Hywel Dda Health Board: Health Board takes actions to protect health and care provision for most critically ill

Health and care services across West Wales are responding to the impacts of the Omicron variant of COVID-19 in order to provide emergency and urgent care for patients in the safest way possible during the coming weeks.

Hywel Dda University Health Board is taking a number of actions today, and appealing for the continued support of our staff and communities to keep Hywel Dda safe as we face this new phase of the pandemic.

Actions are being taken in a planned way due to the high demand we are seeing for non-COVID care during this time of the year, together with high incidence of COVID-19 in our area, like the rest of the UK.

This is starting to result in higher numbers of COVID admissions and incidences in our hospitals and communities.  

It is also having a direct impact on our staffing levels across primary care, community and hospital services.  We currently estimate that at least 10 per cent of our workforce is absent for both COVID and non-COVID related reasons.  This figure is higher in some teams and we expect it to rise in the coming weeks. We need to plan how we deliver the most critical clinical services with the staff we have available. 

Actions being taken include:

• The health board is providing and reminding staff of the services available to them internally to support them at this difficult time. It is standing down some less urgent work in order to redeploy staff where possible.
• To maintain delivery of the most urgent cancer surgery in the short term, this will be undertaken for the Hywel Dda population from Prince Philip Hospital, in Llanelli, with the exception of Head and Neck urgent cancer surgery, which will continue at Glangwili General Hospital, in Carmarthen.. Our clinicians believe that concentrating the majority of our urgent care resources onto one site during the next few weeks is the best way to protect the delivery of this potentially life-saving surgery. This position will be continually reviewed and we will seek to re-establish urgent cancer surgery at our other main hospitals as soon as we can do so safely. We ask patients and families to support us and travel for their surgery. If you have no means to travel for your surgery, then please contact us on our COVID enquiries line on  0300 303 8322 or email COVIDEnquiries.hdd@wales.nhs.uk 
• Outpatient & therapy appointments and clinics will be prioritised for the most urgent patients over the next few weeks. With the exception of a small number of emergency cases and some children’s appointments, we will reschedule outpatient appointments next week.  Patients will be re-booked according to clinical urgency in subsequent weeks. Unless you are contacted directly by the health board, please attend any appointment as scheduled. If anyone has concerns about the delay in their outpatient appointment, as a result of this short term measure, they can contact the health board on 0300 303 8322 or email COVIDEnquiries.hdd@wales.nhs.uk 

Director of Operations Andrew Carruthers said: “The whole of the UK is facing challenge from Omicron and the indirect impact on staffing. This is affecting us in Hywel Dda UHB across all our services whether in the community, primary care or hospitals, but to different degrees and is a very fluid situation. To ensure the delivery of care for the most critically unwell, and to ensure we protect the ability of our staff to provide this care, we have put in place actions that will provide some extra capacity. We apologise to anyone affected adversely by these actions and it remains our ambition, always, to re-establish our planned care services as soon as we are able to, knowing the impact this has on people’s lives.”

Director of Nursing, Quality and Patient Experience Mandy Rayani added: “We are so grateful to our staff who continue to work in difficult circumstances, always driven by the desire to provide the best care possible to our population. We are asking our staff to be vigilant about the behaviours we know reduce transmission of COVID-19 at work and at home; and our public can also play a significant role in supporting the NHS and each other by also adhering to these principles. Unfortunately we are seeing more abuse targeted at our staff and we will not tolerate this. Health and care staff – from the clinicians to the support teams and call handlers in primary, community and hospital teams – provide a service to help our patients and communities and they should never be the victims of abuse, physical or verbal. Please help us to help you.”

Steps you can take to protect more lives, our NHS and each other include:

• Get your full course of vaccination https://hduhb.nhs.wales/healthcare/covid-19-information/covid-19-vaccination-programme/
• Follow Welsh Government guidance on self-isolation and testing, including carrying out regular LFDs (health and care staff have specific and different guidance internally)
• Wear face coverings, or if asked in a health setting, a surgical face mask
• Keep a 2meter distance from others when you can
• Wash hands regularly and be ready to be asked by a healthcare professional to wash hands or sanitise whether in hospital or your own home
• Do not accompany people to hospital, GP surgery, or another setting unless they are vulnerable and need your assistance
• Please be aware that your GP surgery may offer you appointments in different ways where appropriate, such as over the telephone or online. Please allow extra time when ordering prescriptions during this busy time. Community pharmacies are also extremely busy so you may need to wait longer than usual.
• Pre-arrange hospital visiting with the ward sister and be understanding if it is not possible at this time due to safety

The health board continues to work closely with others including the Welsh Ambulance Service NHS Trust, local authorities and other partners to work together in these challenging times.

If you or a loved one is unwell, remember:

• There is support to care for yourself when appropriate, for example at https://111.wales.nhs.uk/livewell/caringforyourself/ and through the online symptom checker. Our community pharmacists can provide some walk-in care, and treatments for common ailments, find your nearest service here: https://hduhb.nhs.wales/healthcare/services-and-teams/pharmacy/; as well as our minor injury units: https://hduhb.nhs.wales/healthcare/hospitals-and-centres/minor-injuries-units/
• If you have a serious, life threatening emergency please continue to call 999.
• If it’s urgent (but not an emergency), visit the NHS111 Wales symptom checker, dial 111, or seek urgent care through your GP.
• If you have a relative or loved one in hospital who is medically fit but is waiting to be discharged, you may be able to help us by providing short term care or considering interim placements in care homes.