Copy of report enclosed
Minutes:
(A) Betsi Cadwaladr University
Health Board
(i) The Chief Executive, Betsi Cadwaladr University Health
Board, noted that he appreciated the importance of this issue, and in the same
manner that the Health Board had questions to be answered. Whilst recognising that the matter
had some history, it was trusted that the report submitted would set out the
Health Board's reasoning in terms of reviewing the service, the implications of
this review in terms of arriving at a point where there is a better range of
services across north Wales and that those are as effective and sustainable as
possible. Also, in terms of moving
forward the Health Board believed that the new Health Centre would enable them
to develop new services as those aimed across the whole of north Wales. These new services were not based on beds,
but they would be effective and sustainable within the proposed clinics in the
new Health Centre. One basic point that
the Health Board had to accept was that they had made some changes giving the
impression that some matters would be implemented before those changes had been
done. This was an error on behalf of the
Health Board, however, having said that, the Chief Executive was of the view
that the rationale established by the Health Board was robust and appeared to
work well in other places. It was hoped that people would see the Health Board
achieving its commitments with a more positive picture of moving forward when
the new services are operational as part of the Health Centre.
(ii) Ffion Johnstone, Area Director (West),
referred to the proposed structure that was trying to get care closer to the
homes of individuals by creating community hubs within the communities. In
terms of consistency and safety for the patient, they endeavoured to get health
services with the same opening hours in the community hubs and within a journey
of 40 minutes by car for patients across north Wales. It was noted that x-ray services together
with minor injuries were available from 9.00 a.m. until 5.00 p.m. from Monday
to Friday in the community hubs. In
terms of Blaenau Ffestiniog, it was proposed to
establish an integrated health and care centre that would include health and
care services as well as the third sector.
It was further noted that it was proposed to hold new clinics at the
Centre such as coronary and pulmonary clinics and to expand learning disability
services and palliative care.
(i)
In terms of the strategy
in the community, Dr Siôn Jones, Consultant in
Elderly Care at Ysbyty Gwynedd, reported on the way
forward to offer a more personal service to individuals in their own
homes. He noted that frailty and the
number of older people were increasing in communities and often admission into
hospital was not ideal for some of these individuals. They were trying to develop a service to deal
with any emergency within the community and to be able to identify frailty
early on. Reference was made to the
success of the arrangements namely the MEC Model (Môn Enhanced Care) with a
team of medical leaders including one part-time GP. 2 nurses together with
healthcare assistants who had seen approximately 250 patients in the community
over the last year. It was trusted that
the model could be expanded across other areas in Gwynedd, however, this was
difficult due to financial and recruitment limitations.
(iv) The Area Director for
the West added that the Health Board had developed a business case and
following a consultation process the plan to develop an Integrated Centre at
Blaenau Ffestiniog had been approved by the Welsh
Government. In terms of the
recommendations, it was resolved to close beds at the Ffestiniog
Memorial Hospital and it was agreed to open an additional six beds at Ysbyty Alltwen. Over four years the average number of patients
from Blaenau Ffestiniog admitted every month to Ysbyty Alltwen was between 5.3
and 8, and this was in accordance with the capacity of an additional six beds
that were opened. Regarding care at home, significant additional resources had
been provided in nursing, social services, the third sector and administrative
support. In the context of the capacity
of nursing / residential homes, it was noted that there was a national shortage
and it was necessary to look at different models. Three beds had been established in Bryn Blodau Residential Care Home for step up / step down care
and these are used 80% of the time.
The x-ray service and the
minor injuries services at Ffestiniog Memorial
Hospital were unsustainable and by now a five day a week x-ray service is
provided and it is proposed to extend the opening hours of the minor injuries
service up to midnight for 7 days a week at Ysbyty Alltwen.
(v) Karen Bampfield,
Community Nurses Leader (Meirionnydd), explained the operational side and noted
that a team of staff operated in the Blaenau Ffestiniog
area with approximately 166 patients as part of their caseload. Approximately 34 persons received palliative
care in the community last year. It was
noted that the nurses' skills had been enhanced to treat patients within the
community. When the team moves to the
Memorial Centre they will share an office with Social Services Officers in
order that they can work together to move the strategy forward.
In conclusion, the Area Director for the West noted
that the Health Board had sought to proceed with a strategy for the community
and to ensure safe services but by so doing had to reduce the number of
hospitals in order to up-skill staff.
Supporting documents: