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Health Care in North Wales is Changing

Friday, 18 January 2013
At today’s extraordinary Board meeting, the Betsi Cadwaladr University Health Board gave their approval to a series changes to the way health services are delivered in North Wales.
 
The changes that have been agreed are the culmination of two year’s work that builds on previous reviews of health services in North Wales.  They are designed to improve the quality of care and to ensure that services continue to be safe and sustainable in the long term,
 
The changes aim to provide the services that patients use most regularly as close to their homes as possible, so we don’t admit people to hospital when we could provide more appropriate care locally.
 
They aim to make community hospital services more dependable and consistent by focusing resources in key locations.  This means that minor injuries services and x-ray can be provided at regular times, so patients know they can depend on them.
 
For more specialist services, the changes will improve the quality of care by supporting increased specialisation and ensuring that those who need complex care are treated by clinicians with high levels of experience and expertise.
 
As a result of the consultation, a number of aspects of the original proposals were amended and additional provisions were included in the recommendations to address concerns that had been raised, particularly in relation to community health services.
 
 
The proposals that have been agreed today are:
 
1.  To improve community services by developing enhanced care at home services and to focus community hospital resources so that more consistent, reliable services can be provided.
 
Ten hospital hubs will be established, offering seven day a week minor injuries services with standardised opening times and an x-ray service available every working day, Monday to Friday.  These will be at:
 
 
·         Ysbyty Penrhos Stanley (Holyhead),
·         Ysbyty Gwynedd,
·         Ysbyty Alltwen (Tremadog),
·         Dolgellau Community Hospital,
·         Llandudno Hospital,
·         Ysbyty Glan Clwyd,
·         Denbigh Infirmary,
·         Holywell Community Hospital,
·         Mold Community Hospital and
·         Wrexham Maelor Hospital
 
 
Following the consultation it was accepted that there was a strong case for designating Mold Community Hospital as one of the ‘hub’ hospitals for North East Wales, retaining Minor Injuries and X-ray services at the site.
 
The enhanced care at home service will be introduced across North Wales on a phased basis and will be operating across North Wales by the end of next year.
 
Proposals to develop primary care resource centres in Blaenau Ffestiniog, Flint and Llangollen were approved as was the development of a new community hospital on the Royal Alexandra Hospital site.
 
Other changes to the proposals that were made as a result of the consultation are:
 
·         Flint Hospital will be retained, on an interim basis, to provide outpatient services including phlebotomy and minor surgery until the proposed primary care resource centre has been developed in the town;
·         A number of  X-ray sessions will continue to operate at Eryri and Bryn Beryl Hospitals and additional services for South Gwynedd residents will be commissioned in Machynlleth
·         In common with a number of other practices in North Wales, the GP practice in Llangollen will be approached to provide a Minor Injuries Service for local residents.
 
In addition agreement has been reached with Powys and Hywel Dda Health Boards and the appropriate Community Health Councils  to establish a formal planning Board to oversee the development and coordination of services across North Ceredigion, North Powys and South Gwynedd.  This will ensure that services can be provided in a flexible manner, across organisational boundaries, to best meet the needs of people living in these areas.
 
As a result of these changes, the Board confirmed that inpatient beds in Blaenau Ffestiniog, Llangollen, Flint and Prestatyn Community Hospitals would close and inpatient care in these localities would instead be provided at Ysbyty Alltwen and community hospitals in Chirk, Holywell and Rhyl.
 
X-ray services will cease in Tywyn, Ruthin and Blaenau Ffestiniog.
 
Minor Injuries services at Flint, Ruthin, Llangollen, Chirk, Colwyn Bay, Blaenau Ffestiniog would also be closed, with services instead provided at the nearest hub hospital.  The services at Bryn Beryl and Tywyn will be retained, with adjusted hours to reflect seasonal demand.
 
 
 
 
 
 
 
 
2  To confirm the expansion of community-based mental health care for older people in Dwyfor and Meirionnydd and the consequent permanent closure of the inpatient beds at Hafan Ward (Bryn Beryl Hospital) and Uned Meirion (Dolgellau Hospital).
 
There will also be a gradual reduction in beds from 25 to 18 at Cefni Hospital as community services are strengthened, with inpatient services eventually relocating to Ysbyty Gwynedd.  Inpatient beds currently provided in Glan Traeth in Rhyl will be replaced as part of the new Community Hospital development in Rhyl
 
 
 
3.  To work with the Neonatal Networks to commission complex or longer term neonatal intensive care services from Arrowe Park Hospital for approximately 36 babies per year who need this level of care.  Neonatal care for over 700 babies will continue to be provided in our local units.
 
 
 
 
4. To work towards consolidating complex inpatient arterial surgery and emergency vascular surgery into a single specialist centre in North Wales; the location of this has yet to be finalised.
 
As an interim step, services will be moved to be provided at two sites (Ysbyty Gwynedd and Wrexham Maelor Hospital) during 2013, with a single centre being set up by late 2014/early 2015 to ensure that the Health Board conforms with national guidance on current minimum surgical activity volumes and to enable preparations for the start of Abdominal Aortic Aneurysm screening, expected in May 2013.
 
 
 
Full details of the recommendations that have been approved by the Board can be found on the health board’s website at http://www.wales.nhs.uk/sitesplus/861/page/63769