Growing numbers of people are realising the benefits of being treated at home or in their communities rather than being admitted to hospital, a leading Hywel Dda GP has said.
Dr Sion James, Clinical Director for Primary Care in Ceredigion, said that many frail and elderly patients were currently being admitted to hospital when they didn’t need to be and were watching their condition deteriorate to the point where they ended up waiting in hospital beds for a place in a residential or nursing home.
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.
Dr James added: “I think people fear change, but there are plenty of examples where we’ve demonstrated that providing services closer to home – often with the help of new technology – are better for people, and that we need to trust healthcare professionals to work with individuals within communities to provide care.
“Some of the challenges we’re seeing in community care include recruitment, as there are not enough GPs to go around, and while we are delivering more and more services to great effect in the community, we don’t really have the resources to take on any more without a real shift in resources from secondary care to primary care and community services.
“A lot of the time it’s very frustrating because we believe that people should be looked after at home, but then we’re forced to admit them [to hospital] because there are no other alternatives – that’s one of my big bugbears.
“The problem with that is that it isn’t the best place for them to be. People do deteriorate very quickly when they’re frail and elderly, they lose their function and then they become patients who are in hospital and waiting for placement in a nursing home or residential home. This Delayed Transfer of Care (DToC) puts further pressure on hospitals as they don’t always have enough beds for inpatients.”
Dr James called for a range of new and different alternatives to the traditional medical model in which patients are referred from their GP to secondary care settings such as hospitals.
He added: “It’s not about buildings or “bricks and mortar,” which is what people tend to focus on when we have these discussions; it’s about using people and the networks of teams that we have so that we’re able to keep people out of hospital and functioning independently. For example, we have a multidisciplinary team with district nurses, palliative care nurses and social workers who all meet regularly so that they can have conversations about people and get the best use of services for that individual.
“I think there’s a great realisation among patients, especially the elderly and frail, that they don’t want to go to hospital. I think they have a lot of experience of people going into hospital and perhaps seeing their physical condition deteriorating, plus they’re away from their family and they don’t want that. I’ve got a lady at the moment who is receiving care with the Acute Response Team (ART) at home and she’s delighted. She didn’t want to go to hospital and before that was the choice – go to hospital or don’t. Now the ART team are there, she’s getting fluids given to her at home and she’s very pleased.”
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:
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
Monday 4th June 2pm-7pm / Rhys Pritchard Memorial Hall, Llandovery SA20 0DS
Monday 11th June 2pm-7pm / Penybanc Welfare Hall, Ammanford SA18 3QS
Thursday 14th June 2pm-7pm / City Hall, St.David’s SA62 6SD
Monday 18th June 2pm-7pm / Tysul Hall, Llandysul SA44 4HS
Tuesday 26th June 2pm-7pm / Pembrokeshire Archives Building, Haverfordwest SA61 2PE
Monday 2nd July 2pm-7pm / Victoria Hall, Lampeter SA48 7EE
Thursday 5th July 2pm-7pm / Pill Social Centre, Milford Haven SA73 2QT
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Yn ôl meddyg teulu yn Nhregaron, mae niferoedd cynyddol o bobl yn sylweddoli manteision cael eu trin gartref neu yn eu cymunedau yn hytrach na mynd i’r ysbyty.
Dywedodd Dr Sion James, y Cyfarwyddwr Clinigol ar gyfer Gofal Sylfaenol yng Ngheredigion, bod nifer o gleifion oedrannus a bregus ar hyn o bryd yn cael eu derbyn i’r ysbyty pan nad oes angen gwneud hynny, a bod eu cyflwr yn cael ei weld yn dirywio hyd at y pwynt lle maent yn aros mewn gwelyau ysbytai am le mewn cartref preswyl neu gartref nyrsio.
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.
Ychwanegodd Dr James: “Rwy’n credu bod pobl yn ofni newid, ond mae yna ddigonedd o enghreifftiau lle rydym wedi dangos bod darparu gwasanaethau yn nes at y cartref – yn aml gyda chymorth technoleg newydd – yn well ar gyfer pobl, a bod angen i ni ymddiried yn y gweithwyr gofal iechyd proffesiynol i weithio gydag unigolion yn y cymunedau i ddarparu gofal.
“Mae rhai o’r heriau rydym yn eu hwynebu o ran gofal cymunedol yn cynnwys recriwtio, gan nad oes yna ddigon o feddygon teulu, ac er ein bod yn darparu mwy a mwy o wasanaethau mewn modd effeithiol iawn yn y gymuned, mewn gwirionedd nid oes gennym yr adnoddau i wneud rhagor o waith heb symud adnoddau o ofal eilaidd i ofal sylfaenol a gwasanaethau cymunedol.
“Mae’n rhwystredig iawn yn aml, oherwydd rydym yn credu y dylid gofalu am bobl gartref, ond yna cawn ein gorfodi i’w derbyn [i ysbyty] oherwydd nad oes dewisiadau eraill – dyma un o’m prif gasbethau.
“Y broblem gyda hynny yw nad yr ysbyty yw’r lle gorau iddynt fod. Mae pobl yn dirywio’n gyflym iawn pan maent yn eiddil ac yn oedrannus; maent yn colli eu gallu i weithredu, ac yna maent yn dod yn gleifion sydd yn yr ysbyty ac yn aros am leoliad mewn cartref nyrsio neu gartref preswyl. Mae’r oedi hwn o ran Trosglwyddo Gofal yn rhoi mwy o bwysau ar ysbytai oherwydd nad oes ganddynt bob amser ddigon o welyau ar gyfer cleifion mewnol.”
Galwodd Dr James am amrywiaeth o ddewisiadau newydd a gwahanol i’r model meddygol traddodiadol, lle caiff y cleifion eu hatgyfeirio gan eu meddyg teulu i leoliadau gofal eilaidd tebyg i ysbytai.
Ychwanegodd: “Nid yw’n ymwneud ag adeiladau neu “frics a morter,” sef yr hyn y mae pobl yn tueddu i ganolbwyntio arnynt pan fyddwn yn cynnal y trafodaethau hyn; mae’n ymwneud â defnyddio’r bobl a’r rhwydweithiau o dimau sydd gennym fel y gallwn gadw pobl allan o’r ysbyty ac yn gweithredu’n annibynnol. Er enghraifft, mae gennym dîm amlddisgyblaethol gyda nyrsys ardal, nyrsys gofal lliniarol a gweithwyr cymdeithasol, sydd i gyd yn cwrdd yn rheolaidd er mwyn cynnal sgyrsiau am bobl a chael y defnydd gorau o’r gwasanaethau ar gyfer yr unigolyn hwnnw.
“Rwy’n credu bod cleifion yn gyffredinol, yn enwedig yr henoed a’r methedig, yn sylweddoli nad ydynt am fynd i’r ysbyty. Rwy’n credu bod ganddynt lawer o brofiad o bobl yn mynd i’r ysbyty, ac efallai o weld eu cyflwr corfforol yn gwaethygu, yn ogystal â’u bod i ffwrdd o’u teulu – ac nid ydynt am i hynny ddigwydd. Mae gen i wraig ar hyn o bryd sy’n cael gofal gartref gan y Tîm Ymateb Acíwt (ART), ac mae hi wrth ei bodd. Nid oedd hi eisiau mynd i’r ysbyty, a chyn hyn dyna oedd y dewis – mynd i’r ysbyty neu beidio. ‘Nawr bod y Tîm Ymateb Acíwt yna, mae hylifau yn cael eu rhoi iddi yn ei chartref, ac mae wrth ei bodd â hynny.”
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 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
Dydd Llun 4 Mehefin 2pm-7pm / Neuadd Goffa Rhys Pritchard, Llandovery SA20 0DS
Dydd Llun 11 Mehefin 2pm-7pm / Neuadd Les Penybanc, Rhydaman SA18 3QS
Dydd Iau 14 Mehefin 2pm-7pm / Neuadd y Ddinas, Tŷ Ddewi SA62 6SD
Dydd Llun 18 Mehefin 2pm-7pm / Neuadd Tysul, Llandysul SA44 4HS
Dydd Mawrth 26 Mehefin 2pm-7pm / Adeilad Archifau Sir Benfro, Hwlffordd SA61 2PE
Dydd Llun 2 Gorffenaf 2pm-7pm / Neuadd Fictoria, Llanbedr Pont Steffan SA48 7EE
Dydd Iau 5 Gorffenaf 2pm-7pm / Canolfan Cymdeithasol Pill, Aberdaugleddau SA73 2QT
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