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WELCOME MID-WALES HEALTH A DECENT HEALTH SERVICE FOR THE PEOPLE OF MID-WALES DELIVERED IN MID-WALES

WHERE ARE WE NOW? BRONGLAIS – From 2001 to 2007 Bronglais was amongst top 40 hospitals in UK - BUT Beds- 25% cut 2007 to 2012 LACK OF STAFF- Hospital closures De-skilling of staff- Afallon Ward closure Lack of facilities- Reduction of front of house Lack of theatre capacity

Health Board Strategy? Disinvestment in secondary care to provide resources in Primary and Community Care. Note- There are proposed service enhancement plans for other hospitals in HDdHB area. Where is evidence of coherent plan for all Bronglais patient catchment area Board

Health Board Strategy? Where is the evidence of investment in Primary Community Care? GP’s already at capacity. A different strategy is required which builds up services in Bronglais to use as community resources.

Community Hospitals Loss of community beds in Ceredigion not matched by investment in other services. Is closure of Community Hospitals consistent with Health Board Plans to provide more health care in the community? Current capacity must be maintained until there is strong evidence of alternative community services

MID-WALES HEALTH BRONGLAIS HOSPITAL Women and Children services SERVICE HAS CHANGED WITHOUT CONSULTATION (2008 RCOG REPORT). SKILLS MUST BE HERE FOR SAFE DELIVERY OF BABIES IN MID WALES. PAEDIATRICS MUST SUPPORT MATERNITY. CONSULTANT DELIVERED SERVICE. There is a need for inpatient theatre capacity.

MID-WALES HEALTH BRONGLAIS HOSPITAL EMERGENCY CARE “GOLDEN HOUR” argument still applies. CAPABILITY TO DEAL WITH ALLCOMERS, NOT A STAGING (DELAYING?) POST. PROPERLY RESOURCED AND STAFFED. NEED THEATRE CAPACITY (CEPOD).

MID-WALES HEALTH BRONGLAIS HOSPITAL Planned Care GENERAL AND ORTHOPAEDIC SURGERY TO BE DEVELOPED, SUPPORTED BY: APPROPRIATE SUPPORT SERVICES BEDS THEATRES FACILITIES

MID-WALES HEALTH BRONGLAIS HOSPTAL MENTAL HEALTH SERVICES CLOSURE OF AFALLON ! THERE IS A REQUIREMENT FOR AN IN-PATIENT FACILITY IN MID WALES. EXACT LOCATION TO BE DEBATED.

MID-WALES HEALTH BRONGLAIS HOSPITAL NEEDS TO BE THE REGIONAL DGH PROPERLY RESOURCED COMPETENT LOCAL MANAGEMENT GOOD LINKS TO TERTIARY CENTRES HUB FOR SEAMLESS RURAL SERVICE

CURRENT CONSULTATION HYWEL DDA PLEASE USE COMMENTS BOXES ON CONSULTATION QUESTIONAIRES COMMUNITY HOSPITALS - MAINTAIN CAPACITY UNTIL EVIDENCE OF ALTERNATIVE COMMUNITY SERVICES IS SHOWN LEVEL 2 NEONATAL UNIT - PROVIDE & DEVELOP MATERNITY / PAEDIATRICS SKILLS IN BRONGLAIS. TO ENSURE SAFETY OF MOTHER AND BABY. OBSTETRIC / PAEDIATRIC SERVICE TO BE CONSULTANT DELIVERED. EMERGENCY CARE - SUPPORT OPTION B AND DEMAND BACKUP WITHIN BRONGLAIS. PLANNED CARE - MAINTAIN SKILLS AND CRITICAL MASS IN BRONGLAIS. USE FURTHER COMMENTS BOXES TO DEMAND A MID WALES HEALTH CARE STRATEGY WRITE TO MINISTER

CURRENT CONSULTATION BETSI CADWALADR QUESTIONNAIRE DOES NOT ALLOW COMMENT ON OUR ISSUES- WRITE TO HEALTH BOARD AND ORS Opinion Research Services The Strand SWANSEA SA1 1AF WRITE TO MINISTER

CURRENT CONSULTATION POWYS LHB NOT CONSULTING THIS PART OF WALES WRITE TO CHIEF EXECUTIVE AND MINISTER

CURRENT CONSULTATION CLOSING DATES FOR CONSULTATION BETSI CADWALADR- 28TH OCT HYWEL DDA-29TH OCT POWYS LHB- SUGGEST SAME TIME VOLUME OF REPLIES SEEM IMPORTANT

Presentation by Dr W J C Roberts

UK Health Board Strategies Concentration of services into larger hospital units In provision of peripheral services

Drivers Saving Money / Cost Cutting Saving Money / Cost Cutting Royal College Protocols Post Graduate Deanery Specialist Training Post Graduate Deanery Specialist Training

Effects in Wales Concentration of specialist services into large hospitals along M4 and A55 corridors. Generalised reduction or withdrawal of peripheral services in Mid-Wales. A large hole in service provision in Mid Wales.

Hywel Dda HB recent behaviours Some increase in service provision in the North. Community services- Cutting continues. Associated “nightmare” responses – some planned- some not.. Against the background of social care- Funding and social service provision

What should have / be happening? The “Hole in the Middle” problem= 300,000+ population= 1/8 of Welsh population. Needs assessment Health Plan- with emphasis on “Bringing secondary care closer to the people” Impact assessment- Duty of care is a legal obligation.

What should the plan contain / do? Drop all plans to demand more of community and GP services. Push secondary care outwards. BY- Increasing patient contact close to home. Use of mobile equipment. Prioritise close to home investigations. Access to 24 / 7 specialist opinion

What should the plan contain / do? (2) Integrate primary and secondary care along with social care. Available skills Make explicit- Manpower Plans Education

What should the plan contain / do? (3) Stop / Keep all community hospital beds- including full mental health provision. Resurrect full obstetric care at Bronglais Hospital Resurrect full Neo-Natal unit at Bronglais Hospital Ensure Full Emergency care and backup at Bronglais Hospital. Ensure that planned care provision be fully resourced at Bronglais Hospital.

How do We / You make it happen? Push / promote “aBer Group’s List”! Enable clinical freedom. Demand seamless care here in Mid Wales. AND EVERYONE PLEASE RESPOND !!!

Proposed Motions Despite assurance from the Minister that she would instruct the Health Boards of Betsi Cadwaladr, Powys and Hywel Dda to work together to produce and enact a strategic health plan for Mid-Wales, the Boards have not done so. This meeting now calls upon the Minister:- 1)to re-arrange the territories, responsibilities and the resources of these three Boards in such a way as to create an authority solely responsible for the health care of the people of Mid-Wales; 2)to ensure that Bronglais hospital, within such an authority, be developed and resourced as a stand-alone provider of secondary care for the people in the West of mid-Wales, obviating the need to travel to the A55 or M4 corridors other than for tertiary care.

Cynigion ar gyfer ystyriaeth cyhoeddus yng nghyfarfod y Grŵp Aber ddydd Gwener 19 Hydref Er gwaethaf ein sicrhau gan y Gweinidog y byddai'n gorchymun Byrddau Iechyd Betsi Cadwaladr, Powys a Hywel Dda i gydweithio i gynhyrchu cynllun iechyd strategol ar gyfer y Canolbarth a’i ddod i fodolaeth, nid yw’r Byrddau wedi gwneud hynny. Mae'r cyfarfod hwn yn awr yn galw ar y Gweinidog: - 1) i ail-drefnu y tiriogaethau, cyfrifoldebau ac adnoddau y tri Bwrdd yn y fath fodd ag i greu Awdurdod sy'n gwbwl gyfrifol am ofal iechyd i bobl Canolbarth Cymru; 2) i sicrhau bod ysbyty Bronglais, mewn Awdurdod o'r fath, wedi ei ddatblygu a'i adnoddi i rhoi gofal ysbyty ar gyfer y bobl yng Ngorllewin Canolbarth Cymru, gan arbed yr angen i deithio i goridorau A55 neu'r M4 heblaw ar gyfer gofal trydyddol.

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