam – emergency surgery was often delayed until water could be boiled.
A breakthrough was made when it was decided in 1954 to convert block 3 of the former Isolation Hospital into a Gynaecology unit and link it to the Maternity department. Initially this was an unpopular choice with staff as this block was the hospital social centre with the wood block floor ideal for dancing. Medical needs prevailed however, and occupation of the converted wards took place in November 1954. The unit was opened by His Grace, Doctor D.D. Bartlett, the Bishop of St. Asaph. The ward had 23 beds: this was extremely „cosy‟ as it had been designed for 18 beds. Nevertheless the unit was recognised by the Royal College of Obstetricians and Gynaecologists as suitable for training medical personnel.
By this time there were two resident medical staff. Miss Lloyd Roberts took three nurses with her to the new Gynaecology ward. Initially there was no ward telephone, any form of heating in the kitchen, and the nurses had to go to the Nurses‟ Home to heat milk or boil water. However the team soon settled down and they came to appreciate the brightly painted wards, new curtains, beds and bedside lockers that Matron Evans and Miss Lloyd Roberts had chosen.
49 Back row – left to right:
Dr. Huw T. Edwards, Chairman, C&D, H.M.C., Rev. Vicar Samuels Rev. John Morris Jones Dr. A. Newall, Treasurer, W.R.H.B. Dr. Alban Jones, A.S.A.M.O., W.R.H.B. Mr. E. Parry-Jones, Cons. Obst/Gynae. Matron B. Evans, H.M. Stanley
Front row, left to right:
Sir Frederick Alban, Chairman, W.R.H.B. Dr. David Daniel Bartlett, Bishop of St. Asaph Ald. Tom Evans Ald. Ceridwen Lloyd. Opening of new Gynaecological Ward 1954
Back row left to right:
Valerie Owen W.F. Morris I. Roberts E. Lloyd M. Coward S/N Owens M. Lloyd Roberts Ceris Jones Howel Williams Ruth Williams A.M. Jones Cynthia Evans Laura Jones Hannah Owen Unknown Molly Hand
Front Row:
Matron Blodwen Evans
E. Parry-Jones
Staff at the opening of Gynaecology Wards 1954
As the reputation of the department grew, so did the pressure on beds. Waiting lists became an issue, despite lengths of stay being reduced to 24 hours and 10-12 days for major surgery patients. Therefore a new block of 12 beds was built between Block 3 and Block 4 and opened in 1969 by Professor A. Turnbull, M.D., F.R.C.O.G. As a result of the combined effort of senior medical and nursing staff, the waiting list was abolished within 12 months.
50 Opening of the extension to the Gynaecological ward, 1969
Mr. E. Parry-Jones Professor A. Turnball Sister M. Lloyd Roberts Mr. D.A. Aiken (Consultant)
Unveiling of the plaque at the opening of the extension
Professor A. Turnbull unveiled the plaque watched by Dr. J.H.O. Roberts, Chairman of the Clwyd and Deeside H.M.C., and Mr. E. Parry Jones.
The new ward was a sectional building and wasn‟t without its mishaps. Within a few weeks of its opening, the architect informed the Management Committee that there had been a design fault and the ceiling was in danger of collapse. The proposal was to put a steel girder supported by pillars down the side of the ward: the architect was persuaded to put this to one side of the ward, thus preserving to some degree the sense of space. These alterations enabled the clinical room to be altered to prevent passers-by seeing patients being examined or treated and thus preserving patient dignity – a principle very high on today‟s NHS agenda. A sister‟s office was also created at the entrance of the ward: all developments that transformed the working and efficiency of the department.
Miss Lloyd Roberts was deeply involved with all the developments in the department. She was promoted to Nursing Officer, and the Gynaecology ward was put in the charge of Sister Mary Roberts.
The Gynaecology Unit moved to Glan Clwyd, with Maternity Services in 1993.
51
52 Chapter 4.6
Ophthalmology (Eye care)
A history of the service through the decades – adapted from articles written in 2001 by Mr. Carl Pierce, Clinical Nurse Manager, Ophthalmology (1961-2001).
In 1954 the Eye Unit opened and Mr. Edward Lyons was appointed as Eye Surgeon to North Wales. However there were no beds available and surgical cases were referred to Liverpool.
The ability to perform surgery did not arise until 1961 when the Eye Theatre was opened. The Eye Unit at that time consisted of 16 beds and 4 childrens‟ cots. Cataract surgery was only carried out if you were nearly blind. Initially instruments were sterilised in fluids until a hot-air oven was acquired.
Waiting lists were long with operating lists held twice weekly - there was no microscope or prepared sutures. The Unit had one consultant and shared a Junior Doctor with Ear, Nose & Throat. The one Night Nurse on duty was required to wash all the patients. Only one set of drops were available to be shared for “clean patients” and one set for “dirty patients”.
The décor of the unit included a coal fire and dark brown tiles. Drums with dressings were packed on the ward and sterilized by the porters. Sheets were changed once a week with the top sheet put on the bottom so you only change one sheet per week. Blankets were wool and were cleaned once a year, the whole ward being closed for up to a week. Between patients, beds were washed down with carbolic. Nurses washed their hands with washing soap. Only Consultants were allowed to use toilet soap. Anything white was starched, and there was only one glass thermometer per ward. Syringes and needles were washed and used again and again. Only when needles had hooks on were they thrown away!
The 1960s saw major changes in Cataract surgery and silk sutures were introduced. Surgery was safer and eyes healed with fewer complications. Intra-ocular lenses were used in place of thick glasses. The Eye Unit had the first Operating Microscope in Wales, improving surgery considerably. A hand held Fundus camera was purchased, another first, and disposable syringes and needles were introduced. An Orthoptic Department was also started with a single handed Orthoptist post in a clinical room in the Eye Outpatients Department.
By the 1970s a much improved Fundus camera allowed introduction of fluorescence angiography. Treatment of diabetic eye changes could be carried out using a Xenon arc laser. Cataract surgery now had the advantage of finer sutures produced commercially, that no longer were threaded by hand. The department appointed a second Consultant in 1974.
In the 1980s there was a major upgrade of the Unit following a move of Ear, Nose and Throat (ENT) to Ysbyty Glan Clwyd. A new clinic area was created and the ward and theatre upgraded. The purchase of additional Argon & Krypton lasers widened treatment options for some patients. A development in surgical technique in cataract surgery resulted in safer operations and improved outcome. The first Ophthalmic course commenced in Wales, and has remained the only post graduate study course for nurses in the Principality. 53
Dramatic changes were seen in the 1990s, brought about by the Hospital gaining Trust status. The Ophthalmic Directorate was set up, and became fully responsible for quality assurance, meeting contracts and finance targets. Computers were introduced into the Directorate and a third Consultant employed. Cataract surgery changes to phaco emulsification technique with use of improved lens implant. By now Day Surgery was the order of the day with over 80% of surgery carried out as day care. Beds were reduced from 24 to 8 as the Day Care Unit adopted preferred reclining chairs. The Nurse Practitioner role developed formally to provide a casualty service and shared care in glaucoma clinics.
The Directorate moved from strength to strength because of staff who have a “can do” culture and a win-win outlook.”
In the 2000s – the new millennium saw further expansion of digital services enabling new treatment options for a variety of patients including those with macular degeneration. This service expanded both locally and nationally with the advent of NICE (National Institute of Clinical Excellence) guidance and available pharmaceutical products producing a significant increase in the volume of patients able to access treatment for their condition. The Eye Clinic Liaison Officer role was also introduced to the Unit in conjunction with Macular services to provide a supporting role for those with low vision needs. In addition this was the decade that patient support groups were developed within Ophthalmology, with monthly meetings scheduled for those affected by Glaucoma and a Low vision support group.
Today in 2011 the Eye Unit comprises of a Day Care Unit, 2 operating theatres, out-patient department, casualty triage unit, an Orthoptic department, and peripheral clinics on five sites. Approximately 5,000 surgical cases are performed annually. The Ophthalmic Outpatient Department sees over 40,000 patients annually in addition to casualty attendees, and provides formal ophthalmic nurse training at post graduate degree level and advance skills utilisation for ophthalmic nurse practitioners. The Unit strives to continuously develop and provide quality patient care, and will continue to do so following the relocation of the service from H.M. Stanley to Abergele Hospital. Abergele Hospital started life as Plas Ucha Sanatorium in 1910, becoming the Abergele Chest Hospital in 1955. Its development from there on is perhaps for another time and another book……
Ophthalmology moved to Abergele Hospital over the Easter period in 2012 and opened for business at Abergele on Monday, 16th April, 2012.
54
Back row – Consultants Date unknown Mr Chandra - Ophthalmic Consultant (Retired) Mr De - Ophthalmic Consultant (Retired) Mr Kamaluddin - Ophthalmic Consultant (Deceased) Mr Lyons - Ophthalmic Consultant (Retired) Dr Bisarya - GP with a special interest in Ophthalmology (still working) Dr Rao - GP (Retired) Front row Registered Nurse Caroline Doherty (Retired) Sister Hilda Roberts (Retired) Registered Nurse Ann Nightingale (Retired) Health Care Support Worker Margaret Davies (still working) Health Care Support Worker Kath Irvine (Retired) Registered Nurse Marie Lewis (still working)
Photograph taken on the occasion of Mr Puvana Chandra's retirement from H M Stanley – 29 January 2010
Back row, left to right - Mr John Mathews, Mr C S Ng, Mr Roger Haslett, Mr Edward Lyons, Mr David Saunders, Mr Kamaluddin, Mrs Divya Mathews, Mr Carl Pierce. Front row - Mrs Helen Juckes- Hughes, Mr Puvana Chandra, Mrs Shanti Chandra, Mrs Gail Pryce.
Mrs. Claire Morton, Consultant, also in attendance but taking the photograph.
55
Consulting Rooms in Outpatients Department
Theatre Scrub area View of Theatre from Corridor
Theatre
56
Personal recollections of Ophthalmology and life on the HMS Eye Unit
On 9th December 2011, the Author attended an Ophthalmology Coffee morning organised by the staff on the Unit to celebrate almost 58 years of Eye Care at H.M. Stanley Hospital. This was attended by present and past staff, and patients who had been treated on the Unit. It was a privilege to meet so many people who were passionate about the Unit and to take a walk down memory lane with them as they viewed photographs and talked about life on the Unit over the last 58 years. Here are some of their stories:
Wilma Roberts, nee Spence. Started work on 30 September 1962 as a Cadet Nurse and started training in 1964. She left in 1967 to have her family and returned to District Nursing in Colwyn Bay 1981. Wilma said her time at HMS were the best years of her life. HMS was such a lovely place to work and live, as she lived in the Nurses‟ home. “The Nurses‟ home was „lovely‟. We all had our own rooms, but we had to be in by 9pm which was a bit tough. Sister Eva Jones looked after us during the day, but it fell to the Night Sisters to make sure we were in.” Wilma started her working life on the ENT ward for 3 days a week, attending Kelsterton College for her theory training on Thursdays and Fridays. A mini-bus and sometimes a coach ferried them to and from Kelsterton.
Wilma‟s best friend was Maureen Pender, and they were known as „Pender and Spence‟. Maureen emigrated to Canada and went on to do Midwifery. One of Wilma‟s memories was about Lucy Jones, the Matron in the sixties, who was Henry Morton Stanley „mad‟. Builders found a window that Stanley allegedly escaped from. Lucy Jones was ecstatic about this and she had to “guard it with her life”. This event has always stuck in Wilma‟s mind.
Wilma and Brenda Brenda O’Riley has worked at HMS Stanley for 48 years. She started in 1963 as cadet nurse, and like Wilma, lived in the Nurses‟ home and went to college 2 days a week. Brenda has worked on every ward and discipline at HMS. She became a student nurse, then a State Enrolled Nurse, then did a conversion to Staff Nurse; a position she still holds today. She said “HMS still remains a friendly hospital. The training I have received is excellent. During my original training in the sixties, the Matrons and Sisters were very strict but there was still laughter around and we enjoyed ourselves on the wards. I have seen many, many changes over the years, particularly Ophthalmology surgery where in the „sixties cataract patients had to stay in bed for 3 weeks and not move their heads, whereas now they are in and out within hours. HMS was, and still is, at the forefront of Daycare.”
Remembering life on the wards, Brenda remembers Consultant Mr. Hardman, who insisted that patients had to be in bed prior to surgery. Not knowing Mr. Hardman to look at, when Mr. Hardman came onto the ward dressed ready for Theatre, Brenda mistook him for a patient and ordered him into bed! Another memory is of the childrens‟ wards. “Quite often children tried to escape. Parents were not allowed to stay so the children screamed blue murder and we had to run after them. The young patients were certainly a handful!”.
Alan Reece was a Charge Nurse on the Eye Unit until December 1991, having arrived already qualified as a Charge Nurse in August 1966. One of his earliest memories is that when he arrived from Birmingham, he couldn‟t believe that patients were still being fed post-surgery. 57 “Although patients had their eyes covered, I couldn‟t understand why they were being fed – after all patients knew where their mouths were! Common sense prevailed and I managed to persuade them that patients could feed themselves. Another change was how casualties were treated. On the Unit, medical staff saw the casualties. However, in Birmingham I was used to seeing casualties, so I started to see them on the Eye ward at H.M. Stanley, calling on medical staff when required. In the early days, although the Eye ward and Theatre were located where they are now, the Eye Outpatients clinic was at the other end of the hospital.”
Alan took early retirement in 1991. Cataract surgery was still performed on an inpatient basis, with patients‟ length of stay typically 1-2 weeks. Reflecting on how times have changed, he believes that although surgical techniques have changed, nevertheless we were probably „over- cautious‟ in the way we looked after patients post-surgery. However, at the time, bed-rest was the accepted practice.
Eric Gleave worked for the Local Authority in the Community, arranging industrial and domestic rehabilitation. He first came to H.M. Stanley in 1986 to cover sick-leave and stayed on. His main role was to sit and chat to patients on a one-to-one basis after their operation, calming them down and talking through the aftermath of the operation, and explaining the services that the Local Authority could arrange for them after their discharge from hospital. He was able to reassure them that everything was ready for them at home. It was not only cataract patients – patients included those who had road traffic injuries, Glaucoma or a detached retina. “Earlier in 2011, I had surgery on the Eye Unit myself for a detached retina and hole in the Macula. I recognised some staff that had been in post when I was here, and it was great to renew acquaintances.”
Christine Pierce (yes - wife of Carl Pierce) joined the Eye department in 1972. She said “I worked on the Eye ward, Outpatients and Theatre making my job very interesting seeing patients at all stages of treatment. There was a large age range from a few days old to 90+ giving a wide range of treatments. The Unit was a very happy one to work on and I was sorry to have to retire on health grounds so early (1991).”
Christine Pierce and Sister Hilda Roberts
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THE SISTERS
Hilda Roberts was the Sister on the Eye Unit from 1971 until she retired in November 1991. Speaking with Christine and Carl Pierce (see below), discussion centered around when Day care started on the Unit. Consensus was that Carl was in Bangladesh when the concept was first mooted where he sketched out proposals on the back of an envelope, with Day care starting in 1995. Hilda remembered that the Eye Ward and Outpatients became the Eye Unit in April 1984. The Outpatients department was located where the old ENT ward was, and it has remained there until the closure of the Unit in 2012. Before that, Outpatients was at the top of the site – the last building on the left. It was called the „Tin Hut‟ because it had a corrugated roof and was noisy when it rained but eventually, according to Hilda this was “turned into a nice clinic.”
Hilda was able to still recite the „Reading Chart‟ and at the coffee morning, a rousing all-staff chorus broke out, chanting “Now we have reached the trees - the beautiful trees! Never so beautiful as today. Imagine the effect of a straight and regular double avenue of oaks, nearly a mile long, arching overhead and closing into perspective like the roof and columns of a cathedral, every tree and every branch incrusted with the bright and delicate congelation of hoar-frost, white and pure as snow, delicate and defined as carved ivory. How beautiful it is, how uniform, how various, how filling.” Lorraine White broke the spell, by saying that actually they do now occasionally use different charts!
Beryl Harvard took over as Sister in 1991. She had previously been Theatre Sister, who was subsequently put in charge of Outpatients. Beryl was not at the coffee morning.
Lorraine White took over as Sister in charge of Outpatients in 1994. She first worked on the Eye Unit in 1986 on a temporary contract, but ended up staying, and is now looking forward to the move to the new Unit in Abergele.
Eye Ward in the 1950s showing sand bags
Lorraine explained the changes to surgery since the „seventies. “I worked as a student nurse in Ophthalmology in 1977. In surgery, patients did not have sutures to stabilise the wound so had to stay in bed and not move. They had a semi-liquid diet to restrict movement from chewing, this meant longer stays in hospital and the average stay for Cataract surgery was about a week. Although it was before my time, patients used to have sand bags placed at either side of their heads to immobilise movement often for the treatment of retinal detachment.
It was quite momentous when sutures were introduced, reducing hospital stays and improving recovery times significantly. Nowadays of course we hardly use sutures at all for cataract procedures. Microsurgery is undertaken, using very small incisions and cataracts are turned into semi-liquid and removed with fine suction instruments, often with no sutures at all. The patient turn around is very quick. Patients walk in, have their surgery, 59 and are free to leave (after the tea & toast) – the key to this is good preparation of the patients and sound pre-op assessment. The fastest one performed is under one hour, from admit to discharge. I must say it is not our aim to be fast, just to give our patients the quality eye surgery experience as efficiently as possible and of course with the best possible outcome.”
In reminiscing about time on the Unit, Lorraine told me about the resident „spook‟ – Henry Moreton Stanley who still walks the corridors. He has always been around, and is still blamed for unexplained doors banging and lights suddenly going out. Wonder if he‟ll move to Abergele with the team? On the lighter side, Lorraine spilled the beans on tricks played on the medical staff. On one occasion, a very quiet and calm medic - Mr. Nithy - collected “medical records” from the outpatient pile and was heard to call in the waiting area for a „Patty O‟Doors‟, and an „Albert Hall‟. The date – April 1st.
Lorraine is looking forward to the move to Abergele, and is quick to point out that it is not the building that makes up the Eye Unit, but the team, and the team are moving lock-stock and barrel. “I tell the patients that they will still see the same staff when they come for their appointments – we are just „moving home‟.” However, she does not underestimate the move. “This is a big move, and I don‟t expect it to be a 100% smooth, but I am confident that we will all benefit from moving to a better environment”.
THE CLINICAL NURSE MANAGERS
Carl Pierce Eye unit 1961-2001. Clinical Nurse Manager/Quality Facilitator
My earliest memories of ophthalmology are from 1953 when I joined the Birmingham Eye Hospital as the first male student nurse. The Second World War had only recently finished. Patients‟ perception was “Gosh is the service free?” The whole culture was different. The public was grateful for the treatment and were willing to queue and wait. Patients brought in their own eggs for breakfast and it was Sister‟s job to boil or fry as required. Patients stayed in bed for 10 days with both eyes covered. Confusion was common, as was deep vein thrombosis and pulmonary embolism following surgery. Surgery was carried out leaving lens matter in the eye; this caused severe inflammatory reaction and wound prolapse was common. Patients had thick glasses +10 which reduced field of vision and steps were very hazardous.
I joined the Eye Unit in H.M. Stanley in 1961. In the last 50 years ophthalmic care has changed beyond recognition. What has not changed are the patient‟s needs but what has changed is the way we meet these needs.
This needs team work, staff that are adaptable and learn new skills on a continuous basis. Staff need to have the time and resources to meet these challenges. The eye unit at H.M. Stanley has always been well known to provide the time and resources, and the staff willingly make use of them. Team work is second to none.
With over 40 years of experience in the NHS, I have found it to be a privilege, exciting, challenging and I enjoyed working with highly professional, motivated staff. Patient care is a privilege and although it is sad that H.M. Stanley is closing, the team is still together and that is what matters, and I am sure they will settle down very quickly in their new home. And the eye unit will go from strength to strength.”
60 Helen Juckes-Hughes joined the Unit in April 1990. Originally, she intended to stay for 2 years but took over from Carl Pierce as Clinical Nurse Manager in 2001 and her passion for ophthalmic care services remains.
The biggest changes Helen has seen has been the speed of results/images making the opportunity from seeing and assessing patients to treating the patient so much faster. Also tasks that the nurses do today would have been done previously by the medical staff; as is similar in so many specialist areas. A major development has also been the ability to treat macular degeneration actively. Through the miracle of technology we are now able to inject the eye and maintain vision, although this brings with it another large volume of patients and systems and treatments are not fully available, so we are not yet in a position to provide this treatment. Helen is confident that “the ethos of ophthalmic care at H.M. Stanley is coming with us to Abergele”.
On reminiscing of her time at H.M. Stanley, Helen remembers the day when Mr. De wanted a cup of coffee in clinic, and he asked to see “Mrs. Maxwell House” next. As a Junior Nurse, Helen didn‟t understand and kept wheeling in the patients regardless. She soon learnt that this was shorthand for a coffee break! She said, “In those days coffee was served on a tray with doilies, and although in time this had to stop, we have realised that all staff perform better if kept hydrated, so now, at 10.30, all clinical staff have drinks courtesy of the housekeeper, and we find this makes a real difference. Happier staff means better throughput of work and more efficiency for patients!”
THE CONSULTANTS
Roger Haslett, Consultant, has been at the Eye Unit since 2001. He believes the feeling of camaraderie in the Unit makes it a very pleasant place to work. Acknowledging that the facilities at H.M. Stanley are somewhat rundown, he is looking forward to the „new home‟ in Abergele and the new theatres which will be a great improvement. He also believes that more space provided at Abergele gives the Unit potential to expand services in the future.
The original Consultants at the hospital were Mr. Lyons and Mr. De, subsequently joined by Mr. Kamaluddin and Mr. K Puvana Chandra. Mr Chandra left in 2010 having dedicated his life to the Unit and did so much to enhance the reputation of the unit by his extremely hard work, innovations and involvement with the Royal College of Ophthalmologists.
In 2012, the Consultants are Messrs. Saunders, Haslett, Ng, Mathews, Tu, Mrs Morton and Mrs. Mathews. As Ophthalmology has developed with increasing sub-specialisation each of the Consultants takes responsibility for a different specialist area as well as providing general ophthalmic care.
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Ophthalmology’s last day in H.M. Stanley
Thursday, 5th April 2012 was the last day for surgery in H.M. Stanley. The patient was Christopher Holmes from Prestatyn. He had cataract surgery in his second eye, having had his other eye done previously. In Theatre was Mr. David Saunders, Consultant, and Sister Alwenna Shacklady.
Following the final surgery, the department took on a bit of a party atmosphere. Helen Juckes- Hughes explains:
“For some staff H.M. Stanley has been their only place of work. For many they have completed over twenty years of ophthalmic nursing practice at St Asaph, so the final day at H. M. Stanley could have been a particularly miserable day. It was therefore pleasing to experience more of a feeling of pride from everyone, pulling together and helping each other out with the packing and patient care. The staff felt proud to have been part of an extremely special and dedicated care team with a long history of excellent patient services and care. There were a few tears in leaving behind a part of our history and memories, but most staff are ready to be part of the next chapter of ophthalmic patient care at Abergele Hospital.
Some staff had remembered to bring their own cameras in and during their break time, several colleagues went on one last walk around the hospital; for some it was their first and final view of some of the nooks and crannies in the old building. The last day had lots of laughter, smiles and hugs.
Medical, clinical, nursing and administration staff have always worked closely as a team at H.M. Stanley and the comradeship exhibited on our last day demonstrates that there is no reason for this not to continue when we relocate to Abergele.
We close our doors at H.M. Stanley and say thank you to everyone who has been part of our history for making H.M. Stanley Eye Unit a place to be proud to have worked at.”
Photographs taken on the last day (courtesy of Daily Post).
Consultant Mr. David Saunders and Consultant Mr. David Saunders, Patient Mr. Sister Alwenna Shacklady Christopher Holmes, Health Care Support Worker Paul Moffatt (with notes), Sister Alwenna Shacklady Staff Nurse Shirley Blomley, Paul Williams, Operating Department Practitioner.
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Paul Williams, Mr. David Saunders and Alwenna Shacklady
Sister Alwenna Shacklady, Health Care Support Ophthalmic Nurse Practitioner Diane Pritchard and Worker Bethan Jones, Registered Nurse Jo Bryan Staff Nurse Tracy Turner
THE TEAM Outside the Eye Unit at H.M. Stanley hospital on the last day – 5th April 2012
Photographs courtesy of the Daily Post
63 Article reproduced courtesy of the Daily Post
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Chapter 4.7
Stroke Rehabilitation Unit
The Stroke Service started life on Stanley A Ward in the early 1980s. This was renamed „Elwy‟ ward in 1986, and in 1987 through a legacy left by Miss Bertha Harrison of Abergele, a dedicated Stroke Rehabilitation Unit was established near to the ward.
Professor Bim Bhowmick, OBE, DL, MD, FRCP, Emeritus Consultant Physician, (retired in February 2007) pioneered Stroke care as we know it today. He explains how it all began at H.M. Stanley.
“The first ever Stroke Rehabilitation Unit in Wales was established in H.M. Stanley. Stroke was totally neglected subject in the „70s and „80s. I remember as a General Medical Registrar in West Midlands, whenever a patient with stroke was admitted we despaired, as we knew the patient would block the bed forever. We just referred them to Geriatricians who gave them a low priority and we found that the acute patient beds were almost always full with long-term rehab or long stay patients.
It took up to 2-3 months for stroke patients to be referred from the Acute service to the Geriatrics department, and as a consequence by this time patients were hopeless, depressed and totally neglected. During ward rounds, Consultant physicians and trainees would pass the stroke patients without even saying hello and with unkind and totally inappropriate comments like „why is he/she still here‟? There was no evidence-based measure and no concentrated team to deliver rehabilitation, including Therapists.
This set me thinking how we could change the situation and develop expertise to really make a difference to the lives of stroke victims. Following a Kings Fund College Conference in London that I attended about multidisciplinary stroke care, I met with my team including Physiotherapy, Occupational Therapy, Speech Therapy and the nurses. I explained that I wanted to make a difference to the care of stroke victims and establish a Stroke Rehabilitation Unit. There was enthusiasm for the venture: we vacated an Acute ward at H.M. Stanley and initiated the admission process. Unfortunately resistance soon came via the Senior Nurse in charge of all nurses. She persuaded her nurses that they would not only have to undertake heavy lifting, but would become deskilled from acute patients: she was totally against the concept. Some nurses started to go off sick. This led to the hospital management coming to see me to advise on dismantling the idea and reverting the ward back to being acute.
Undaunted I did not yield. I believed it was the right place for the stroke patients, despite there being no evidence base yet available. I contacted the Clwyd Health Authority where I was well known, and following the move of the Senior Nurse to a teaching post, I was able to appoint a very enthusiastic individual and we moved on. Within a year the results were spectacular. The 65 Clwyd Health Authority agreed to spend £250,000 to refurbish the ward and totally modernise the Unit.
The Unit then became the Demonstration Centre for Stroke Rehabilitation for Wales. Many Welsh and English teams, and a team from Sweden came to visit. I was extremely honoured that the Health Authority allowed ME to open the refurbished Unit in the presence of MPs and other dignitaries, with a plaque on the wall in my name! I remained in charge and responsible for Stroke and of course Geriatrics. With such beginnings, now most District General Hospitals have specialised Stroke Units.”
Stroke Rehab Unit opened by Dr. Bim Bhowmick 13 January 1997.
This Centre was moved to the newly refurbished „Stanley C‟ ward which became the „Stroke Rehabilitation Unit‟ in January 1997 at a cost of nearly a quarter of a million pounds. The refurbished ward had previously been a Care of the Elderly Ward, „Conwy Ward‟. A large conservatory was added to the ward for patients and their families to enjoy and the ward kitchen, dining and sitting room areas were made comfortable and modern. The Unit provided complete Stroke Care with an expert multi-disciplinary team.
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View down the Unit from the entrance
Entrance and sitting area to the Day Unit Entrance to the Unit
The Nurses‟ Station The Nurses‟ Station
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Stroke Unit Dining Room Conservatory with organ
Looking up from the Unit towards the entrance
This „centre of excellence‟ also served as an Education Unit for local and national health care professionals, and the Stroke Diploma Course, initiated by Prof. Bhowmick, and recognised by the Welsh Nursing Board was also run from the Unit.
Stroke Association Family Stroke Support Workers to advise, educate and counsel the relatives and carers of stroke victims were established. The first ever Stroke Support Worker was Carol Jones, and as there was no health funding to support this appointment, Prof. Bhowmick contacted the Stroke, Heart and Chest Association, who agreed to fund the post.
A Multidisciplinary Stroke Outreach Assessment Team to assess, treat and rehabilitate patients with stroke in the community (not admitted to hospital) was established in 1995. This was a ground-breaking service that ensured that patients were seen as soon as possible after their symptoms had occurred. Now stroke is treated as a medical emergency.
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Stroke outreach team 1994 This article was taken from the Glan Clwyd District General Hospital staff magazine „Grapevine‟, published in the Autumn of 1994.
Stroke Clubs run by volunteers, the first in Wales, were set up to enable stroke patients to have social get-togethers, entertainment, educational talks about stroke and importantly, the chance to be with people and share thoughts with those who had lived through the same experiences. The Stroke Association opened a branch in a Portacabin at HMS and transferred to Stanley B following some refurbishment.
The following is taken from information provided by Josie Wray, Sister on the Stroke Ward.
“On March 1st 1999, a 4-bedded stroke admission bay was created on Ward 14, in Ysbyty Glan Clwyd. This was to ensure that acutely ill stroke patients received care from a multidisciplinary team expert in stroke. The Rehabilitation Unit continued at H.M. Stanley and the nurses from the Unit would go to see the patients in Glan Clwyd to assess them and tell them about rehabilitation and what to expect before they travelled across to the unit in H.M. Stanley Hospital to begin their period of intensive rehabilitation. This „closed the loop‟ even more, working towards that seamless service.
In 1997 the Stroke Clinic began in H.M. Stanley. This was a follow-up clinic for patients that had been on the Stroke Unit and had now been discharged. The clinic continues today! Patients and their families return to the Stroke Unit to check how their recovery is going and to see if there is any further help and support that can be offered. Patients will have their blood pressure checked and receive secondary prevention advice. Seeing the patients return to the Stroke Unit and seeing their recovery is always a great pleasure for the Nurses, Doctors and Therapists that have treated them.
The Stroke Unit always ensured that the patients and their families felt relaxed and motivated to make a good recovery. Families were encouraged to visit and be with their relatives at any time of day and would walk in the grounds or relax in the sitting room together. There were always activities going on and the Stroke unit had an „Activities Nurse‟ that offered the patients
69 stimulating things to do in groups or individually, such as bowls, quizzes, film afternoons, and reminiscence.
Many events were organised at the Stroke Unit for both patients on the Unit and patients who had been discharged from the Unit. These were always very jolly and busy occasions! The Strawberry Tea was in July and the Mince Pie afternoon in October. There would always be a raffle and entertainment. There was an organ on the Unit and Nurse Mair Ward would play for the pleasure of the patients
Staff would take a great deal of time to organise these events; Christmas Services were held and visiting choirs from the local schools would attend to the delight of the patients, their families and staff.
Therapy would take place both on the Ward and in the Gym and Occupational Therapy room next to the unit with the patients and their families working very hard to gain independence. Families and carers were always encouraged to be with relatives during rehabilitation and team would offer education, support and advice. The Stroke Association had very close links with the unit and their offices were in H.M. Stanley.
Alongside the Stroke Unit was the Rehabilitation Day Unit. Patients from the Stroke Unit who had been discharged home could attend the Day Unit as an outpatient to carry on with the therapy that they had received on the ward. This area also ran a Stroke Educational Programme for patients and their families to be able to continue to learn about their condition and ways to adapt to its effects.
The Dyserth and District League of Friends supported the Stroke Rehabilitation Unit over a number of years. They ran regular fundraising events with the proceeds going towards important pieces of equipment for the Unit and items that made the patient stay on the Unit more comfortable. They provided the funds for a landscaped area adjacent to the Unit with paving, landscaping and garden furniture. The plants and trees that they provided were decorative and scented, providing a pretty and peaceful experience for the patients and their families. The patients would help to maintain the flowerbed areas. Volunteer groups and individuals have always been very generous in supporting the Unit.
Growing evidence in how we manage stroke care in our hospitals meant that our Stroke Patients needed to be close to Acute and Rehabilitation services so that they can benefit from them as soon as possible after their stroke to ensure that they make the best recovery they can.”
Information Board. Now with a message that the staff will miss the Unit!
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Stroke staff 1991
The entire Stroke Service moved to Ysbyty Glan Clwyd between May and July 2011.
Stroke continues to have a high national presence, and there remains an annual Bim Bhowmick lecture as part of an Annual Welsh Stroke Conference, together with a Bursary of £2,500 to encourage research/educational travel for Stroke. This lecture is somewhat unusual as normally such lectures are named in memory of notable people after they are dead. At the time of closure in 2011, Professor Bhowmick is alive and well, and still living locally in Trefnant.
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72 Chapter 4.8 Other Services
Anaesthesia
In 1945, a Boyle‟s anaesthetic machine for surgical purposes was acquired. This allowed the use of oxygen and nitrous oxide along with trilene or ether to be given in a more controlled doses, instead of the previous technique of dropping ether or chloroform onto a gauze-soaked mask.
The anaesthetics were administered by General Practitioners for many years, until in 1951 Dr. Nancie I. Faux, wife of Ivor Lewis, was appointed as a Consultant Anaesthetist. She was Boyle‟s gas machine c 1940 joined in 1955 by Dr. Buddug Owen, and over subsequent years more Consultants and other grades of Anaesthetists joined the team.
With the enlargement of the anaesthetic staff, the need to employ General Practitioners decreased and finally ceased, but their role in keeping the service going while the NHS became properly established cannot be overlooked.
Dr. Faux introduced the use of intubation and muscle relaxants which transformed surgical procedures both for the patient and the surgeon. In 1970 Dr. Buddug Owen initiated the use of epidural analgesia for women in labour, although this took some time to be generally accepted. There is no denying that these modern techniques made surgical and obstetrical & gynaecological work easier and safer. When obstetric & gynaecological services moved to Ysbyty Glan Clwyd in 1993, it ensured that women could have the reassurance of the safety of a District General Hospital around them when giving birth or having operations.
It is worthy of recording a co-incidence that has arisen. The General Outpatients department at H.M. Stanley transferred to Ysbyty Glan Clwyd on 13th June 2011. To assist with this, a new building was erected to house some outpatient and pre-operative assessment clinics. The building was named The Ivor Lewis Building. Ivor Lewis was an eminent local surgeon who pioneered the combined abdominal and thoracic approach for excision of cancer of the oesophagus. He also played a major part in developing the National Health Service, both in Rhyl and nationally. As Dr. Faux, his wife, worked at H.M. Stanley for many years, it is fitting that the association with H.M. Stanley continues at Ysbyty Glan Clwyd in this way.
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Chaplaincy
When the Workhouse Guardians met in 1838, there was a lack of agreement amongst the members whether a Chaplain was needed for the workhouse. A few meetings later the matter was resolved and a Chaplain was agreed upon. The Chaplain was responsible not only for taking divine service but also for giving the inmates religious instruction. Doctors are usually so involved with the physical care of patients that they often overlook the spiritual needs, and over the years many members of the clergy from all denominations looked after the inmates and later the patients at the hospital.
Christmas Blessing card – unfortunately there is no date on it.
Chaplains as at 1998.
The last Clergyman recorded at H.M. Stanley was Reverend Robert Griffiths. Services ended in the Chapel in 2005 and the last service was conducted by Rev. G. Berw Hughes (bottom row 2nd from right in photo) and Revd R Roberts (top row 2nd from right).
74 However a chaplaincy service continued at H.M. Stanley for the inpatients until the relocation of the Stroke Unit to Ysbyty Glan Clwyd in May 2011.
Radiology
When the labour wards were transferred to their new location in the Fever/Isolation Hospital in 1950, the vacated rooms were acquired for the X-ray department. In 1978 these were expanded to create a very pleasant and spacious unit. The Maternity department did house its own Ultrasonic Diasonograph machine but this was transferred to the X-ray department on completion of the expansion. Through the interest and support of Dr. Rodney Green, the senior Radiologist, a portable Real Time Scanner was provided for the sole use of the Obstetricians and Gynaecologists in 1979.
Picture of the Diasonograph similar to the one in use at HMS
The X-ray expansion provided a new ultrasound suite and this service was established and run by Dr. Carl Wright. As this process uses high frequency sound waves to produce an image, this stopped the practice of having to take two to four high dose films to determine the foetal position or any abnormality.
It is interesting to recall that in the 1950s radiographic films were taken and developed by members of the nursing staff, and, at that time, notably S.E.N. Megan Morris. . Miss Margot Johnson was appointed as a radiographer in H.M. Stanley in November 1966, and provided the Radiology service. By 1980, H.M. Stanley boasted four Radiologists. Of course at that time Ysbyty Glan Clwyd opened with initially 6 diagnostic rooms. Miss Johnson transferred to the new hospital in 1980, and Mrs Christine Hughes continued providing the service at H.M. Stanley.
H.M. Stanley continued to provide an acute diagnostic screening and x-ray service, together with an obstetric and general ultrasound service. Radiology provided a service to the Eye Department, Obstetrics and Gynaecology, Care of the Elderly, the outpatient clinics and a service for general practitioners in the St Asaph area.
Work diminished when Maternity and Gynaecology transferred to Glan Clwyd in 1993, but the ultrasound service continued for outpatients until 1999. When the acute Care of the Elderly 75 transferred to Glan Clwyd the workload was further diminished. A part-time Radiology service continued at H.M. Stanley until May 2010, when the X-ray function ceased its operations.
Pathology
There was no pathology laboratory at HMS until 1954 when Mr. J.J. Wright, the Senior Chief Technician was appointed. Prior to this specimens were sent to the Royal Alexandra Hospital in Rhyl where the department was housed in one room on the ground floor in the charge of Dr. J.T. Alban Lloyd, MC.
Memories of Pathology and working at H.M. Stanley by Mr. Andrew Pritchard.
Andrew was Senior Medical Laboratory Scientist at H.M. Stanley from circa 1977 to its closure in 1992 when he transferred to Ysbyty Glan Clwyd. Andrew retired from YGC in 2007.
“I passed my fellowship exam in1975 and was placed at HMS pathology the following year. The totemic presence at the lab was JJ Wright, or JJ as he was known to all. His diligence was legendary. Here was a man revered by his peers and professionals alike. If you wanted it, or wanted to know about it, JJ was your man. The lab, under JJ‟s tutelage was a multi-disciplinary unit that had an essential three-pronged approach to Pathology. All histology (apart from some cervical smears that JJ and Dr Aileen Hampton handled) went to Royal Alexandra Hospital Rhyl and then on to Ysbyty Glan Clwyd in the „80s. Haematology, there being no sub-section to blood-banking then, was a two or three woman job. Bugs (microbiology) was, as ever, a solitude existence. Along with JJ, the other absolute rock of the department was Ruth Houlston. Ruth would wash it, clean it, clear it, prepare it, keep it, and know about it (including how many sugars) with a remarkable degree of stoicism.
The work would come via transport from all over the Vale of Clwyd. This meant all surgeries and outlying hospitals - Llangwyfan, both Denbighs (the North Wales Hospital, Denbigh and Denbigh Infirmary), Ruthin and beyond. On top of this would be all nearby surgeries and our own wards and out-patient departments. A very busy department! Before the substantive change which saw maternity moved to Ysbyty Glan Clwyd, we kept the two-pronged approach to service delivery where we sent the bulk of specimens to Glan Clwyd by taxi and dealt with all except emergency pathology, in-house. Finally, against JJ‟s better judgement, it all came to an end in 1992. The service was gradually getting too complex for the dual-site approach and we began running down the services at H.M. Stanley and transferring them to the “big house”.
It is worth mentioning another side to H.M. Stanley. From 1956 until the early „90s, the social and artistic elements of the site were always a source of entertainment (and beer). The theatre group and the cricket side were extremely popular, and events, plays, and the annual match between the old enemy at Royal Alexandra Hospital in Rhyl and latterly Ysbyty Glan Clwyd were eagerly anticipated.
The Pathology Laboratory closed at H.M. Stanley in 1992 and the staff transferred to the „big house‟ i.e. Ysbyty Glan Clwyd, in our opinion „to show them how it‟s done‟.
Andrew Pritchard in the Pathology Laboratory
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Medical Records
As at 1954, the responsibility for the Medical Records Department came under the General Office, which was run by Mr. W.F. Morris (the last Master of the Workhouse and the first Hospital Secretary) and Mr. Roger Jones, Deputy Secretary, who kept all the records of admissions, births and deaths.
The Records Office consisted of two cubicles in the Isolation Block (Pavilion B2 on the hospital diagram). All the hospital out-patients and in-patients records, as well as those of the peripheral ante-natal clinics were housed in a cubicle measuring 11ft x 9ft. Imagine that today! The only exceptions were the case sheets of Miss Hilary Long, the general surgeon from Llandudno. These notes were guarded by Sister Salisbury who ran the H.M. Services outpatient clinic.
In the Records Office were also some older cardboard boxes containing the pre-NHS records, and Mr. E. Parry-Jones and his Secretary, Miss Gwen Jones, started to number and file these.
When the new departments of Ear, Nose & Throat and Ophthalmology opened in 1956 the Records Office increased substantially in size, and continued to expand, as other departments opened, in a nearby building. Card indexes became a thing of the past as a computerised system was introduced; this system also replaced the handwritten lists of admissions and discharges. As departments transferred to the Ysbyty Glan Clwyd the records transferred as well. The department next moved to rooms in the main building (the old Central Sterilising Services Department and part of the former Catering department). The old building was demolished in 1998 - it was cold and drafty in the winter, so perhaps no great loss. Records stayed in these rooms and, at the time of closure of H.M. Stanley, dealt mainly with notes for patients attending the Eye department, but also with some older notes from Ysbyty Glan Clwyd.
Administration by Doris Roberts –who started in 1957 at Llangwyfan and retired in 2001 as Senior Administrator - Conwy & Denbighshire NHS Trust
“I became part of the health service administration team NHS in 1957 and eventually took over responsibilities for some of the support services at H. M. Stanley . By this time, there was reduced inpatient occupation, leaving the Stroke Unit, General Outpatient clinics and the Ophthalmic Outpatients Unit. The Ambulance Trust took over the midwifery wards and theatres, Finance was placed in the nurses‟ home and St. Kentigern‟s hospice occupied the Gynae. ward. I recall that during alterations to Ophthalmology outpatients, work was suspended until a badger set within the building was declared „unoccupied‟. It was still a busy hospital indicative perhaps by no parking spaces again !
There was still on site some Part 111 accommodation with a few residents who were served meals in a designated dining room, clean but so dark and dismal. ( To explain Part 111 - Part 111 of the 1948 National Assistance Act, was that local government had responsibility for providing residential accommodation for the elderly and infirm who needed care but not constant medical care as well as for the homeless).
Administratively we refurbished two committee rooms and the boardroom which were all used extensively for meetings etc. across the Trust. The Retirement Fellowship Group (retired health service staff) were one of the „regular‟ groups who met at H.M. Stanley until 2011. The meeting rooms were all within the area of the former workhouse, particularly the area occupied by the former Master‟s living accommodation.
77 Of course, the hospital was well served by an excellent facilities department which provided catering, portering, domestic and maintenance services. Their support kept the hospital functioning well, both for the staff and the patients. Many of these staff have either moved to Glan Clwyd or relocated with the services when they moved.
One anecdote recollects that the Head Porter delivered the mail around the individual buildings on a push-bike, and even managed to balance bags of case-notes on the bike‟s handlebars. This wouldn‟t pass a health & safety assessment these days!”
Library Services
Small departmental libraries were started and maintained by interested staff in Midwifery, Care of the Elderly and Ophthalmology. In the 1980s with the appointment of Mr. John Bladon, the first professional Librarian at Ysbyty Glan Clwyd, these libraries were catalogued and classified and added to the Glan Clwyd Library database. As the departments transferred to Ysbyty Glan Clwyd, these resources have been incorporated into the Main Library there.
The Ophthalmology Library, on the ground floor near Library the Chapel, was maintained by Library Staff from (Eryl Smith, Library Manager, Ysbyty Glan Clwyd) Glan Clwyd, (although it was never manned) until 13
April 2012, when it was moved to Abergele Hospital.
The number of journals subscribed to in print is in decline as the future is electronic journals, so computers are now necessary items of library equipment. However Ophthalmology staff want to retain a Library so they have a place they can go to to study and research best practice.
Recreation Hall
You will have read in the Gynaecology chapter that Block 3 of the former Isolation hospital was taken over by Gynaecology in 1954. Up to then this block had been the hospital social centre with wood block floor ideal for dancing. Dances then had to be held in the Nurses home. In time a special committee was formed to fundraise and an appeal was launched in 1959 (in many ways this committee was the forerunner of the St. Asaph Hospital League of Friends). The Patron of the Committee was Sir Watkin Williams Wynn, the President Father J. Butler, and the Chairman Mr. J.E. Jones, Manager of the Midland Bank at St. Asaph.
The hall was built in 1963 and opened on 13th November (cost unknown). It contained a large room which extended the entire length of the building with two additional rooms on each side which served as a kitchen, cloakrooms and store-room. At one end was a stage, separated from the main hall by curtains. The hall was used for concerts, dancing, discos, pantomimes, plays, table tennis, parties and games, and the hospital management also made full use of the largest room in the hospital for their more populated meetings. In its latter days, it became the first Creche for staff use, called “The Magic Toybox”.
The position of the Recreation Hall can be clearly seen in the middle of the Workhouse and Infirmary diagram in the „Hospital‟ chapter. It was demolished early in 1998 along with accommodation formerly used as Elwy Ward, Delfryn Home, Medical Records, Social Work and Ophthalmology Secretarial staff office.
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Recreation Hall
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80 Chapter 5
Supporting the Hospital
St. Kentigern Hospice
taken from information provided by Lindsey Thomas, Fundraising Assistant, St Kentigern Hospice
In 1986 Dr Anne MacLeod expressed the opinion, shared by many, that a hospice was needed for North Clwyd. St Kentigern Hospice was founded in 1995 through the commitment and vision of a dedicated group of fundraisers.
Below is the article in the Visitor Newspaper dated February 25th 1993, announcing that the Hospice would be located in the former post-natal ward which relocated to Ysbyty Glan Clwyd on 20th February 1993 – a very quick turnaround for the building!
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Following extensive remodelling of the building, St Kentigern Day Care service was established, catering each day for the individual needs of 15 patients with life limiting illness.
In 2000 the Inpatient unit was opened, providing terminal nursing, respite care, pain and symptom control and bereavement support 24 hours a day, 365 days a year. However at that time not all of the 8 beds could be opened. In 2005 a 3-year grant from the Welsh Assembly Government was received which enabled the Hospice to open all of the beds and employ a Family Support Counsellor.
Staff and volunteers are hugely committed to providing a high standard of care and the Hospice accepts patients from Colwyn Bay in the west to Flint and Holywell in the east and from inland as far as Ruthin.
St Kentigern Hospice is one of three adult hospices in North Wales supporting patients and their families. Its work is almost entirely dependent on voluntary contributions and it receives only 18% of funding from the local Health Board and Welsh Assembly Government. The main sources of income derive from donations, fundraising, retail and the hospice lottery.
The Hospice is indebted to the people of North Wales who have taken St Kentigern to their hearts and ensured that financial and volunteer support has been available in order to provide excellent palliative care services for their community.
Welsh Ambulance Service
In 1991/92 Clwyd and Gwynedd ambulances services were amalgamated to form the North Wales Ambulance Service whose base was in a building on the site (possibly called Delfryn – see Building no. 16 on plan below). This was the HQ for the service until 1997 when proposals were passed by the Welsh Office for one Welsh service and the Welsh Ambulance Service Trust appeared in 1998.
The Welsh Office decreed that St Asaph became the headquarters of the Trust – home to the Chief Executive Officer, Director of Finance, Corporate Services, Project team, Estates, PCS, Informatics, Medical Director, Deputy Chief Executive and supporting auxiliary staff. In 2012, the Welsh Ambulance Trust is housed in former Pavilion B4 and B5 on the diagram.
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H.M. Stanley Hospital League of Friends & Womens Royal Voluntary Service (WRVS)
The WRVS and the League of Friends were the first people to be seen by the public when they entered the hospital. Their aim was to extend a warm and caring greeting, together with an escorting service.
Jean Craven, second from left back row, has been a WRVS volunteer for more years than she can remember, first in Bury and then moving down to St Asaph. She pushed a trolley of refreshments around the gynaecology and maternity wards before they closed. She then started serving in the tea bar in the eye clinic. No hot drinks were on the trolley, just sweets and pop. You had to go to the tea bar to get a hot drink. Jean was also on the League of Friends committee until it disbanded in March 2011; a truly faithful supporter of the hospital.
Val Williams, third from left back row, and Ruth Renowden, far right back row, are also servers in the tea bar and on the League of Friends Committee; they have been doing the job for many years.
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Jan Cawley, third from left front row, is the newcomer and baby of the support team. “I started working in the tea bar about 2007 and found the service we give very rewarding. I hear many tales of the miracles that the doctors and nurses perform”. Jan too is on the League of Friends Committee and for her sins, was the Chair, until the group disbanded. Jan said “It has been a privilege to work with these women”.
In the sixties and seventies the League of Friends used to hold annual summer fundraising fetes on the grass outside the recreation hall. These were great fun for staff and local people. With mixed feelings, the decision was taken at the 49th AGM to disband the League of Friends after almost half a century of support and fundraising for H.M. Stanley hospital. Over the past decade alone the group have donated equipment to the value of £250,000 to the hospital.
Jill Galvani, Executive Director of Nursing, Midwifery & Patient Services, said “The WRVS and League of Friends provided an invaluable service for the hospital and, as volunteers, were an asset to the organisation”.
At the coffee morning held on 9th December to celebrate almost 58 years of Eye care at H.M. Stanley hospital, the author caught up with Barbara Wallace. Barbara started working in the WRVS tea bar in 1988 and has worked virtually every Friday morning since then. She said that at its height there were 25 volunteers but towards closure numbers dwindled to 12. Some of the volunteers have found other things to do, but Barbara herself also helps out at Glan Clwyd and intends to continue there.
Doris Roberts, Retired Senior Administrator also recollects “Mrs. Elsie Williams, Chairman of the League of Friends, held fund raising events for many years with her loyal members and friends which greatly helped towards the cost of essential equipment .The Dyserth Voluntary Group were also invaluable with their contributions.”
******************** Over the years H.M. Stanley has been home to many independent organisations that have provided additional services to the Health Board and Conwy & Denbighshire NHS Trust prior to that.
British Red Cross, Home from Hospital Service
The Home from Hospital Service was established at H.M. Stanley in 1996; initially serving the counties of Denbighshire and Flintshire, later extending to the Borough of Wrexham and the County of Conwy.
At the time of H.M. Stanley‟s closure, the hospital was base for the service in Central employing 4 staff. Many of the organisation‟s volunteers also visited the site regularly for meetings and training sessions in the Conference Room.
About 11,000 referrals were received in that time asking for volunteer support to newly discharged patients, visiting them in their own homes and helping them to regain their confidence and independence following long periods of hospitalisation.
84 North Wales Chrysalis Trust
When the independent charity Chrysalis was initially founded in 2001 by Kay Parry-Jones, part of their support from the Conwy and Denbighshire NHS Trust was a small office at H.M. Stanley. Initially only two members of staff were employed (even this was a tight squeeze for the tiny office!) but this had later grown to four and a larger office was found.
Chrysalis offers a free information, counselling and support service to families who have a child diagnosed with a life-threatening, life-limiting or terminal illness. A bereavement service is also offered to parents and siblings following the loss of a baby or child. Most referrals come from within the hospitals or from local GPs, although people can self-refer. During the time at H.M. Stanley over 3,500 enquiries were received and over 3,000 counselling hours given to about 600 clients.
NISCHR – CRC
The National Institute of Social Care & Health Research – Clinical Resource Centre was established in 2010, bringing together the Former CRC Cymru and Wales Cancer Trials Network. The service is hosted by Velindre NHS Trust via a contract from Cardiff University.
The overall aim of NISCHR CRC is to improve future care by developing and supporting research excellence within health and social care. NISCHR CRC also leads for the National Institute of Health and Social Care on training and development, Patient and Public Involvement and is funded by NISCHR Welsh Assembly Government.
Under their previous guise of CRC Cymru, the service moved to H.M. Stanley in June 2008 to the offices previously occupied by the Creditor Team of the Conwy & Denbighshire NHS Trust Finance function following their becoming part of the North Wales Business Support Partnership at Alder Court on the St. Asaph Business Park. Up to 10 staff worked from their offices at any given time.
Vision Support
Vision Support is a Regional Charity recognised as the leading provider of local support and services to people of all ages living with vision impairment in North Wales and Cheshire. The Charity has supported H.M. Stanley over the years by providing a Vision Team based from the Eye Clinic at H.M. Stanley in St Asaph. Originally established in 1993, the Vision Team changed over the years with a Vision Team Co-ordinator and Low Vision Practitioner remaining at H.M. Stanley from 2003 onwards. Following the closure of H.M. Stanley, only the Low Vision Practitioner moved to the Abergele Hospital in April 2012 to work alongside the Ophthalmic team in the new Eye Unit.
This ongoing service has helped to bridge the gap between medical diagnosis and community services, provide intervention and support at the point of diagnosis, assessments for Low Vision Aids, on-going support and reviews of client‟s needs, and worked to enable patients independence in order to contribute to the delivery of an effective eye care service by the Eye Clinic at H.M. Stanley.
Vision Support offer a wide range of services to those with visual impairments of all ages within the local community such as Resource Centres and Mobile Information Units, ICT and Braille training, a Home Visiting service, the supplying of daily living equipment and low vision aids, a 85 range of social and activity clubs, Rehabilitation Services under contract to local authorities, and much more.
St. John’s Ambulance (Kindly supplied by Doris Roberts - Retired Senior Administrator - Conwy & Denbighshire NHS Trust)
“Prior to working in the NHS, I was a member of the St. John‟s ambulance service and part of our „training‟ for a home nursing certificate was to spend a number of hours working on a hospital ward. I did so at St. Asaph hospital as it was known then.
In a grey dress with a white starched apron and cap - both my friend and I really thought we were the „bees-knees‟ and so did some of the medical staff ! The Ward Sister on the medical ward we were assigned to was very tolerant of our ignorance in basic duties - making beds with proper corners, preparing afternoon teas, blanket-bathing bed patients and of course those bed pans! In time we became useful and the staff were kind to us and do you know who was in charge? Why the Matron of course - no managers!”
86 Chapter 6
Reprovision of the Services
The transfer of services off the H.M. Stanley site was a complex piece of work involving a wide range of stakeholders internally and externally. To co-ordinate the work, a project team was established, involving representation from Clinical Programme Groups, corporate services, staff, staff representatives, and users of the site.
The Project Team was led by a Project Director, John Darlington, the Assistant Director of Planning and Contracting. The Project Team was the key recommendation making group for the project, responsible for ensuring the delivery of the services and estate re-provision strategy.
The work of the project team and project work-streams, of which there were 6, was divided into two parts. The first phase was to develop and agree clinical service plans and agree a „critical path‟ / implementation plan for service re-provision. These plans were then taken to the Board of Directors for approval. Following agreement, the project team and workstreams then led on the implementation of changes and transition of services to other sites, and, finally, to the de- commissioning of the H.M. Stanley site.
The Project Team meeting at H.M. Stanley. The room used on this occasion was the original „Stanley B – male section – ward‟ which in its final years became part of the Workforce & Organisational Development department.
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The Relocations
The relocations of Care of the Elderly, Maternity and Gynaecology to Ysbyty Glan Clwyd have already been covered earlier in this publication.
The services of Stroke Rehabilitation and General Outpatients were reprovided during 2011. Ophthalmology was reprovided in 2012.
Stroke Rehabilitation
Stroke rehabilitation services relocated to Glan Clwyd in May 2011. Building work was undertaken to house the rehabilitation services adjacent to the acute stroke service.
The new Stroke facility opened on May 9th, 2011. This combined the Stroke Rehabilitation Unit and Rehabilitation Day Unit, previously located at H.M. Stanley, with the Acute Stroke Unit already based in the former Ward 14 at Glan Clwyd.
Medical evidence tells us that a combined acute and rehabilitation unit is the best way to provide stroke services, allowing patients to have a streamlined service to help reach their full level of recovery. The unit has 30 beds and is based in Ward 14. It is adjacent to the Therapies department. The Unit has been refurbished and extended to ensure a comfortable, peaceful and calm environment, which we know helps patients recover. A conservatory and garden area is also planned.
The combined unit provides a number of benefits for patients, including:
Better access to Therapy services, allowing the development of one specialist Therapies Stroke Team. Making it easier to extend the existing weekday Thrombolysis service for stroke in the near future. A more efficient and streamlined service, allowing the beds and staff to be used more flexibly. The development of a service model resulting in shorter lengths of stay for patients, allowing them to return home sooner.
A representative of the North Wales Stroke Forum said “We welcome the Stroke Services all coming under one roof in a combined unit and we believe this will have important long term effects on the outcome of stroke patients treatment. It will enable a „Centre of Excellence‟ for Stroke Services to be developed, whilst allowing us to make the most effective use of our resources.”
Outpatients
On 13th June 2011 the general outpatient clinics held at H.M. Stanley moved to Glan Clwyd. On 20th June 2011 the Orthopaedic clinics held at Abergele hospital also moved to Glan Clwyd. To make the best possible use of time and space for these extra clinics, the clinics were moved around and some clinics held in a new „outpatient‟ building called the “Ivor Lewis Building” at Ysbyty Glan Clwyd.
This name was chosen following a competition for the staff to name the new building. Mr. Ivor Lewis was an eminent surgeon who pioneered the combined abdominal and thoracic approach
88 for excision of cancer of the oesophagus. He also played a major part in developing the National Health Service, both in Rhyl and nationally. After Ivor Lewis‟ death in 1982, Glan Clwyd Doctors set up a memorial fund, and there is still an annual Ivor Lewis Memorial Lecture at the Postgraduate Education Centre at Ysbyty Glan Clwyd.
Ivor Lewis Building
The Ivor Lewis Building is a new building, with its own access, that is situated near to the Cardiac Catheter Lab on the car park to the left hand side of A&E at Ysbyty Glan Clwyd.
Clive Sparkes, Chief of Staff for Therapies and Clinical Support Services said “We are delighted to commission this new building in which to hold some of our outpatient clinics. The new building will enable the expansion of surgical super clinics and provide pre-operative assessment on the same visit. We are sure that patients will be happy with the expansion of services, and will benefit from improved patient care due to the reorganisation of clinics.”
Ophthalmology
Ophthalmology moved to Abergele Hospital in April 2012 to a new unit called “The Stanley Eye Unit”. It opened for business on Monday, 16th April 2012. In the first instance the service co- located with Orthopaedic Inpatients on the Abergele site. This was an interim measure whilst work to remove asbestos from the theatres at Ysbyty Glan Clwyd was undertaken. Orthopaedic inpatients will then move to Glan Clwyd and this will allow the Eye services to expand.
The new Eye Unit has a Macular treatment suite (IVT), Primary Care area, Outpatient department, Day Care Unit and twin theatres, providing some of the latest technology for a comprehensive eye service (including emergency treatment) to the residents of Conwy, Denbighshire, Flintshire and its visitors, and surgical retinal specialty services across North Wales. Although emergency treatment will be undertaken at the Unit, there will not be a „walk- in‟ casualty service at Abergele.
Talking about the move, Mr. Roger Haslett, Clinical Lead for Ophthalmology said “We are looking forward to moving to Abergele which will allow us to provide better facilities for patients, with new Theatres, wards and a Macular Treatment Centre. It will take a little time for the team to settle in but we are confident that we can build on the previous service provided at H.M. Stanley for the last 58 years to provide an excellent ophthalmic service suitable for patient care in 2012 and onwards.”
89 Clinical Nurse Manager, Helen Juckes-Hughes adds “Just as in our previous home at H.M. Stanley, Abergele staff have been witness to the transformation of the Health Service and Care changes. It is now part of Ophthalmology‟s path to embrace the hospital of Abergele and continue to add to its long successful history of clinical innovation and an excellent standard of patient care into the 21st Century.”
The Finale
On completion of the Project, the hospital element of the HMS site is to be sold, and monies returned to the Welsh Government for reinvestment into health care. However the St. Kentigern‟s Hospice and the Headquarters of the Welsh Ambulance Services Trust will continue to operate from the site. The area for sale is shown on the diagram below:
Chester-based agents Legat Owen were instructed to market the site which extends to 8.33 acres and their sales literature states that it is identified within the emerging Denbighshire Local Development Plan as being suitable for residential development.
At the time of writing this process is ongoing, but no-one can deny that H.M. Stanley hospital has served the local population very well, both in the early days as a Workhouse and latterly as a Hospital.
As for the future for the old hospital site, only time will tell………………
THE END
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Bibliography:
Flintshire County Record Office
Owen, B., Yuille, T., Stringfellow, G., Hilton-Jones, C. (2000) Ysbyty Glan Clwyd : Birth and Life of a hospital, Bodelwyddan : Conwy & Denbighshire NHS Trust. ISBN: 0953368211
Parry-Jones, E. (1981) From workhouse to hospital : a story of H.M. Stanley hospital, St. Asaph 1840 – 1980, Clwyd Area Health Authority. ISBN: X420031617 .
Disclaimer:
Whilst every effort has been made to check and validate the information, the editorial team cannot guarantee the accuracy of any of the content contained in this publication.
Editorial Team
Top Row – left to right
Dawn Davies, Communications Officer (Editor) Eryl Smith, Library Manager, Ysbyty Glan Clwyd
Bottom row – left to right
Anne Hughes, Higher Clerical Officer, H.M. Stanley Julie Jackson, Higher Clerical Officer, H.M. Stanley
Mike Jones, Medical Photographer
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