Change needed to tackle A&E waits, says senior Hywel Dda consultant / Angen newid i fynd i’r afael ag amserau aros mewn adrannau brys, meddai uwch-ymgynghorwr yn Hywel Dda

A senior emergency medicine consultant at Hywel Dda has called for more senior medical staff “at the front door” of busy emergency departments in order to improve the quality of patient care, improve flow through the hospital and reduce waiting times for those in need of emergency medical treatment.

Mr Jeremy Williams, Consultant in Emergency Medicine and Clinical Director for Unscheduled Care at Hywel Dda, said that large numbers of patients were coming to the Emergency Units who could be better dealt with if services were structured differently.

The health board has officially launched a 12-week consultation, “Hywel Dda – Our Big NHS Change,” which is aimed at making provision of local health and care better for our communities.

We’re asking residents across Carmarthenshire, Ceredigion and Pembrokeshire, as well as the wider cross-border regions, to get involved and have your say on three proposals to improve the way we provide care for our population. Each proposal has been designed and tested by our clinicians to ensure that our services are safe, sustainable, accessible and kind for our generation and those to come.

Mr Williams, who is based at Glangwili Hospital and has worked in emergency care for over 20 years, said: “Glangwili and the other Emergency Units in Hywel Dda are under similar pressures to the rest of the UK.  Large numbers of patients are coming in, many of whom could be dealt with more appropriately in the community.  Nursing and medical staff in the departments are extremely stressed.  One of our main problems is that when we’ve initially managed these patients and realised that they require admission to hospital there is often no appropriate bed for them to be placed, so patients are spending too long in the Emergency Units.

“Generally speaking the job I do now is really very dissimilar to the job that I started doing 21 years ago.   We are looking after patients for longer, in effect acting as a Clinical Decision Unit – patients should actually be discharged, transferred or admitted from the Emergency Unit within four hours, however too many are spending significantly longer than this which often interferes with their care and places additional pressures on our staff.

“In my opinion the most important component of any organisation is its staff and there are certainly many dedicated nursing and medical staff in the emergency units across Hywel Dda, and this is extremely important because in an imperfect system – which is what we currently have – individuals can make a difference.

“We don’t currently have enough senior medical staff at the front door and we’re splitting the ones that we do have between three sites – three Emergency Units and one Minor Injuries Unit.  In my view there would certainly be benefits to be gained from amalgamating these staff; it would improve the quality of care, it would improve recruitment and allow us to place more senior decision makers at the front door for more hours of the day, which would significantly improve patient care.”

You can find out more about the consultation and the health board’s proposals, or tell us your views, by:

Completing the online questionnaire at: www.hywelddahb.wales.nhs.uk/hddchange

Emailing us at: hyweldda.engagement@wales.nhs.uk

Telephone: 01554 899 056

Coming to one of our drop-in events:

• Friday 4th May 2pm – 7pm / The Great Hall, Guildhall, Cardigan SA43 1JL
• Tuesday 8th May 2pm – 7pm / St Peter’s Civic Hall, Carmarthen SA31 1PG
• Friday 11th May 2pm – 7pm / Regency Hall, Saundersfoot SA69 9NG
• Tuesday 15th May 2pm – 7pm / Letterston Memorial Hall, Letterston SA62 5RY
• Friday 18th May 2pm – 7pm / Morlan Centre, Aberystwyth SY23 2HH
• Tuesday 22nd May 2pm – 7pm / Selwyn Samuel Centre, Llanelli SA15 3AE
• Thursday 24th May 2pm – 7pm / Llandybie Memorial Hall, Llandybie SA18 3UR

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Mae uwch-ymgynghorydd  meddygaeth frys yn Hywel Dda wedi galw am ragor o uwch-staff meddygol “wrth ddrws ffrynt” adrannau brys prysur, a hynny er mwyn gwella ansawdd y gofal i gleifion, gwella’r llif trwy’r ysbyty, a lleihau’r amserau aros ar gyfer y rheiny y mae arnynt angen triniaeth feddygol frys.

Dywedodd Mr Jeremy Williams, Meddyg Ymgynghorol ym maes Meddygaeth Frys a’r Cyfarwyddwr Clinigol ar gyfer Gofal Heb ei Drefnu yn ardal Hywel Dda, fod niferoedd mawr o gleifion yn dod i’r Unedau Brys, y gellid ymdrin â nhw’n well pe byddai’r gwasanaethau wedi’u strwythuro’n wahanol.

Mae’r Bwrdd Iechyd wedi lawnsio “Hywel Dda – Trawsnewid ein Gwasanaeth iechyd,” ymgynghoriad cyhoeddus 12-wythnos â’r nod o wella darpariaeth iechyd a gofal yn lleol.

Rydym yn gofyn i drigolion ar draws Sir Gaerfyrddin, Ceredigion a Sir Benfro, yn ogystal â’r rhanbarthau trawsffiniol ehangach, i fod yn rhan o hyn ac i ddweud eu dweud ar y tri chynnig i wella’r ffordd yr ydym yn darparu gofal ar gyfer ein poblogaeth. Ein clinigwyr sydd wedi cynllunio a phrofi pob un o’r cynigion, er mwyn sicrhau bod ein gwasanaethau’n ddiogel, yn gynaliadwy, yn hygyrch ac yn garedig ar gyfer y genhedlaeth hon a chenedlaethau’r dyfodol.

Dywedodd Mr Williams, sydd yn gweithio yn Ysbyty Glangwili ac sydd wedi gweithio ym maes gofal brys ers dros 20 mlynedd: “Mae Ysbyty Glangwili ac Unedau Brys eraill yn ardal Hywel Dda o dan bwysau tebyg i weddill y DU. Mae niferoedd mawr o gleifion yn dod i mewn, a gellid ymdrin â nifer ohonynt yn fwy priodol yn y gymuned. Mae’r staff nyrsio a’r staff meddygol yn yr adrannau o dan straen mawr. Un o’r prif broblemau sydd gennym yw nad oes yna welyau priodol ar gael ar gyfer y cleifion hyn pan fyddwn wedi gweld atynt i gychwyn, a sylweddoli bod angen iddynt gael eu derbyn i’r ysbyty, felly mae’r cleifion yn treulio gormod o amser yn yr Unedau Brys, ac mae hynny’n bell o fod yn ddelfrydol.

“Yn gyffredinol, mae’r swydd yr wyf yn ei gwneud ‘nawr yn wahanol iawn i’r swydd yr oeddwn wedi dechrau arni 21 mlynedd yn ôl. Rydym yn gofalu am gleifion am fwy o amser gan weithredu, i bob pwrpas, fel Uned Penderfyniadau Clinigol – mewn gwirionedd, dylai’r cleifion gael eu rhyddhau, eu trosglwyddo neu eu derbyn o’r Uned Frys o fewn ychydig o oriau. Fodd bynnag, mae gormod ohonynt yn treulio llawer mwy o amser na hyn yn yr Uned, ac mae hyn y aml yn amharu ar eu gofal ac yn rhoi pwysau ychwanegol ar y staff.

“Yn fy marn i, cydran bwysicaf unrhyw sefydliad yw ei staff, ac mae yna nifer o staff nyrsio a staff meddygol ymroddedig, yn bendant, yn yr unedau brys ledled ardal Hywel Dda, ac mae hyn yn hynod o bwysig oherwydd, mewn system amherffaith – sef yr hyn sydd gennym ar hyn o bryd – gall unigolion wneud gwahaniaeth.

“Ar hyn o bryd, nid oes gennym ddigon o uwch-staff meddygol wrth y drws ffrynt, ac rydym yn rhannu’r rhai sydd gennym rhwng tri safle – tair Uned Frys ac un Uned Mân Anafiadau. Yn fy marn i, byddai yna fanteision o gyfuno’r staff hyn, yn sicr; byddai hynny’n gwella ansawdd y gofal, yn gwella’r broses recriwtio, ac yn ein galluogi i leoli rhagor o unigolion uwch sy’n gwneud penderfyniadau wrth y drws ffrynt am ragor o oriau bob dydd – byddai hynny’n gwella’r gofal i gleifion yn sylweddol.”

Gallech ddweud eich dweud yn y ffyrdd canlynol:

Llenwi’r holiadur ar-lein: www.bihyweldda.wales.nhs.uk/trawsnewidhdd

Ebostio: hyweldda.engagement@wales.nhs.uk

Ffonio: 01554 899 056

Dod i un o’n digwyddiadau galw-heibio:

• Dydd Gwener 4 Mai 2pm – 7pm / Y Neuadd Fawr, Neuadd Y Dref, Aberteifi SA43 1JL
• Dydd Mawrth 8 Mai 2pm – 7pm / Neuadd Ddinesig San Pedr, Caerfyrddin SA31 1PG
• Dydd Gwener 11 Mai 2pm – 7pm / Neuadd Regency, Saundersfoot SA69 9NG
• Dydd Mawrth 15 Mai 2pm – 7pm / Neuadd Goffa Treletert, Treletert SA62 5RY
• Dydd Gwener 18 Mai 2pm – 7pm / Canolfan Morlan, Aberystwyth SY23 2HH
• Dydd Mawrth 22 Mai 2pm – 7pm / Canolfan Selwyn Samuel, Llanelli SA15 3AE
• Dydd Iau 24 Mai 2pm – 7pm / Neuadd Goffa Llandybie, Llandybie SA18 3UR