Cardiac ‘hub’ in Carmarthen suggested for heart services

First published in Milford Mercury news

HEART services could be the next to change in Hywel Dda as the health board sets up a clinical project board to look at a report into its cardiology services.

Following a number of “anecdotal and untoward incident reports”, the University Health Board commissioned a full, independent, external review by recognised experts, the Royal College of Physicians into quality and safety of cardiology services.

It suggests a central cardiac ‘hub’ be developed at Glangwili.

The review said two cardiologists had raised concerns about patients receiving “poor service”.

Serious concerns were also raised about an “apparently high risk adjusted mortality index (RAMI) for cardiology patients in one DGH, Withybush Hospital and the collection of data throughout HDHB”.

The distance between the Hywel Dda hospitals and the tertiary centre at Swansea also created a “formidable challenge” and centralisation at Glangwili is suggested.

Medical director Dr Sue Fish said: “Our patients deserve the best possible care and we would like to reassure patients we take the issues raised in the report very seriously.

“The review did not look at any specific issues relating to individual patients and has not identified any parts of the service that are currently unsafe.

“However, it did make a number of recommendations advising us on how they believe we should configure cardiology services to improve the care of patients across the university health board.

“We will have to consider the recommendations very seriously before reaching a decision on how we implement them.

“A number of the issues identified in the report are already being addressed. We have been reviewing all deaths in our hospitals over several of years to ensure that lessons can be learned and patient care improved.

“It’s important to stress that no decisions have been.

“We have undertaken a further review of the Risk Associated Mortality Index (RAMI) data in our hospitals, we have improved the management of clinical incidents and we are ensuring that we participate in National Clinical Audits in order that we can benchmark the care our patients receive against that in other hospitals in England and Wales.

“When the review was commissioned we were already working with our clinicians to look at how services could be improved and we will now set up a clinically led project board to discuss the report and its recommendations in detail, formulating an action plan as a matter of urgency.”

Despite concerns raised in the report it adds: “We have met some very impressive people with great commitment to the population they serve and we can see no reason why HDHB should not develop a first class cardiology service of which all can be proud.”

It will provide its official response to the report at the public board meeting in May.

If anyone has any concerns about their care contact the patient support team on 0300 0200 159

Comments (9)

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10:30am Thu 13 Mar 14

PembrokeshireMan says...

If they'd have conjured up some concerning figures about the Special Care Baby Unit in Withybush they wouldn't have had all the fuss about moving it.

They've learnt from their mistake.

Who would argue against moving disparate failing services to an improved centralised service?
If they'd have conjured up some concerning figures about the Special Care Baby Unit in Withybush they wouldn't have had all the fuss about moving it. They've learnt from their mistake. Who would argue against moving disparate failing services to an improved centralised service? PembrokeshireMan
  • Score: 0

11:44am Thu 13 Mar 14

pembrokedock123 says...

please do not anyone demonstrate against this report and in favour of 'keeping Withybush hospital as it with no change' - there is a lot that is wrong at Withybush hospital and it is difficult to improve services, get good full time staff + keep them once they are there, if there are always demonstrations against change and improvement.

How would Withybush match up against the proposed new standards on minimum nursing levels? .is there a professional full time ophthalmology service at Withybush or not?
please do not anyone demonstrate against this report and in favour of 'keeping Withybush hospital as it with no change' - there is a lot that is wrong at Withybush hospital and it is difficult to improve services, get good full time staff + keep them once they are there, if there are always demonstrations against change and improvement. How would Withybush match up against the proposed new standards on minimum nursing levels? .is there a professional full time ophthalmology service at Withybush or not? pembrokedock123
  • Score: -15

4:45pm Thu 13 Mar 14

Lludw Coed says...

pembrokedock123 wrote:
please do not anyone demonstrate against this report and in favour of 'keeping Withybush hospital as it with no change' - there is a lot that is wrong at Withybush hospital and it is difficult to improve services, get good full time staff + keep them once they are there, if there are always demonstrations against change and improvement.

How would Withybush match up against the proposed new standards on minimum nursing levels? .is there a professional full time ophthalmology service at Withybush or not?
There may be things wrong with Withybush, but thats no reason to right it off and through the towel in. With the right attitude you can improve things for the better. Health Boards and Local Authorities are far from being always right!
[quote][p][bold]pembrokedock123[/bold] wrote: please do not anyone demonstrate against this report and in favour of 'keeping Withybush hospital as it with no change' - there is a lot that is wrong at Withybush hospital and it is difficult to improve services, get good full time staff + keep them once they are there, if there are always demonstrations against change and improvement. How would Withybush match up against the proposed new standards on minimum nursing levels? .is there a professional full time ophthalmology service at Withybush or not?[/p][/quote]There may be things wrong with Withybush, but thats no reason to right it off and through the towel in. With the right attitude you can improve things for the better. Health Boards and Local Authorities are far from being always right! Lludw Coed
  • Score: 10

9:30pm Thu 13 Mar 14

Tttoommy says...

Maybe the Hywel DDa managers need to look at the TV documentary about health care , everyone except them who I understand have private health care KNOW about the "golden hour" - a stroke or a heart attack needs treatment within that hour.

i guess they get bonuses for "efficiency" targets and s0d the patient so long as things look good

May the Good Lord look after you because the NHS in Wales doesn't give a flying f*** :(
Maybe the Hywel DDa managers need to look at the TV documentary about health care , everyone except them who I understand have private health care KNOW about the "golden hour" - a stroke or a heart attack needs treatment within that hour. i guess they get bonuses for "efficiency" targets and s0d the patient so long as things look good May the Good Lord look after you because the NHS in Wales doesn't give a flying f*** :( Tttoommy
  • Score: 6

10:19pm Thu 13 Mar 14

Pembs girl says...

The gradual movement of Withybush Hospital's departments to Glangwili Hospital is nothing more than a cost-cutting exercise that uses any excuse to do so.
The impact on the family members of the patient, travelling back and forth to Glangwili hospital each day to visit from often remote areas of Pembrokeshire, is expensive, inconvenient and a draining experience to say the least. This consultation will not have the community's best interests at heart but rather the easiest way to make cuts.
I have experienced the cardiology department at Withybush, through relatives who have had treatment there, and can only hope that the seemingly inevitable shift of cardiology services to Glangwili provides the Pembrokeshire community with the same excellent treatment as the current provision does in Withybush.
With the gradual move of NHS provision to Glangwili, I would imagine Pembrokeshire will also see less families/couples moving into the area. People without a family link to a specific area will generally look for good services in the area in which they settle. Hospitals provide an important service to the community. Living close to one can make the difference between life and death.
The gradual movement of Withybush Hospital's departments to Glangwili Hospital is nothing more than a cost-cutting exercise that uses any excuse to do so. The impact on the family members of the patient, travelling back and forth to Glangwili hospital each day to visit from often remote areas of Pembrokeshire, is expensive, inconvenient and a draining experience to say the least. This consultation will not have the community's best interests at heart but rather the easiest way to make cuts. I have experienced the cardiology department at Withybush, through relatives who have had treatment there, and can only hope that the seemingly inevitable shift of cardiology services to Glangwili provides the Pembrokeshire community with the same excellent treatment as the current provision does in Withybush. With the gradual move of NHS provision to Glangwili, I would imagine Pembrokeshire will also see less families/couples moving into the area. People without a family link to a specific area will generally look for good services in the area in which they settle. Hospitals provide an important service to the community. Living close to one can make the difference between life and death. Pembs girl
  • Score: 9

3:09pm Fri 14 Mar 14

Hetscam says...

I have just read the report on the Hywel Dda UHB website. Shades of the 'Listening and Engagement' farce all over again. They did not visit the hospitals in question and the Withybush representative was Dr Iain Robertson Steel, who was one of the Health Board members scrutinised by Pembrokeshire County Council recently, so he was hardly going to fight Pembrokeshires corner! It is yet another example of skewing the evidence to fit a pre-determined outcome (centralisation in Glangwili) that will be neither 'safe' nor 'sustainable' for those of us who do not live in Carmarthenshire.
I have just read the report on the Hywel Dda UHB website. Shades of the 'Listening and Engagement' farce all over again. They did not visit the hospitals in question and the Withybush representative was Dr Iain Robertson Steel, who was one of the Health Board members scrutinised by Pembrokeshire County Council recently, so he was hardly going to fight Pembrokeshires corner! It is yet another example of skewing the evidence to fit a pre-determined outcome (centralisation in Glangwili) that will be neither 'safe' nor 'sustainable' for those of us who do not live in Carmarthenshire. Hetscam
  • Score: 7

6:05pm Fri 14 Mar 14

Tttoommy says...

I keep going on about the "golden hour" especially in Heart and stroke cases where clot busting drugs need to be administered VERY quickly otherwise death or long term disablement occurs - Possibly ambulance men will be able to administer these drugs? I know they can in England unfortunately ambulance response times on the average in Wales doesn't hit targets, dire 's the word I'm thinking of :(
I keep going on about the "golden hour" especially in Heart and stroke cases where clot busting drugs need to be administered VERY quickly otherwise death or long term disablement occurs - Possibly ambulance men will be able to administer these drugs? I know they can in England unfortunately ambulance response times on the average in Wales doesn't hit targets, dire 's the word I'm thinking of :( Tttoommy
  • Score: 7

10:31am Tue 18 Mar 14

PembrokeshireMan says...

If they came out and said "Look, we don't have enough money for decent healthcare in Pembrokeshire, you'd be better off moving closer to the services in Carmarthen" at least they'd be being honest.

That is what it is coming down to.

Pembrokeshire people are going to die as a result of living too far from services. It is just a political game to those ultimately holding the purse strings however.

We need to ask "Who is fighting for Pembrokeshire?"
If they came out and said "Look, we don't have enough money for decent healthcare in Pembrokeshire, you'd be better off moving closer to the services in Carmarthen" at least they'd be being honest. That is what it is coming down to. Pembrokeshire people are going to die as a result of living too far from services. It is just a political game to those ultimately holding the purse strings however. We need to ask "Who is fighting for Pembrokeshire?" PembrokeshireMan
  • Score: 6

10:42am Tue 18 Mar 14

Tttoommy says...

I'm a cynic possibly BUT salaries and bonuses work against the patient.

We've seen cases where the hospital looks efficient (all those score cards filled in) so managers get HUGE salaries and bonuses

When things are looked into we discover patients in their filth as nurses don't have time - fewer nurses on a ward= efficient isn't it
deaths occur, the press get involved, politicians pointificate, the said managers get hundreds of thousands of pounds to go quietly - we then find they've just gone to another heath authority and they're killing more patients in the name of efficiency (aka personal greed)
I'm a cynic possibly BUT salaries and bonuses work against the patient. We've seen cases where the hospital looks efficient (all those score cards filled in) so managers get HUGE salaries and bonuses When things are looked into we discover patients in their filth as nurses don't have time - fewer nurses on a ward= efficient isn't it deaths occur, the press get involved, politicians pointificate, the said managers get hundreds of thousands of pounds to go quietly - we then find they've just gone to another heath authority and they're killing more patients in the name of efficiency (aka personal greed) Tttoommy
  • Score: 4

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