Sick children who require an overnight hospital stay won’t be able to stay at Aberystwyth’s hospital children’s ward following a decision by Hywel Dda health board despite warnings of a “huge, irreversible impact on the children and families of Ceredigion.”
At a Hywel Dda University Health Board meeting held in Carmarthen on Thursday, 26 September, members discussed plans to take away inpatient overnight beds from Bronglais Hospital’s Angharad ward for six months due to a lack of nurses.
The move will see the overnight beds taken away for six months , with only a 24/7 four bed Paediatric Ambulatory Care Unit (PACU) that allows children to be assessed and treated at Bronglais for up to 24 hours with an assessment room, stabilisation area and waiting area on Angharad Ward.
Any child that requires more than a 24 hour stay from 1 November will have to be transferred to Glangwili hospital in Carmarthen.
The meeting heard that removing the six inpatient beds will mean around four children a month transferring to Glangwili.
Director of Operations Andrew Carruthers told the meeting that it was a “difficult issue for us.”
“During the last eight-and-a-half months, service sustainability risks at Angharad Ward, Bronglais General Hospital have increased significantly due to shortfalls in the availability of paediatric nurses,” he told members.
“The service has been operating at risk, with a significant reliance on variable pay staff to enable service delivery to be maintained.”
While staff have been brought in from Glangwili hospital to cover any shortfall at Angharad ward - that cover will not be available from 1 November, the meeting heard.
The nursing levels are going to be further affected by two members of staff set to being maternity leave.
“We are looking to plug the staffing shortfall and if we get to that point in the next six months, we will look to restore services,” Mr Carruthers said.
The meeting heard it was “unsafe” to continue with the current staffing and bed levels.
Lisa Humphrey General Manager for Women and Children Services, told the meeting that the plan will still be able to care for “the majority of children”, and that staffing risks under the current model was leading to ad hoc complete overnight ward closures.
“Closing services at Bronglais, with the distance it is from Glangwili in an unplanned, ad hoc way is really, really risky,” she said.
“We got to a position where we managed to mitigate that but without changing the model for a period of time we would be facing unplanned ad hoc closures which increase the risk even more.”
Nick Williams-Davies, Service Delivery Manager for Acute Paediatric & Neonatal Services told members said he had a “quiet confidence” that the health board “would be able to pull this back before the end of the six months.”
News of the planned move, revealed by the Cambrian News, led to dismay amongst residents, with hundreds responding to say any closing of Angharad ward would be “devastating” for Aberystwyth and Ceredigion.
In a letter to the health board ahead of the meeting, Dr Gwen Rees wrote that the move would have a “huge, irreversible impact on the children and families of Ceredigion.”
“This decision is not only impacting services in the near future, but sets the precedent for there being no inpatient paediatric care in the county which will inevitably lead to poorer health and wellbeing outcomes in the future,” she said.
“As the parent of a child who has required inpatient care at Angharad Ward, I live one hour 40 minutes from Glangwili hospital.
“Moving inpatient care to Glangwili further disadvantages residents of north Ceredigion and risks their health and wellbeing, and access to healthcare.
“My husband is a GP in North Ceredigion and is acutely aware of the devastating impact of this decision on his patients and the quality of care provided to them by Hywel Dda Health Board.
“That GPs in the region were not considered stakeholders and therefore were not consulted on the impact of these changes is indefensible.
“That the nursing situation has been allowed to reach a point where 2 members of staff taking maternity leave impacts the entire region's access to paediatric care is a scandal and does not evidence good governance.”
Dr Neil Wooding, Chair of Hywel Dda University Health Board told members: “We’re not here to be popular, we’re here to make the right decisions.”
“This is a reactive approach to managing this, and we need to be more strategic,” he said.
“I know it must feel a bit like a fait accompli to the communities.
“I’m sure there will need to more service changes in the future and we need to be ahead and consulting with communities to understand what we are trying to achieve.”