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Issue 3: June 2013

Your

Healthcare Keeping you up to date with what’s happening across Merthyr Tydfil and Rhondda Cynon Taf

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Chief Executive’s note Welcome to our third edition of Your Healthcare - our e-newsletter which will help you stay in touch with all the changes and developments to healthcare services across Merthyr Tydfil and Rhondda Cynon Taf. Please share it with your friends and family who might want to keep up with our news. Don’t forget, to be sure you don’t miss out on future editions please register your details here to get your very own copy direct to your inbox. I hope that you find our e-newsletter useful and interesting and if you have any ideas for future editions please email our communications team. Thanks Allison Chief Executive Cwm Taf Health Board

Useful contacts Royal Glamorgan Hospital: Hospital 01443 443 443 Prince Charles Hospital: Hospital 01685 721 721 Ysbyty Cwm Cynon: Cynon 01443 715 211 Ysbyty Cwm Rhondda: Rhondda 01443 430 022 Ysbyty Cwm Rhondda Minor Injuries - Phone First: First 01443 444 075 Dewi Sant Hospital: Hospital 01443 486 222 Ysbyty George Thomas: Thomas 01443 430 022 Y Bwthyn: Bwthyn 01443 443 758 Keir Hardie Health Park: Park 01685 351 021 www.cwmtafhb.wales.nhs.uk Follow us on twitter https://twitter.com/CwmTaf @cwmtaf


CONTENTS South Wales Programme - consulting on four options for the future of four hospital services

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What’s your technique? Patients to be offered free training to use their inhalers

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“Team Wales” project nominated for Health Service Journal award

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Phone first for faster treatment

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Alan Williams, a Rotarian for 20 years, is asking his local community; “Have you got a bottle?” New strategy launched to ensure carers get appropriate information and advice Cwm Taf Health Board shorlisted for construction excellence awards

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Missed issue 2? Read it here

Cwm Taf hospitals map Use our interactive map for more information about our hospitals


South Wales Programme consulting on four options for the future of four hospital services provide these four services has yet been decided but, based on the evidence the health boards have looked at in preparation for consultation, it appears that the “best fit” option for the populations of South Wales and South Powys, is to provide these services at University Hospital of Wales, Cardiff; Morriston Hospital, Swansea; the new Specialist and Critical Care Centre, which will be built near Cwmbran and will provide specialist services currently based at Nevill Hall Hospital, in Abergavenny and Royal Gwent Hospital, in Newport; Prince Charles Hospital, in Merthyr Tydfil and Princess of Wales Hospital, in Bridgend.

Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff and Vale, Cwm Taf and Powys health boards are consulting on four options for the future of four hospital services – consultant-led maternity and neonatal care, inpatient paediatrics and emergency medicine (A&E) for the most seriously in-

vided, by concentrating them in fewer hospitals, there is a very real risk some will collapse and health boards will have to take individual, urgent action to protect patient safety.

jured and sick patients.

A&E department will close as a result of these changes, but they will offer different levels of care – just as they do now. Local emergency care will continue to be available in all hospitals but care for those patients who have serious or life-threatening injuries who need to see a highly-skilled emergency medicine doctor, will be concentrated in four or five hospitals. These patients will usually be taken directly to hospital by ambulance.

The purpose of consultation is to share the options and this evidence with the public and NHS staff for scrutiny and comment. The final decision will be based on this evidence and further evidence to emerge from the consultation, which runs until July 19, but it must provide better clinical outcomes for all patients. All the evidence we have used to develop the options for consultation is available at: www.wales.nhs.uk/swp

No decisions about which four or five hospitals will

A recurring question raised at the well-attended public

We can no longer continue providing these services in all hospitals as we do not have the senior doctors we need to provide round-the -clock care – the way services are currently provided on all sites mean they are not meeting national clinical standards and it can be something of a lottery whether a senior doctor with the appropriate skills is available when a patient comes in, especially at night or the weekend. If we do not change the way these services are pro-

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In respect of A&E, we have been very clear that no


meetings held to date is about how the responses to the South Wales Programme consultation will be analysed after July 19. All the responses to the consultation are being analysed by the independent company Opinion Research Services (ORS). This analysis will be shared with the five health boards— Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff and Vale, Cwm Taf and Powys— and with the five community health councils. A statement from ORS says: “Consultation should promote accountability: public bodies should give an account of their plans or proposals and they should ensure that all responses are taken into account in order to: · Inform decision-makers of any issues, viewpoints, implications or options that might have been overlooked; · Contribute to the reevaluation of matters already known; · Encourage priorities and principles to be critically reviewed where appropriate. Nevertheless, consultations are not referenda; and influencing public policy through consultation is not simply a ‘numbers game’ or ‘popularity contest’ in which the loudest voices or the greatest numbers automatically determine the outcome. Interpreting the

overall meaning and implications of consultations is neither straightforward nor just ‘numerical’, for all the various consultation methods have to be assessed: they cannot be simply summated because they

are different types of responses. All aspects of consultations are important – for example: the open questionnaire and household survey responses; public and staff

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meetings; forums and focus groups; and submissions and petitions. All of them should be taken into account. In this context, ORS' independent analysis and report will highlight contributions that are: · Well-evidenced – for example, submissions from professional bodies, staff and concerned people or local groups; · Deliberative – based on thoughtful discussion in public meetings and other group settings; · Representative of the general population; · Focused on the views of under-represented people or equality groups. ORS will identify where strength of feelings may be particularly intense while recognising that consultation is not a matter of ‘counting heads’. ORS will classify written submissions by type of organisa-

tion/person and will report the full range of opinions clearly; a cross-section of submissions will also be summarised in detail to make their viewpoints widely accessible and to highlight alternative proposals; and no submissions will be disregarded because they are not ‘formally’ expressed. Petitions are legitimate and important expressions of opinion and will be given due consideration both by ORS and the health boards. In interpreting and reporting them, ORS will take account of the ‘petition statements', the numbers of people signing, and the ways in which they were compiled. We shall report the open consultation questionnaire and the household survey in parallel, while suggesting that the reliance to be placed on each of them should depend on how

representative they are of the general population. While ORS will present the findings in a detailed evidence-based report, there can be no single ‘right interpretation’ of all the consultation elements. Within health boards, professional and board member judgment will be needed to assess the consultation outcomes, and the community health councils will respond to their respective boards and may make alternative proposals. Both the health boards and the CHCs will need to consider the consultation findings in the context of all the relevant evidence. Ultimately, the final decision will require both the executive and independent members of the health boards to assess the merits of the various options as the basis for public policy.”

What’s your technique? Patients to be offered free training to use their inhalers Community pharmacists and GP practice nurses across Cwm Taf Health Board are offering patients free inhaler technique training to improve control over their illness. Many people who are prescribed an inhaler to help control their lung or respiratory problem are not us6

ing them properly - studies have shown up to 90% patients have poor inhaler technique. Poor inhaler technique can mean patients do not get the right dose of the medicines they need to relieve the symptoms of longterm diseases, such as asthma or chronic obstruc-

tive pulmonary (COPD).

disease

All community pharmacists and practice nurses working in Merthyr Tydfil and Rhondda Cynon Taf have been offered training so they can assess and correct people’s inhaler technique.


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Dr Amit Benjamin, a consultant physician at Royal Glamorgan Hospital, who has been involved in the inhaler project, said: “Studies have shown that if people are not using their inhalers properly, because their technique is poor, their disease will not be well controlled. “But if people are using them properly, with the correct technique, their outcomes are better and their disease is better controlled.”

vide medicine in a fine aerosol and it is important patients adopt a soft and gentle technique to ensure it works. Dry powder inhalers, which are typically round in shape, deliver a dose of medicine combined to a sugar particle. The best technique for using these inhalers is hard and fast. Approximately 5.2 million people in the UK suffer from asthma, and many of these people use medicine delivered through an inhaler.

Inhalers are used for two main lung and respiratory conditions – asthma and COPD – to help open up the airways. There are two main types: the metereddose inhaler and dry powder inhalers.

One asthma sufferer who lives in the area, said: “I have been asthmatic for a number of years, and am periodically called by my practice nurse for an asthma review.

Metered dose inhalers pro-

“At my last review I was

asked if I could demonstrate how I used my inhaler each day. I was quite surprised to learn that I had been inhaling too quickly and for too short a time. “My practice nurse talked me through why it was important to inhale at an intensity and speed that allowed my inhaler to best reach all the areas of my lungs. “I practised a few times until we were both happy that I had improved my technique. I’ve since noticed a real improvement in my asthma control as a result, with hardly any need to use my blue inhaler during the day. I’ve also noticed that I now rarely cough or wheeze.” To support the campaign to improve inhaler tech7


nique across Cwm Taf, a short bilingual video has been made demonstrating the different ways of using the two main types of inhalers and posters will be on display in GP practices and in high street community pharmacies.

macist at Cwm Taf Health Board, said: “Work carried out in other parts of the country has shown that helping patients with their inhaler technique can reduce hospital admissions and help patients manage their condition more effectively.”

The Cwm Taf inhaler training programme is a joint project between Cwm Taf Health Board and GlaxoSmithKline – both organisations have pooled experience and resources with an equal commitment to the successful delivery of patient-centred outcomes.

Brian Hawkins, chief phar-

“Team Wales” project nominated for

Health Service Journal award financial year as a result of the collaborative project.

A UNIQUE “Team Wales” approach to improving quality in secure mental health services has been shortlisted for a prestigious Health Service Journal award. Julian Baker, from Cwm Taf Health Board, Shane Mills, at Powys Teaching Health Board and Nic Cowley, from NHS Wales Shared Services Partnership, have been nominated for the HSJ Efficiency Awards 2013 for their work on the NHS Wales Secure Services Collaborative Procurement Project. The project brings together

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health boards to commission specialist secure services under a single national framework. Clinical and non-clinical staff have worked together on the project, which also includes agreed Welsh specifications and quality outcomes, monitored by a new allWales performance, quality and case management team. It has improved the quality of low and medium secure mental health services for patients in Wales, while also making £4.7m of savings for NHS Wales in 2012 -13. A further saving of £1.5m is expected in this

An independent review of the work by NHS Tayside Centre for Organisational Effectiveness described the first phase of the project as an “outstanding success”, adding: “The success of the Team Wales approach should be shared on a wider basis to help support service redesign in other clinical domains.” Allison Williams, chief executive of Cwm Taf Health Board and the lead chief executive for the Welsh Health Specialised Services Committee (WHSSC), said: “This nomination is well deserved and recognises a unique collaborative project which is improving quality for patients and delivering value for money for NHS Wales. “I am delighted the collaboration has successfully delivered both improved quality and financial savings and I am looking for-


ward to ensuring the success and lessons from this project are applied to additional independent care sector settings which provide health services to Welsh patients.” The collaborative NHS Wales project was supported by a £169,000 Invest to Save grant from the Welsh Government. An all-Wales delivery group, chaired by Karen Howell (Hywel Dda Health Board),

ensures independent care providers are delivering quality care against key performance indicators and are being proactively performance managed. A second phase, also backed by Invest to Save funding, will see the project extended to cover all adult mental health and learning disability independent hospital services. The project’s nomination

for an HSJ Efficiency Award follows its success in winning the GO/John F McClelland Collaborative Procurement Initiative of the Year Award - Health and Social Care Organisations and Welsh National Procurement’s Outstanding Procurement Leadership Award. The winners of the HSJ Efficiency Awards will be announced on September 25.

Phone First for faster treatment “We are all experienced practitioners and are able to deal with any minor injury – from removing foreign bodies, putting in stitches to relocating dislocated fingers and toes.”

PATIENTS are receiving faster care without waiting by calling ahead for an appointment when they have suffered a minor injury. Hundreds of patients have phoned first for an appointment at the minor injuries treatment centre at Ysbyty Cwm Rhondda in the since the Phone First service was launched in 2012. Waiting times have been cut to just minutes for

these patients, who are seen by experienced nurses at the minor injuries treatment centre. Sue Davies, an emergency nurse practitioner in the minor injuries treatment centre at Ysbyty Cwm Rhondda , said: “When patients phone first they are given a time to come in so they aren’t hanging about. There are no waiting times – once they arrive for their appointment they are seen more or less immediately.

Lynda Williams, Cwm Taf Health Board’s director of nursing, said: “We are keen to fast-track patients to the correct treatment – Phone First supports the patient to get help in the right place. “Phone First enables us to arrange a suitable time for the patient to be seen in the unit by highly-skilled nurses, providing a first class minor injuries service.” The Phone First number is:

01443 444 075. 075

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“Have you got a bottle?� This is what Alan Williams, a Rotarian for 20 years, is asking his local community. a green cross and emergency written across the front. It contains a form for people to write all their information which can include medical and personal information as well as next of kin and any other information they believe should be shared should they be unable to communicate in the event of an emergency at home.

Aberdare Rotary Club funds the Message in a Bottle scheme, which ensures a person's vital medical information is stored in one place - usually the fridge - and can be accessed by paramedics, police and social services in the event of an emergency. Mr Williams, who recently retired and handed the reigns over to his daughter from the riding school in Dare Valley country Park, Aberdare, is married with 2 children and 3 grandchildren, said: "I see lots of people in the community in my role as a Rotarian and the riding school sees more than 60 children and adults with a disability so I know how important it is to have relevant medical information at your fingertips." Message in a Bottle is a small plastic container with

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The container is widely recognised with all emergency services including ambulance, police, fire, social services. The scheme was initially launched as a nationwide campaign in 2007 in a bid to save lives thousands of the small bottles have been distributed. Chris Moore, Clinical Support Lead Manager for the Welsh Ambulance Service commented: "The information in the bottles can mean the difference between life and death. When a paramedic, or other health professional, gets to the scene it's vital they know as much information as possible about the patient - medical history, allergies, medication, operations crucial details which can save time and ultimately save a life. The more people who have the 'Message in a Bottle' in their homes, the better".

The container should be kept in the fridge door, as the majority of people have a fridge at home and it is easily found. In the container there are two green emergency stickers which can be displayed where its visible to alert emergency services that it is in their fridge. Mr Williams said: "Someone once suggested that it would be useful to write other relevant information on the form such as, 'I have a pet canary which is kept in the other room. Please look after it.'" He added: "I believe there are still a lot of people that don't know about this scheme and I believe it can save lives. If you have a medical condition that emergency services should be made aware of why not keep one of these bottles in the glove box of your car".


New strategy launched to ensure carers get appropriate information and advice

A NEW strategy to support carers in Merthyr Tydfil and Rhondda Cynon Taf has been launched today. The Carers Measure Information and Consultation Strategy sets out the support carers can expect from the NHS and local councils Census figures from 2011 show that in Merthyr Tydfil there were 7,427 carers whilst in Rhondda Cynon Taf the figure was 29,640. Of the 37,067 carers across the Cwm Taf area, 11,752 carers were providing over 50 hours of care per week. This represents a sharp increase in the number of hours since the 2001 census. With an aging population these figures are expected to increase further over the next 10 years. There are also many young carers across the Cwm Taf

area. In 2012 the number of known young carers – those under the age of 18 years – was 77 in Merthyr Tydfil and 231 in Rhondda Cynon Taf respectively. The real number of young carers however is suggested to be higher. Maria Thomas, nonexecutive board carers champion at Cwm Taf Health Board, said: “Carers play a vital role in the provision of care and make an enormous contribution to supporting people in the community. It is a very demanding role and we are committed to ensuring they are supported. “Today isn’t just about launching a strategy; it’s about making sure the needs of carers are met.” The launch event at Garth Olwg Lifelong Learning Centre in Church Village also hosted a short play “Who cares for the carer” which was performed by local carers and Spectacle Theatre Production. One of the carers who performed in the play, said: “I’ve been a carer for 11 years. My son who is now a young adult is bipolar and extremely unwell. “I’m fortunate to have a very understanding employer so I can work flexibly but I know lots of other carers who aren’t so lucky. “Being a carer is incredibly stressful. As soon as my

son wakes he is very very dependant on me emotionally. It can be extremely difficult to cope sometimes. “A lot of the time, carers just need to know how they can access advice and support. “I can’t begin to imagine how difficult it is for some of the younger carers.” Speaking on behalf of Merthyr Tydfil and Rhondda Cynon Taf councils, Ellis Williams, director of Social Services at Rhondda Cynon Taf Council, said: “I feel very humbled by what I’ve seen in the short play today – it’s helped us recognise and value the hard work of carers, in particular that of young carers. “I’m delighted that we are launching this strategy today which will help us ensure we are giving carers the advice and support they need.” Keith Bowen, director of Carers Wales, said: “Today - and all the work leading up to it - is a really good example of health and social services working together to help improve things for carers. “Carers need to know what help and support is available to them and the launch of this strategy will help achieve that.”

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Cwm Taf Health Board shorlisted for

construction excellence awards

In conjunction with the construction firm Laing O'Rourke two of Cwm Taf Health Boards major capital schemes recently completed have been nominated and shortlisted in various categories of the Constructing Excellence in Wales awards. Both the Keir Hardie Health Park and the Emergency Care Centre at Prince Charles Hospital have made a final shortlist of schemes across Wales for "Project of the Year". These awards are open to all major construction projects and former winners include the duelling of the Heads of Valleys. In addition both the above schemes are also shortlisted in specific design and efficiency categories of the 12

awards, namely: ECC Value Award and KHHP Innovation Award and the Sustainability Award . Allison Williams, chief executive of Cwm Taf Health Board, said: “There is a huge amount of evidence to demonstrate that the environment of care has a direct bearing on the wellbeing of staff and patients. Over the past few years in Cwm Taf we have had massive investment in new facilities and have taken the opportunity, working with architects and construction partners, to get the very best of modern buildings for our communities. “The fact that this work has been recognised in being shortlisted for “Constructing Excellence in Wales Awards” is fantastic recognition of what can be

done when we all work together for the benefit of patients. I congratulate the team for getting this far and am keeping everything crossed for taking home the awards!” The short listing process has involved written submissions, presentations and a formal question and answer session. The winners will be announced shortly at an awards event being held on July 5th.


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Your healthcare issue 03