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An address by Maria Battle, Chair

Hywel Dda COVID update

On behalf of Hywel Dda University Health Board, thank you for everything you are all doing to support us in the NHS and people in our communities to stay safely at home. The outpouring of kindness and help from our own staff, communities, businesses, local authority partners, Welsh Rugby Union, the Military, retailers, the voluntary sector and more, has been overwhelming. These are extraordinary times and everyone is stepping up in quite extraordinary ways. We are working together in new ways at great speed which will enable us to weather the storm better together. 

In the last few weeks significant reconfiguration work has taken place at all our four main hospitals, Bronglais, Withybush, Glangwili and Prince Philip, to respond to COVID-19. Led by our clinicians and hospital managers these hospitals now have designated areas for the care of both non-COVID-19 and confirmed or suspected COVID-19 patients. There are temporary facilities (tents or temporary buildings) outside our Emergency Departments, to allow for triaging of different patients. Staff are also designated to work in specific areas, either COVID-19 or otherwise in order to minimise risk and protect patients and staff. We are expanding our critical care capacity and improving oxygen flow on our hospital sites.

GP surgeries across Hywel Dda are adopting safe measures to protect the public and staff. All requests for a GP appointment will be triaged by telephone or a video consultation. If a doctor assesses that a patient needs to be seen, they will make that provision.

Opening hours for most Community Pharmacies remain largely unchanged but some may need to work behind closed doors for a period each day due to the high volume of prescriptions needing to be dispensed. All GP practices have been asked to let their patients know what their arrangements are for repeat prescriptions.

In order to be prepared as possible, staff have been deployed and trained in new skills and some former staff have returned to work. We have undertaken specific COVID -19 recruitment campaigns for registered nurses, healthcare support workers, skilled maintenance, laundry, catering, cleaning staff and porters. To date we have made 700 job offers and are about to advertise for additional allied health professionals. We especially thank all those who have applied for jobs with us; your willingness to put yourselves on the front line to help others at this time is both heartwarming and appreciated.

It is essential that as many beds currently within our hospitals are freed up so we can care for COVID-19 patients and other patients who urgently need our care. The three local authorities have been working tirelessly to ensure that patients who are medically fit can leave hospital with the appropriate care support.  We are grateful and ask families to continue to help us discharge their loved ones home when they are ready.

All non-urgent procedures and outpatient appointments have been postponed so we are able to respond to the virus. Clinicians are also making risk based decisions in the patient’s best interests in regards to emergency and urgent procedures and care.

In the last few weeks we have been working with our local authority partners setting up field hospitals in seven locations (two co-located) across Carmarthenshire, Ceredigion and Pembrokeshire. When complete, this will more than double our bed base. The contractors have worked 24/7 to erect the hospitals in record time, advised by the Military and our own clinical, planning and logistical experts.  We are also teaming up with private sector partners, including the Werndale hospital, to support our hospitals by treating some of our patients who needs planned care.

We have based all our planning assumptions on the reasonable worst case scenario, mitigated by the social distancing and stay at home measures introduced by the UK Government, which is why it is so important that we all follow these measures.

The additional beds will be in Parc y Scarlets, Carmarthen Leisure Centre, Llanelli Leisure Centre, Selwyn Samuel (Llanelli), Bluestone, and Cardigan Leisure Centre, and a co-located hospital at Penweddig School and Plascrug Leisure Centre, Aberystwyth.

All sites are expected to be up and running by the end of April, with the Carmarthenshire sites operational first. The plan and design of the field hospitals means they can be flexible according to local need in the light of the actual experience of the pandemic here in west Wales.  

We also have a dedicated Command Centre up and running which provides the co-ordination of testing for staff and other key workers and a single point of contact for staff enquiries on clinical, operational and workforce guidance. It also helps connect offers of support from local businesses to the health board and matches requests from staff via the email  

It is important that we learn lessons during this outbreak and continue working in the best new innovative ways after the storm has passed. We have set up a Recovery Rethinking and Innovation Group to pull together the learning and experience of staff and patients to improve our services going forward.

Like you all, I am humbled and grateful for the courage, dedication and service of our frontline staff who are putting themselves at risk in the fight against COVID-19.

Your support makes such a difference. We have seen huge kindness shown to staff - from home cooked meals and refreshments to offers of accommodation and hire cars.

It is safer for you and our staff that these kind offers are channelled through our Command Centre (via the above email address) from now on, rather than entering our sites and potentially risking your health and that of others.

Staff have told me how the weekly clapping and the rainbow pictures in windows and on roadsides have unexpectedly reduced them to tears and given them strength. We are all anxious at this time and our staff are no different. They are naturally worried about their loved ones, their own health, their colleagues as well as their patients. Your support is making a huge difference.

We have stepped up and deployed our psychological and wellbeing support to our staff generally and particularly in key areas such as intensive care. We are trying to make sure that all staff have access to the information, resources and the support needed to maintain their emotional and mental health wellbeing. We are putting in place calm rooms to sustain wellbeing during shifts learning from our colleagues in Italy and China.

There has been a lot of media coverage about personal protection equipment for staff. We have been doing, and will continue to do, everything we can to source the right protective equipment for our staff and PPE has been distributed to all clinical areas. But we remain concerned and are grateful to our local manufacturers and schools and communities who have stepped up to help produce safety visors and safety equipment. We are putting in place systems to test and quality assure any equipment we receive and ask all staff to contact the Command Centre if they receive such donations.

In many ways we have been the first in Wales, in the Coronavirus testing units, the  construction of field hospitals, trialling the use of hoods successfully for patients with chest issues, and the local manufacturing of a ventilator product.  The collective response has been overwhelming and inspirational.

Without all your support it would not have been possible to achieve so much in so little time. Thank you for supporting your NHS. Together we will succeed.