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South Wales Programme
I’m not a carer am I?
Older people’s mental health
Au revoir Nick
Dangours of stockpiling
March 12 Keir Hardie University No Smoking Day Health Park
tion la s n a r t e g ngua la h ls e W r Fo his logo t e e s u o y ver click where
WE ARE A NO SMOKING HEALTH BOARD PLEASE DON’T SMOKE AT ANY OF OUR HOSPITALS
CONTENT
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SOUTH WALES PROGRAMME
STOCKPILING MEDICINES AT HOME COULD BE DANGEROUS PHARMACISTS WARN
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KEIR HARDIE UNIVERSITY HEALTH PARK
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I’M NOT A CARER AM I?
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REDESIGNING SERVICES TO IMPROVE OLDER PEOPLE’S MENTAL HEALTH
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HEALTH BOARD SAYS AU REVOIR TO NICK
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NO SMOKING DAY 12 MARCH
South Wales Programme In a message to staff in Cwm Taf University Health Board about the South Wales Programme, chief executive Allison Williams said:
“
Cwm Taf University Health Board held a special meeting in public at Llantrisant Leisure Centre on February 13 to discuss 10 recommendations from the South Wales Programme board about the outcome of the consultation. Almost 200 people attended the meeting – the majority were there to hear every last word. It feels like we’ve been working on and talking about the South Wales Programme forever; actually it’s been just over two years
complex set of recommendations, which we believe will allow us to work collaboratively, across health board boundaries, in a very different way in the future, which will ensure patients continue to have access to high-quality, local services. One of the key recommendations is the creation of three acute care alliances across the whole of South Wales (including Hywel Dda), which will ensure we have stronger mechanisms to support sustainable services in the longterm. These alliances will formalise and normalise the arrangements for clinicians to work together across
“We want to ensure we have very robust local services that ensure those who do need to go elsewhere are simply the people who will truly benefit from a more centralised model of service delivery.” since we started to look at the issues facing consultant-led maternity and neonatal care, inpatient children’s services and emergency medicine (A&E). In that time the NHS has moved on and so too have the challenges – the recommendations our board (and the other health boards) were asked to make a decision about reflect those changes. We weren’t being asked to make a choice – simple or otherwise between one option and another. Instead, we were considering a page 3
health board boundaries; they will share expertise and skills; patients will have access to local care but it will also mean that our sickest and most seriously-injured patients will increasingly be treated in specialist centres when they need that level of care. Prince Charles and Royal Glamorgan hospitals will be in the South Central Wales alliance with Princess of Wales Hospital, Llandough Hospital and University Hospital of Wales.
Like our neighbouring boards, we fully support this move towards the alliances. Our board believes we need to develop the alliances as swiftly as possible. The recommendation from South Wales Programme board said that option three – UHW, Morriston, SCCC, Prince Charles and Princess of Wales – should be the starting point for the transition to the alliances. As reported in the media, our board had difficulty with this element of the recommendation – not because we don’t accept the need for services to change in Royal Glamorgan Hospital but because there are a number of things we need to work through practically as part of the transition to the alliances. The recommendations in full – and the board’s decision against each – is available below. Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff and Vale and Powys health boards accepted all 10 recommendations as put forward by the South Wales Programme board. As you might imagine, there have been a lot of discussions going on since the special board meeting as we all try to find a way forward together, which delivers the best possible outcomes for patients and at the same time meets the needs of all our communities. There are inevitably going to be significant changes to the way in which the very sickest and most seriously-injured adults and children will be looked after in the future and this will mean that some of those services will not be delivered in Royal Glamorgan Hospital in the longer term. Our board fully accepts that as it will
mean outcomes for patients will ultimately be better. At the same time, however, we want to ensure we have very robust local services that ensure those who do need to go elsewhere are simply the people who will truly benefit from a more centralised model of service delivery. We are continuing to discuss the detail through the South Wales Programme board and I sincerely hope that very shortly we will be able to come to a position where everyone is in agreement. In the meantime, it is really important that you remember that when the music stops it is likely that all hospitals will be doing something different to what they do today – that isn’t something we should be fearful of. The same number of patients (if not more) will still need to be treated in South Wales; all of our hospitals will need to be fully utilised; and the skills of all our staff will be needed to deliver care. Many of you will have attended briefings I’ve done (particularly in Royal Glamorgan) over the past week and I’ve been overwhelmed by the can-do attitude I’ve seen everywhere. In Cwm Taf, we have some of the most clever, committed and innovative people anywhere in the NHS and I know that if we focus all that energy on creating the future - whatever that may look like - and not hanging on to a past that we know is not serving us well, we can achieve anything! Can I personally thank everyone who has been involved in the process thus far; we have come a long way and at the same time recog-
nise we still have even further to go on this journey of change and improvement. It’s not easy but it will be worth it when we truly achieve sustainable services and better outcomes for our patients.
”
The 10 recommendations from the South Wales Programme board are as follows:
ONE
New systems of care, which network hospitals and their services more firmly together, must be developed to strengthen the delivery of services across the whole of South Wales and South Powys. This will allow all the skills, expertise and facilities within that network to be maximised for the benefit of all patients. The Welsh Ambulance Services NHS Trust will be an important partner in the development and success of
the new arrangements, particularly in developing pre-hospital assessment and care and ensuring that when patients require hospital care they care conveyed to the most appropriate facility. Cwm Taf University Health Board supports this
TWO
Three such networks or alliances should be established for the wider South Wales area (including Hywel Dda) based around three “major acute” centres at Morriston Hospital, University Hospital of Wales and the Specialist and Critical Care Centre (SCCC) (when built). These alliances will need to develop new systems of governance to ensure that clinical and financial accountabilities are appropriately ascribed and that clinical services are safely delivered. It is recognised that there will need to be continuing engagement with stakeholders as page 4
these alliances develop. Cwm Taf University Health Board supports this
THREE
In recognition of the need to balance the risks (as articulated by, among others, the National Clinical Forum) associated with a greater number of centres providing these services with a clear public preference to maintain access in as many places as possible, it is recommended that the key services affected – consultant-led maternity and neonatal care, inpatient children’s services and emergency medicine (A&E) – should be located on five sites. Cwm Taf University Health Board supports this and believes a foursite contingency plan should also be prepared
FOUR
Following the engagement and consultation exercise, option three (UHW, Cardiff; Morriston Hospital, Swansea; SCCC, to be built near Cwmbran; Prince Charles Hospital, Merthyr Tydfil; Princess of Wales Hospital, Bridgend) is the recommended starting point for the transition to these three alliances. This represents the start of a process of closer joint working across health boards to deliver new models of care that create sustainable services in the longer term. In order to develop a transition and implementation plan, our planning assumptions include the following: Within an alliance, centred around UHW, Royal Glamorgan Hospital becomes a beacon site for developing a new and innovative model of acute medicine page 5
that maximises the opportunity of delivering the widest range of medical care in a hospital setting Royal Glamorgan Hospital will also develop a significant role in diagnostics and ambulatory care supporting a wider network of hospitals with a South Wales Central alliance and accelerate a different local delivery model for paediatric assessment services in Royal Glamorgan Hospital for the Rhondda and Taff Ely populations. The paediatric clinical reference group will be asked to lead this work Royal Glamorgan Hospital, Princess of Wales Hospital and Prince Charles Hospital (and their host health boards) will work closely together and with Cardiff and Vale University Health Board to ensure services for patients are appropriately staffed and developed in a safe and sustainable way. Cwm Taf University Health Board supports the move to three acute care alliances as quickly as possible. The board is convinced the better and more deliverable starting point for the alliances is for services to be jointly provided by Princess of Wales and Royal Glamorgan hospitals. Cwm Taf University Health Board supports the need for a transition and implementation plan. In any scenario, the board supports Royal Glamorgan Hospital becoming a beacon site for acute medicine and playing a significant role in diagnostics and ambulatory care. The board also supports partnership working, as outlined above.
FIVE
The South Wales Programme clinical reference groups will
be maintained and others will be established to ensure clinical leadership remains at the heart of service redesign. Cwm Taf University Health Board supports this
SIX
Where the evidence points clearly to improved outcomes for patients and where proper engagement has occurred to ensure a shared understanding of clinical benefits, the principle of clinical pathways determining location of treatment will be extended across other services. All current and future decisions made about service reconfiguration will be consistent with the alliance model and the joint arrangements that will be established to strengthen local service delivery. Cwm Taf University Health Board supports this
SEVEN
On the basis of operational and workforce requirements, some changes will need to be made urgently and certainly ahead of the development of any potential capital solutions, health boards and the Welsh Ambulance Services NHS Trust will work together to develop a transition and implementation plan that ensures continuity of service delivery during the transition to the networked arrangements. This transition and any urgent change required should be consistent with option three. Cwm Taf University Health Board recognises some changes may need to be made urgently and supports the principle of working together to develop a transition and implementation plan.
The board believes any urgent change should be consistent with the services being provided jointly by Princess of Wales and Royal Glamorgan hospitals in the context of the alliance.
EIGHT
The NHS in Wales will work with the Wales Deanery to align the allocation of trainees to the alliances so education can be optimised, delivering an effective blend of learning across the full range of health services. Cwm Taf University Health Board supports this
NINE
Health boards will work together urgently to collectively commission training providers to develop and deliver advanced practitioner roles locally to support the implementation of the new service models. Cwm Taf University Health Board supports this
TEN
Health boards and NHS trusts will work together to develop new systems that facilitate cross-organisational working for clinical staff while preserving clear lines of governance and accountability to employers. Cwm Taf University Health Board supports this.
Cwm Taf University Health Board will be holding public forum meetings in March to discuss the outcome of the South Wales Programme. Further details of these events will be available at www. cwmtafuhb.wales.nhs.uk
I’m not a carer am I? A NEW campaign to offer support to carers is being launched by Cwm Taf University Health Board together with Merthyr Tydfil and Rhondda Cynon Taff councils. The campaign will raise awareness of the reasons why people become carers but also why they may not think of themselves as carers – some see themselves as a parent, child, wife, partner or friend.
The 2011 Census showed there are 29,640 carers in Rhondda Cynon Taf and a further 7,427 in Merthyr Tydfil – more than 37,000 across Cwm Taf. A total of 11,752 carers in Cwm Taf provide more than 50 hours of care every week. This has increased by 9% in Merthyr Tydfil and 7% in Rhondda Cynon Taf since the 2001 Census. This shows that Cwm Taf carers are providing more substantial care, which can often impact on their health. The campaign will also raise awareness of the support and advice available to all carers. The type of support they may need may depend on their individual circumstances, for example, someone with a mental health problem may need emotional support, whereas someone who cares for a disabled or frail person
may need assistance with practical skills, hygiene or lifting skills. A young carer who looks after their parent, sibling or grandparent may need help and advice about continuing their education, training, employment or social development. Maria Thomas, Cwm Taf University Health Board’s carers champion and an independent board member, said: ”Carers often ignore their own needs, as they often put the person they care for first. This often prevents them from seeking professional help and support. “For this reason, we are looking to identify carers in order to provide them with appropriate and timely information, support and advice that can help them in their caring role.”
For more information about how you can get help, support or advice please contact: Cwm Taf University Heath Board: David Watkins on 01443 744844 David.Watkins@wales.nhs.uk Merthyr Tydfil Council: Elaine James on 01685 353907 Elaine. James@vamt.net Rhondda Cynon Taff Council: Anne Morris on 01443 668814 Anne.Morris@rctcbc.gov.uk
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Redesigning services to improve older people’s mental health CWM Taf University Health Board is unveiling ambitious ideas to improve mental health care for older people by developing new community-based services. The new model of care will create age-appropriate and needs-led services, which provide care according to the needs of people living in Merthyr Tydfil and Rhondda Cynon Taf and not solely their age. The health board will talk to staff, patients, families, carers and the public about its ideas for older people’s mental health services during an extensive engagement phase, which will last until March 28, 2014. The redesign of services for older people follows the successful introduction of the recovery model for mental health care for adults of working age. Dr Mark Winston, clinical director of adult mental health services, said: “We want to provide a good service for older people – we’ve started that journey for younger adults, now we need to continue it for older adults. “We want to provide equity of access to services and to outcomes appropriate to the life stage of
patients. “Crucial to this will be to develop good community-based services for older people – hospital liaison services and an enhanced crisis resolution service.” Among the ideas being put forward for older people’s mental health services in Cwm Taf are: • Develop and enhance the role of the crisis team • Extend home treatment to include all ages – this will help reduce admission-to-hospital rates and length of stay • An enhanced primary care mental health support service – this will offer general and age-appropriate services across the age spectrum • Improve discharge planning • Improve services to nursing home residents • Develop additional day care services • Improve services to primary care The redesign could also see an overall reduction in the number of inpatient older people’s mental health beds across Cwm Taf as more care is provided by community-based services. Currently, two wards providing speciality dementia care for older people are very isolated - in Dewi Sant Hospital, in Pontypridd and
Prince Charles Hospital, in Merthyr Tydfil. It is proposed inpatient assessment for older people could be concentrated on one site at the Royal Glamorgan Hospital, in Llantrisant, where inpatient care for adults of working age is also based. Dr Winston added: “Over the next three years we want to redesign older people’s mental health services to shift the focus of treatment and care from inpatient settings to the community to improve the quality of patient care. “Our aim is for patients to have high-quality treatment and care in the right place at the right time without delays and to be treated by staff with a high level of expertise.” Cwm Taf University Health Board’s ideas for redesigning older people’s mental health services will be shared and discussed with staff, patients, families and carers over the course of the next two months. They will also be discussed in Cwm Taf ’s regular public forum meetings as part of the engagement exercise and with key stakeholders.
Full details about the ideas, including how to have your say, are available at www.cwmtafuhb.wales.nhs.uk/older-persons-mental-health page 7
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Health board says au revoir to Nick
when he was asked to join the commissioning team for a new accounting system that was to be introduced across Mid Glamorgan Health Authority. His daily routine for the next two years consisted of standardising and undertaking preparatory work for the new accounting system with his trusty assistant Helen Williams, who is now a clinical psychologist. Over the years, as health authorities became NHS trusts and eventually local health boards, Nick and his team worked from converted bathrooms and toilets in a former nurses’ home at East Glamorgan Hospital as their department became fully computerised.
COUNTER fraud specialist Nick Goss is retiring from Cwm Taf University Health Board this month after more than 42 years of service in the NHS. He didn’t plan on staying that long when he took a temporary job in 1971 at just 19, but the rest, as they say, is history. Born in 1952 in Trowbridge, Wiltshire, Nick came to Wales when his parents moved to Cardiff for work reasons. When they had to move back to England in 1972, he decided to stay in Wales. Nick had originally intended to go to Nottingham University to study for a degree in town planning when he left Cathays Grammar School for Boys but a road accident during his upper sixth form year left him in a coma, which meant he missed a lot of school and the start of the college year. page 9
While he was recovering from his long spell in hospital he took a temporary job in the finance department at Lansdowne Hospital – what was meant to give him some time to think about his future turned out to be the start of a 42-year NHS career. Nick, now 61, was quickly promoted to team leader and by 1973 his salary had risen from £686 to nearly £2,000 which, he says, made it difficult to leave the job and go to college so he thought he would stay a little longer! While working at Lansdowne Hospital Nick met Irene who also worked on the complex as a payroll team leader and wedding bells soon followed in April 1974. In 1975 Nick applied for the post of financial services manager in the East Glamorgan Health District at Dewi Sant Hospital. He carried on that role until 1981
Nick, who lives in Llanharan and is based in Dewi Sant Hospital, in Pontypridd, has been Cwm Taf ’s counter fraud specialist since 2009. He took on the role part time in 2005 working alongside Jaime Blackburn who was the counter fraud specialist at the time. Speaking about his career Nick said: “Although I drifted into the NHS, I’ve enjoyed my career and the people I have worked with.
“The health board is quite an understanding organisation to work for. I think when staff have a problem in the NHS the NHS will work with them to get around it which I do not think is the case with a lot of employers.” During his long career, Nick has particularly enjoyed the period
when he worked in East Glamorgan NHS Trust for six years and also the last nine years in counter fraud. Nick and Irene will celebrate their ruby wedding anniversary on April 6 this year. Irene retired as a payroll manager in Glanrhyd hospital in December 2011. They have two children, both teachers. Helen is 37 years old and married to John and Catherine, 33, has a partner Gethyn. The whole family is eagerly awaiting the arrival of Helen’s twins in a few weeks time. He is an avid Swansea City fan and season ticket holder since 1968 and attends home and away games with Huw Evans, the health board’s head of corporate finance. But mention Cardiff City football club and his expression changes, he says he ‘enjoys’ the team rivalry. He was the scout leader in the village of Llanharan for more than 20 years still helping out occasionally and was also the parish treasurer until handing over the reigns. Nick enjoys mountain walking and following retirement he plans to be a volunteer walk leader with Brecon Beacons National Park. He also would like to do part time tour management in Europe, looking after groups of travellers mainly in France. Both Nick and Irene are cricket fans supporting both Glamorgan and England and Nick is a member of England’s Barmy Army. Their ambition is to watch a Test series in Australia or West Indies, which fits nicely with the couple’s intention to travel.
Stockpiling medicines at home could be dangerous pharmacists warn PHARMACISTS are warning people not to stockpile prescription medicines in their homes as part of Cwm Taf University Health Board’s ongoing Your Medicines Your Health campaign. Keeping large quantities of medicines in bathroom cabinets, kitchen cupboards and drawers can be potentially harmful and could even result in an accidental overdose. Cwm Taf University Health Board is encouraging people to return their unwanted and unused prescription medicines to their local pharmacy in Merthyr Tydfil and Rhondda Cynon Taf as part of the Your Medicines Your Health campaign, which was launched on January 20. People who return unwanted or unused medicines can also ask for a free medicines use review with their local pharmacist to help them make the most of their prescription. Martin Davies, chief pharmacist for the Rhondda, in Cwm Taf University Health Board, said:
“We know that there are many people who don’t take the medicines which have been prescribed for them for a number of reasons and, because they don’t want to tell their doctor, they often end up keeping these at home. “But stockpiling medicines at home can be dangerous – to them and to other people who live in the home. We want people to take their medicines if they can and to tell us if they can’t.
“It’s also never a good idea to keep prescription medicines like antibiotics for the future, just in case.” All unused or unwanted medicines should be returned to your local pharmacist to be disposed of because: Taking an out of date medicine could be harmful as their strength can change as they age; Taking a medicine meant for someone else can be dangerous; Taking a medicine prescribed for a similar but not necessarily the same symptom or illness could by masking a serious condition; Stockpiling medicines could increase the risk of an accidental overdose by another member of the family, a child or a pet. page 10
Keir Hardie
University Health Park HEALTH Minister Mark Drakeford has officially rename Keir Hardie Health Park to commemorate Cwm Taf ’s new university health board status. From now on the state-of-theart integrated health park will be known as the Keir Hardie University Health Park. Cwm Taf became a university health board in December 2013, reflecting its long-standing partnerships with Cardiff University and the University of South Wales. Officially renaming the health park, Health Minister Mark Drakeford said: “University health board status recognises Cwm Taf ’s commitment to continuous improvement and excellence, and to understanding how to provide better quality and more efficient services.
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Health Minister Mark Drakeford and John Geen, Consultant clincal biochemist
“I know that there is enthusiasm and expertise here. I am sure that Cwm Taf University Health Board will seize this opportunity to show how applied research and learning can deliver real benefits for patients and for Wales.” The health park’s change of name is significant to staff and to the local community as it symbolises the health board’s commitment to teaching and retaining locally-trained people. A new medical school will be built on site to train 60 student doctors every year. Dr Chris Jones, chairman of Cwm Taf University Health Board added: “This is a fantastic achievement for the health board and the realisation of a long-held ambition, which recognises the long-standing partnerships we have with both Cardiff University and the University of South Wales. “This is much more than adding university to our name - it represents our vision for Cwm Taf to create opportunities for and in our communities and to strengthen healthcare for our local populations by working together. “University health board status will also help us realise our ambition of providing the best patient care through research, teaching and innovation.”
The health board recognises the importance and benefits of collaborative working and university health board status has clear advantages for the local NHS, students and the universities.
“The expectations which arise from university health board status provides us with an opportunity for new aspirations and ambition for the services provided for the Cwm Taf population.
The development of the Keir Hardie University Health Park in Merthyr Tydfil will provide further opportunities for the training of student doctors, dentists and nurses and will facilitate the development of inter-professional learning.
“The University of South Wales brings to the partnership its state of the art clinical and laboratory facilities and cadre of experienced researchers which can be drawn upon to realise the aspirations of Cwm Taf University health Board.”
Having been awarded university status the health board is more likely to be able to attract and recruit high calibre professionals to vacant posts.
And Professor John Bligh, Cardiff University’s dean of medicine and head of school, school of medicine, college of biomedical and life sciences added: “Cardiff University congratulates Cwm Taf on achieving its university health board status.
The latest research, developments and innovations will be directed at the patient helping to improve the health and well being of the local population. All of this while creating a cutting-edge learning environment for our professionals of the future. Professor Donna Mead, professor of nursing and dean of the faculty of life sciences and education at the University of South Wales said: “The University of South Wales is proud to stand alongside Cwm Taf University Health Board as one of its academic partners. “The relationship between our organisations is longstanding and has its basis in shared objectives. These include working together to provide the highest calibre of trained health professionals who provide care for the Cwm Taf population and undertaking research which informs the way in which clinical services are delivered.
“This is a significant achievement that reflects the board’s commitment to research, teaching, and clinical innovation. “We are looking forward to working with clinicians and managers in the Board to improve health care in the region.”
Keir Hardie
University Health Park Aberdare Road Merthyr Tydfil CF48 1BZ 01685 351 021
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For more information or support please contact Cerys Preece, Health Promotion Practitioner, Cwm Taf Public Health Team cerys.preece@wales.nhs.uk or 01685 351453
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