Improved access to trauma care / Gwella mynediad at ofal trawma

Patients who suffer a major or moderate trauma in Carmarthenshire, Ceredigion, Pembrokeshire and borders, will have access to strengthened services, which should improve their health and well-being outcomes, following Hywel Dda University Health Board’s approval of additional resources on Thursday 26 September.

To support the Major Trauma Centre in Cardiff, which will provide very specialist services, the Board endorsed Glangwili Hospital, Carmarthen, as the interim Trauma Unit for the Hywel Dda area until a new urgent and planned care hospital is built.

This is an essential part of the establishment of the Major Trauma Network model for South, Mid and West Wales. The Board also considered and accepted feedback from an engagement exercise held on these developments with the community during the summer and the considerations of Hywel Dda Community Health Council.

The Board approved a number of recommendations including investment of £70,000 into medical, nursing and therapy posts needed for the Trauma Unit in the last quarter of this financial year (and £515,289 on an annual basis). In addition, the Board acknowledged the need for a contribution of £165,500 this year, rising to £2.5m per annum, as our share of the funding required to support the set-up of the Major Trauma Centre in Cardiff, subject to the sign-off of the All-Wales Major Trauma Network Business Case.

Dr Stuart Gill Anaesthetics Consultant and Major Trauma Clinical Lead for Hywel Dda University Health Board said: “Patient’s in South and Mid Wales are disadvantaged compared to the rest of the UK through living in the only region that does not have a Major Trauma Network. It is vital that Hywel Dda is able to contribute effectively to this network. A key aspect of that is establishing a functioning trauma unit. The improved co-ordination of care pathways will improve both patient outcomes and experience when managing major trauma.”

The recommendations address some concerns from the engagement exercise, for example through investment into additional clinical support and rehabilitation services to support local patients. There were various opinions presented by the public on preferred location of the Trauma Unit, but Glangwili Hospital is the closest to meeting Trauma Unit standards, which offers many benefits. It was also noted that Bronglais Hospital, in Aberystwyth, and Withybush Hospital, in Haverfordwest, will support the Trauma Unit at Glangwili Hospital and will not be downgraded as a result of this development. Bronglais and Withybush hospitals will continue to admit patients with less severe traumatic injury and retain the ability to stabilise and transfer patients who suffer moderate or severe trauma either to the Trauma Unit or the Major Trauma Centre.

Director of Planning, Performance, Informatics and Commissioning Karen Miles said: “We are extremely grateful to our staff and public who contributed to the engagement on major trauma within the Hywel Dda area. The health board will continue to work on a local and national level to develop the major trauma network, and this will be informed by feedback from the engagement exercise and reported into the Health Board.”

The Major Trauma Network is planned to be active from April 2020, but development will be phased in and ongoing during the first five years. Local rehabilitation resources will be reviewed one year in to assess if there is a need for more staff and/or a dedicated ward for moderate trauma.

For the latest news and updates from Hywel Dda University Health Board visit www.hywelddahb.wales.nhs.uk

Gwella mynediad at ofal trawma

Bydd gan gleifion sy’n dioddef trawma mawr neu gymedrol yn Sir Gâr, Ceredigion, Sir Benfro a’r ffiniau fynediad at wasanaethau cryfach, a dylai hyn wella eu canlyniadau o ran iechyd a llesiant. Daw hyn yn dilyn cymeradwyaeth Bwrdd Iechyd Prifysgol Hywel Dda (ar ddydd Iau 26 Medi) i adnoddau ychwanegol.

I gefnogi’r Ganolfan Trawma Mawr yng Nghaerdydd, a fydd yn darparu gwasanaethau arbenigol iawn, cymeradwyodd y Bwrdd Ysbyty Glangwili, Caerfyrddin fel yr Uned Trawma dros dro ar gyfer ardal Hywel Dda nes adeiladu’r ysbyty gofal brys a gofal wedi’i gynewydd.

Mae hon yn rhan hanfodol o sefydliad y model Rhwydwaith Trawma Mawr ar gyfer De, Canolbarth a Gorllewin Cymru. Bu i’r Bwrdd hefyd ystyried a derbyn adborth o ymarfer ymgysylltu gyda’r gymuned ar y datblygiadau hyn yn ystod yr haf, yn ogystal ag ystyriaethau Cyngor Iechyd Cymuned Hywel Dda.

Cymeradwyodd y Bwrdd nifer o argymhellion yn cynnwys buddsoddiad o £70,000 i swyddi meddygol, nyrsio a therapi sydd eu hangen ar gyfer yr Uned Trawma yn chwarter olaf y flwyddyn ariannol hon (a £515,289 yn flynyddol). Yn ogystal, gwnaeth y Bwrdd gydnabod yr angen am gyfraniad o £165,500 y flwyddyn hon, gan godi i £2.5 miliwn y flwyddyn fel ein cyfran o’r arian sydd angen i gefnogi’r gwaith o sefydlu’r Ganolfan Trawma Mawr yng Nghaerdydd, yn amodol ar gymeradwyaeth Achos Busnes Rhwydwaith Trawma Mawr Cymru Gyfan.

Meddai Dr Stuart Gill, Ymgynghorydd Anaestheteg ac Arweinydd Clinigol Trawma Mawr Bwrdd Iechyd Prifysgol Hywel Dda: “Mae cleifion de a gorllewin Cymru dan anfantais o gymharu â gweddill y DU gan eu bod yn byw yn yr unig ranbarth lle nad oes Rhwydwaith Trawma Mawr. Mae’n hanfodol bod Hywel Dda yn medru cyfrannu’n effeithiol tuag at y rhwydwaith. Agwedd allweddol o hyn yw sefydlu uned trawma weithredol. Bydd y cydlynu gwell o lwybrau gofal wrth reoli trawma mawr yn gwella canlyniadau cleifion a’u profiadau.”

Mae’r argymhellion yn mynd i’r afael â rhai o bryderon yr ymarfer ymgysylltu, er enghraifft trwy fuddsoddi mewn cymorth clinigol a gwasanaethau adsefydlu ychwanegol i gefnogi cleifion lleol. Cyflwynwyd barn amrywiol gan y cyhoedd ar leoliad yr Uned Trawma, ond Ysbyty Glangwili sy’n bodloni orau safonau Uned Trawma, sy’n cynnig nifer o fuddion. Nodwyd hefyd y bydd Ysbyty Bronglais, Aberystwyth ac Ysbyty llwynhelyg, Hwlffordd yn cefnogi Uned Trawma Ysbyty Glangwili, ac ni fyddant yn cael eu his-raddio o ganlyniad i’r datblygiad hyn. Bydd ysbytai Bronglais a Llwynhelyg yn parhau i dderbyn cleifion ag anafiadau trawmatig llai difrifol ac yn cadw’r gallu i sefydlogi a throsglwyddo cleifion sy’n dioddef trawma cymedrol neu ddifrifol naill ai i’r Uned Trawma neu’r Ganolfan Trawma Mawr.

Meddai Karen Miles, Cyfarwyddwr Cynllunio, Perfformiad, Gwybodeg a Chomisiynu: “Rydym yn ddiolchgar iawn i’n staff ac i’r cyhoedd sydd wedi cyfrannu i’r ymgysylltu ar trawma mawr yn ardal Hywel Dda. Bydd y bwrdd iechyd yn parhau i weithio ar lefel leol a chenedlaethol i ddatblygu’r rhwydwaith trawma mawr, bydd adborth o’r ymarfer ymgysylltu yn bwydo mewn i hyn a bydd yn cael ei adrodd i’r Bwrdd Iechyd.”

Bwriedir i’r Rhwydwaith Trawma Mawr fod yn weithredol o fis Ebrill 2020, ond bydd datblygiadau mewn camau ac yn barhaus yn ystod y pum mlynedd cyntaf. Bydd adnoddau adsefydlu lleol yn cael eu hadolygu ar ôl blwyddyn i asesu a oes angen mwy o staff a/neu ward bwrpasol ar gyfer trawma cymedrol.