24/7 A&E departments, co-located with purpose-built clinical decision and assessment facilities, will be provided in Aberystwyth, Carmarthen and Haverfordwest, the Extraordinary Board Meeting confirmed.
The Health Board has listened to all feedback received from the consultation exercise and other evidence, and subsequently approved a broader recommendation, with a clinically led group to re-design an unscheduled care service for Prince Philip Hospital and the Llanelli community.
The current A&E Department will be re-titled in line with NHS terminology and will deliver a doctor supported, primarily nurse delivered service within an integrated model of GPs, pharmacists and community service teams. In addition, we will maintain a 24/7 consultant-led emergency medical assessment and admission service.
The implementation process will be led by doctors, with representation of GPs, anaesthetists, consultant physicians, nursing staff and associate director of clinical services, who will consider the whole of the unscheduled services across primary (community based) and secondary (hospital based) care. They will provide assurances that the model is safe before any changes are made.
It is anticipated changes will be made over the course of two years.
Dr Sue Fish, Medical Director for Hywel Dda Health Board, said: “To fully comply with professional standards, the Health Board would have needed to establish a single full emergency department for the three counties of Carmarthenshire, Ceredigion and Pembrokeshire.
“We hope today’s decision demonstrates to residents of Ceredigion and Pembrokeshire that this Health Board acknowledges the importance and unique locations of Bronglais and Withybush Hospitals. As a Health Board we cannot stress strongly enough to the people of Llanelli that their concerns and alternate proposals for providing emergency care at Prince Philip Hospital have been recognised and fully deliberated. However, we must be clear that a consultation must ensure accountability and due to its very nature cannot be a referendum. These changes approved by the Board will demonstrate improved outcomes for our patients, be safe and sustainable. We will not compromise on patient care.
“The way the service at Prince Philip Hospital is provided at the moment is not as safe as it could be. We must get this right; for too long a cloud of uncertainty has hung over this important service and Llanelli now deserves stability with investment in training and up-skilling of clinical staff to provide a safe and efficient service. This change will be led by the staff who care for Llanelli residents and no change will be made until this clinically led group judges that it is safe to do so.”
Our doctors are re-designing the emergency services in Llanelli. There are a number of strands to this. Our sickest patients will be medical patients and managed by medical teams. Other will include Emergency Nurse Practitioners delivered services, primary care services and greater links to social care. The health board wants to ensure that all of our services work well together. This work will form a blueprint for how we deliver emergency and urgent care across our health board.
Medical emergency patients (e.g. patients with strokes, diabetes, infections and asthma attacks) will be admitted directly into Prince Philip Hospital through an Emergency Medical Admission Unit. This unit will be consultant led and available 24 hours, seven days a week, improving the assessment and management for the most unwell medical patients.
Dr Philip Kloer, Director of Clinical Services, said: “This is an improvement for medically unwell patients as they will come directly into the hospital, bypassing the walk-in unit and with only one assessment as opposed to two. They will therefore get much quicker access to a physician for the treatment they need.”
The majority of emergency medical patients come into the hospital via the ambulance service or by referral from GPs and this would continue under the new proposal.
The full recommendation report, and other resources, can be found at www.hywelddahb.wales.nhs.uk/Consultation
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