Health Board will refresh strategy for a healthier mid and west Wales
28 November 2024
Hywel Dda University Health Board will refresh its strategy and consider further changes needed to provide safe, quality, and sustainable care across primary and community settings, as well as hospitals, a board meeting agreed today (Thursday 28 November 2024).
The Board heard a combination of reasons why health services are under significant pressure across the UK, and the specific challenges in west Wales.
The Board’s strategy A Healthier Mid and West Wales, published in 2018, details the issues in providing care across a large and predominantly rural setting, with some services provided across multiple sites.
The strategy’s vision is for more preventative care, and delivery in community settings whenever possible.
Executive Director of Strategy and Planning Lee Davies said: “The vision remains, so it is worth reassuring people that this is not a radical change of direction but rather refinement in how we deliver the strategy in the current environment, which is different to what it was six years ago. We are eager to engage and work with our communities of staff, patients, partners and our local population on refreshing our strategy.”
In a meeting today, the Health Board recognised achievements towards the strategy have been made, for example supporting more patients in the community, improving nurse staff sustainability, and successfully bringing together some services.
However, challenges have continued, and in some areas worsened.
A key enabler of the existing strategy is reliant on the intent to secure and deliver a new Urgent and Planned Care Hospital in the south of the Hywel Dda area. Estimations are that delivery of a new hospital, if achieved, since financial support is not yet secured, is likely to be at least 10 years from now.
In the meantime, the Board heard services across the UK have consolidated and standards increased and Hywel Dda risks falling significantly behind other areas with consequences for patient care and staff recruitment.
Mr Davies said: “The pandemic and subsequent programme delays have meant the timescale for delivery of the programme, in particular the new hospital network, is substantially longer than originally anticipated. It is now highly likely that the new hospital would not be operational for at least a decade.
“In accepting that a new hospital will not be operational in the near future, it follows that the key service changes unlocked through a new hospital will now need to be considered ahead of a new facility and within existing hospitals.” Work to support fragile services in the interim of a new hospital has already begun through a programme of work called the Clinical Services Plan.
Staff, including clinicians, working with stakeholders and patient representatives have reviewed issues and challenges faced, agreed minimum standards, and developed draft options for nine fragile services.
The nine services are Critical Care, Emergency General Surgery, Stroke, Endoscopy, Radiology, Dermatology, Ophthalmology, Orthopaedics and Urology. They are services which need change and support to continue safely providing care in the medium term.
Board agreed that the programme prepares for a public consultation to involve further staff and communities in this work. The scope and matters for a future consultation, including the options, will be prepared for the next Health Board meeting at the end of January 2025.
Executive Director of Strategy and Planning Lee Davies said: “In the absence of a new hospital in the south of our area to address challenges, we need to consider other options to bring together some of our services. We anticipate the emerging model, informed by work on the Clinical Services Plan, will seek to build on the strengths of each of the hospital sites in a way that builds complementary areas of expertise.”
The Board also received a report on developing a strategic plan for primary care (these are the services provided by contractors such as GP practices, dental services, optometric practices, and community pharmacies) and community care.
The Health Board spoke to staff and communities during September and October as part of the early engagement programme called My Health, My Choice. Feedback has been reviewed, and common themes include support for more integrated ways of working, improving access to care, as well improving knowledge on the range of community and primary care services available.
Further work will take place to develop draft options for primary and community services.
Updates on the progress towards consultation for hospital services (CSP), and option development for primary and community services are expected to be discussed by Health Board again in January 2025.
Those interested in participating in future engagement or would like to keep up to date with the Health Board’s work, can join the Hywel Dda engagement scheme Siarad Iechyd/Talking Health (opens in new tab).