To receive representatives from Cwm Taf Morgannwg University Health Board, providing Members with an update in respect of Covid recovery, elective recovery programme, Maternity Services and other key work of the Board.
Minutes:
The Chairman of the Cwm Taf Morgannwg University Health Board, Mr Emrys Elias introduced himself and four members of the Executive team, Mr P Mears, Chief Executive, Dr Kelechi Noaham, Director of Public Health, Mr Greg Dix, Director of Nursing and Mr Gareth Robinson, Chief Operating Officer.
Through the aid of Power point slides the Chief Executive of the Cwm Taf University Health Board., Mr Paul Mears, presented an overview of key matters under the following headings:
In addition to the matters included on the Power Point presentation, the Chief Executive advised on the current hospital visiting arrangements across all the hospital services which have been implemented in line with the National Guidance. He added that there is a red, amber and green status for visiting, currently the Cwm Taf University Health Board is adhering to the red status with restricted visiting although that is currently being reviewed as the transmission rates within the hospital reduce. From a maternity perspective, visiting has continued with birth partners attending dating scans although visiting to post-natal wards has been restricted to mitigate transmission from external visitors to new mothers and babies.
The Chief Operating Officer also provided an update on the minor injury unit at Ysbyty Cwm Cynon which has experienced a sustainability issue as two of the four nursing staff are currently on long-term sick, therefore the service has been consolidated into Prince Charles Hospital so it can operate more effectively and consistently. It is hoped the unit will re-open in the New year when the staff will resume their duties.
The Leader of the Council thanked members of the Cwm Taf Morgannwg University Health Board for their presentation and for their close working relationship with the local authority throughout covid-19 particularly within the social care sector which is under huge pressure. The Leader acknowledged the good will of everyone despite the short-term staff shortages and the difficulties experienced at the moment.
The Leader referred to the latest report from the Independent Maternity Oversight Panel which found major failings in over 20 cases and stated that he felt vindicated about speaking up at the time and felt he had been lied to with regards to the failings regarding those cases where a different outcome could have been achieved had it not been for the staff shortages and failures to report serious incidents.The Leader sought confirmation as to whether all the recommendations raised as a result of the review had been addressed. He commended the current leadership and executive team at the Cwm Taf University Health Board for the actions they have undertaken to address the issues.
The Chief Executive of the Cwm Taf UHB confirmed that the immediate ‘make safe’s’ have all been actioned and he advised that the Independent Maternity Oversight Panel had been commissioned directly by the Cwm Taf UHB as they felt that the neonatal services were not functioning at the required level. He added that following the review there have been improvements to the clinical practice as there is now a full-time Pharmacist in place at Prince Charles Hospital to prescribe and support the neonatal unit and importantly there are better established links with the specialist centres in Cardiff and Swansea so that consultants and neonatal nurses can access specialist expertise and receive training and develop the necessary skills. Other recommendations will take longer to implement.
Councillor P Jarman asked the following questions:
-Initially, South Wales Police had taken an interest in the Maternity Services, is this still the case and is there is any indication that the neonatal services will be removed from Special measures?
-Can you clarify the situation with A&E in Prince Charles as it doesn’t appear to be coping well with waiting times or the availability of beds?
The Chief Executive responded that the initial referral to South Wales Police had not been progressed. He acknowledged that some of the challenges at Prince Charles Hospital are due to the layout within the department and because of the flow of patients waiting for follow on placements to care homes or in other cases, palliative care, which is being reviewed, to free up space within the hospital. He advised that staff are working very hard with recent input from with guidance and advice from Health Inspectorate Wales (HIW) but in the absence of a quick solution, the teams are trying to make the patient experience as good as it can be.
Other questions were asked as follows:
-How are Elective Surgery lists managed and are consultants being listened to?
-It was suggested that GP Practices in Aberdare are advising patients to go directly to A&E in Prince Charles Hospital as there are no appointments available within the GP practices.
-What steps are being taken to deliver vaccinations to vulnerable young people with autism or learning difficulties? Some of the experiences to date have not been satisfactory.
-There has been a recent BBC news story about 2,000 patients dying in hospital after catching the virus, what is the situation in Cwm Taf Morgannwg University Health Board?
The Chief Executive of the Cwm Taf UHB advised that he would address the specific case about the GP Practice in Aberdare following the meeting and ensure a response is forthcoming to the individual Councillor, although he acknowledged the pressure that GP’s are under at this time as they struggle to keep up with the demand. He responded to the issue of young people with autism/learning difficulties attending the vaccination centres and advised that communication has been circulated to ensure that arrangements are in place which are sensitive to the young people’s needs, such as a separate room to administer the vaccine. He added that arrangements are now in place to ensure their experience is a satisfactory one.
In response to the national figures released regarding the deaths linked to covid in hospitals and identifying if the deaths were due to community acquired infection or catching covid whilst in hospital, the Chief Executive of the Cwm Taf UHB advised that they are working closely with Welsh Government to establish the data and would be sharing the findings with the families concerned and with key partner organisations such as the local authority.
In response to orthopaedic waiting lists, the Chief Operating Officer advised that patients coming in through the emergency pathway are operating normally within usual timescales. The Orthopaedic Consultants at Prince Charles Hospital are front and centre of the response to the elective recovery programme up to and including looking to build the capacity for delivering orthopaedic surgery in other hospital sites which can expand and catch up on the orthopaedic backlog more quickly.
Further questions were asked:
-What are you doing to work in partnership with the GP Practices?
-Are younger people receiving treatment ahead of older patients?
- Can you advise whether the handover arrangements within Maternity Services has improved?
The Chief Executive of the Cwm Taf UHB explained that there is much closer working between GP’s and the Health Board but there is no immediate solution to the challenges that Primary Care colleagues are facing. He added that it is crucial that patients have access to their GP’s when they need it but there is room for the processes between hospital and GP to be more fluid. He recognised that there are also further ways in which the Health Board can remove some of the administrative elements of the GP’s work to ensure their clinical time is better used.
The Chief Executive of the Cwm Taf UHB confirmed that there is no strategy in place which means that younger patients are treated ahead of older patients, the treatments are based on time waited, age is not a factor. In conclusion, the Chief Executive advised that there are processes in place for reporting complaints and incidents relating to Maternity Services and there have been changes made to the handover processes.
The Leader of the Council expressed his gratitude to the representatives of the Cwm Taf Morgannwg University Health Board for attending and suggested that a return visit to Full Council would be arranged in the Spring next year to discuss elective surgery, Primary Care and the vaccine roll out.
Members were advised that any further questions should be addressed to the Cwm Taf University Health Board for a response.