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Bwrdd lechyd Prifysgol Hywel Dda University Health Board

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Our big NHS change

easy read

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Contents Introduction 3

Hywel Dda University Health Board 4

Why change? 6

Our plans 8

Proposal A 14

Proposal B 16

Proposal C 18

What do you think? 20

Drop-in events 21

What next? 22

For more information 22

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Help us improve our

NHS for Mid and

West Wales

Introduction

Last year we asked you what you wanted from local health services in Mid and West Wales.

We listened to what people said and we have used the information to think about how we should change our NHS services.

This document sets out three proposals for change.

Please read through this document and then tell us what you think.

We need to receive your views by Thursday 12 July 2018.

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Hywel Dda University Health Board

The Hywel Dda University Health Board provides NHS health services in Carmarthenshire, Ceredigion and Pembrokeshire.

Currently we have:

• 4 main hospitals:

• Bronglais in Aberystwyth

• Glangwili in Carmarthen

• Prince Philip in Llanelli

• Withybush in Haverfordwest

• 7 community hospitals:

• Amman Valley in Carmarthenshire

• Llandovery in Carmarthenshire

• Tregaron in Ceredigion

• Aberaeron in Ceredigion

• Cardigan in Ceredigion

• Tenby in Pembrokeshire

• South Pembrokeshire Hospital

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• 51 local doctor’s surgeries (GP practices)

• 46 dental practices

• 99 community pharmacies

• 64 general ophthalmic practices (eyes)

• 11 health centres

• Mental health and learning disability services

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Why change? The main challenges are:

• People are living longer. There are more:

• Older people

• People living with a long lasting health conditions

We expect there to be many more older people who will be needing regular health care and social care.

• In our area some people live in towns and some in country areas. It is hard to make sure services are in the right place for people to access.

• In our area many people live along way from services. Helping people to live at home while they have treatment can involve a lot of travel for health workers.

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• People want to be supported to manage their health in their own homes. About 4 out of every 10 hospital beds are filled by people who could be treated at home.

• There are differences in the quality of services provided in our area.

• People in some parts of our area will live healthier and longer lives than people in other parts of our area.

• We are finding it hard to get enough staff, especially specialist medical staff.

• We are not using new technology well enough.

New technology includes, computers, phones, telehealth and telecare.

• A lot of our hospital buildings are old and need a lot of money to keep them going.

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Our plans We’re planning a big change to health services in Carmarthenshire, Ceredigion and Pembrokeshire.

Health care in the community We want people to be able to access most of the health care they need in their local community.

We want more people to be able to stay at home while they are getting treatment, rather than having to go into hospital.

We want more opportunities for vulnerable people, including people with learning disabilities to live independently in their local community.

We want to work with other people who provide health and care to make it better for you.

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Better hospital services Reducing the number of main hospitals will mean:

• Less of a difference in standards of care in different parts of our area to make things more equal for people

• Shorter waiting times and fewer cancellations

• More money for local and community health services

Better use of technology We plan to use technology like lap-tops, tablets, telehealth and telecare so that people in country areas can get good health support.

Making a difference Our doctors think our proposals will make a lot of things better but it might be difficult for some people to get to the services, especially if they do not have much money or a car.

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BRONGLAIS DISTRICT GENERAL HOSPITAL

HUB

3 proposals In all 3 proposals:

• Bronglais District General Hospital will continue to provide services for mid Wales.

• A new hospital will be built somewhere between Narberth and St Clears.

This will be for urgent care, and will include planned care in some proposals but not all.

It will also be for mental health assessment and treatment.

• There will be 10 community hubs.

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In our proposals a general hospital will provide:

• Overnight care for people:

• Who are seriously ill

• With long lasting health conditions

• Who are recovering from something serious

• Day care for people who can travel

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Community hospitals will provide:

• Beds for people who need a little more treatment than they can have at home

• Treatment for minor injuries

• Tests including scans

• Midwife led services (In Glangwii and Withybush hospitals but not Prince Philip Hospital)

A Planned Care Hospital can provide quick treatment for people who need a test or an operation.

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An urgent care hospital is for serious injuries and illnesses where the patient’s life is at risk.

It includes an Accident and Emergency Unit, and intensive care.

Community hubs are buildings close to where you live which provide:

• A range of health and care services - particularly for older, frail and vulnerable people

• Advice and support

• Some treatment that used be done in hospital

• Some will have minor injury units and some won’t and some will have beds and some won’t

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HUB

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Proposal A

In this proposal we will have:

A new urgent care and planned care hospital between Narberth and St Clears

Community hospitals in:

Glangwili in Carmarthen

Prince Philip in Llanelli

Withybush in Haverfordwest

A general hospital in: Bronglais in Aberystwyth

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Advantages of Proposal A • Having planned care and

emergency care in one hospital means that all the right equipment and specialist staff are in one place

• Having only 2 main hospitals is better to attract new staff

• This proposal makes best use of money

Disadvantages of Proposal A • Some people will have to travel

further to a main hospital

• People may prefer to travel to hospitals in Swansea, outside our area

• Routine operations may be cancelled when doctors are called away to work on emergencies

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Proposal B

In this proposal we will have:

A new urgent care and planned care hospital between Narberth and St Clears

Community hospitals in:

Glangwili in Carmarthen

Withybush in Haverfordwest

General hospitals at:

Prince Philip in Llanelli

Bronglais in Aberystwyth

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Advantages of Proposal B • Having 2 main hospitals in the

south of our area will be better for patients living in and around Llanelli

• Having planned care and emergency care in one hospital means that all the right equipment and specialist staff are in one place

Disadvantages of Proposal B • It may be difficult to get enough

staff for 3 main hospitals

• Routine operations may be cancelled when doctors are called away to work on emergencies

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Proposal C

In this proposal we will have:

A new urgent care hospital between Narberth and St Clears

A new planned care hospital on Glangwili site in Carmarthen

Community hospitals in:

Withybush in Haverfordwest

General hospitals at:

Prince Philip in Llanelli

Bronglais in Aberystwyth

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Advantages of Proposal C

• Having 3 main hospitals in the south of our area will mean less travel for patients living in and around Carmarthen and Llanelli

• Having planned care and emergency care in separate hospitals means that routine operations are less likely be cancelled when doctors are called away to work on emergencies

Disadvantages of Proposal C

• There are still four main hospitals, as now, which means:

• It will still be difficult to find enough staff

• There will be less money to invest in community services

• Having emergency and planned care in different hospitals may mean that patients may have to be transferred from one hospital to the other in an emergency

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What do you think? We want to know what you think about these plans.

Please tell us your views by:

• Completing the online questionnaire at: www.hywelddahb.wales.nhs.uk/hddchange

• Emailing us at:hyweldda.engagement@wales.nhs.uk

• Telephone: 01554 899 056

• Coming to one of our drop-in events

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Drop-in events Friday 4th May 2pm - 7pm The Great Hall, Guildhall, Cardigan SA43 1JL

Tuesday 8th May 2pm - 7pm St Peter’s Civic Hall, Carmarthen SA31 1PG

Friday 11th May 2pm - 7pm Regency Hall, Saundersfoot SA69 9NG

Tuesday 15th May 2pm - 7pm Letterston Memorial Hall, Letterston SA62 5RY

Friday 18th May 2pm - 7pm Morlan Centre, Aberystwyth SY23 2HH

Tuesday 22nd May 2pm - 7pm Selwyn Samuel Centre, Llanelli SA15 3AE

Thursday 24th May 2pm - 7pm Llandybie Memorial Hall, Llandybie SA18 3UR

More events may be organised

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What next? Hywel Dda University Health Board will take account of people’s views when they make their final decision.

The Board will be meeting to make the decision in the Autumn of 2018.

For more information If you need more information please contact us by:

Web: www.hywelddahb.wales.nhs.uk/hddchange

Telephone: 01554 899 056

Email: hyweldda.engagement@wales.nhs.uk

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