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Improving our out of hours service

Patients who need to access overnight Out of Hours services in south Ceredigion and Carmarthenshire are set to be boosted by temporary changes that will help ensure they have better access to a clinician.

From 9 March the Health Board will bring in measures aimed at providing more consistent and robust care during the overnight period (11pm – 8am, Monday to Sunday).

Patients in Llanelli who dial 111 during the overnight period will be directed to the 24/7 GP-led Minor Injuries Unit at Prince Philip Hospital if they need to see a clinician, while people living in Llandysul and the surrounding area will be asked to attend the Out of Hours base at Glangwili General Hospital, Carmarthen, during the same period.

By closing the overnight Out of Hours base in Llanelli and moving the GP in Llandysul to Glangwili during the same period, we hope to be able to fill more of our weekend clinical shifts - when more people access the service - and provide a more consistent and robust service for our patients, so that they retain the ability to be reviewed as appropriate. There is no change to the Minor Injuries Unit at Prince Philip Hospital - if you have an urgent care need that can’t wait for an in-hours appointment with your GP, you can still access it as before.

For some time our Out of Hours service has become increasingly fragile due to difficulties in filling GP rotas, with the position especially challenging at weekends.  This has led to us having to move available clinicians around to try and manage the shortfalls as and when required, or – increasingly – close bases for long periods of time if no cover can be found, in the interests of patient safety.

These temporary changes will help inform our longer-term transformation of the Out of Hours service, in line with our Healthier Mid and West Wales strategy, and we will be asking patients for their feedback about their experience of the temporary change to help inform our decision-making.

Dr Richard Archer, an Out of Hours GP and Clinical Lead for the service, said: “It’s been well publicised that for some time now we have struggled to provide a robust Out of Hours service in all three counties due to difficulties filling the rotas.” o

“Where no clinical cover has been available at all, we’ve had to temporarily close bases and redirect patients to A&E, which puts further pressure on our emergency services as it isn’t always the most appropriate place for them to go.

“By bringing about these temporary changes we hope to be able to provide more telephone consultations and more of an overnight GP presence in Llanelli and Carmarthen.

“We recognise that this does mean some patients living in Llandysul and the surrounding area will need to travel to Glangwili if they are given a face-to-face appointment after midnight, and I would like to apologise for any frustrations or inconvenience that this may cause. We know that we typically experience far less Out of Hours activity in Llandysul during the overnight period than elsewhere and we expect that the impact of these changes will be minimal.

“I would like to pay particular tribute and offer my sincere thanks to all of our GPs and clinicians who continue to work tirelessly to help provide the best possible service for our patients in what has been a very challenging environment.”

Andrew Carruthers, Director of Operations at Hywel Dda University Health Board, added: “Putting patients first is at the heart of everything we strive to do and this has been a key driver behind our desire to develop the Out of Hours service, both in the short and long term. 

“It’s fair to say that this service has experienced significant pressures in recent years and we would like to thank the public for their understanding while we continue to evolve the model. We hope that by introducing these temporary measures we can return to providing greater resilience within the service, while at the same time looking at what we need to do going forward to provide the care our patients deserve.”