Health Board proposes temporary service changes to maintain safety and sustainability of health care in Powys
A number of temporary changes to services provided by Powys Teaching Health Board are proposed to take place from Autumn 2024.
A meeting in public of the Board on 24 July highlighted the need to consider temporary changes to opening hours of some minor injury units provided by the health board, and temporary changes to the clinical model for inpatient beds in Powys community hospitals.
A period of engagement with patients, the public, staff and stakeholders is taking place during the summer to explain the temporary changes and invite feedback. Further details will be available from the health board’s engagement website at www.haveyoursaypowys.wales/temporary from Monday 29 July with engagement taking place until Sunday 8 September.
The NHS across the UK, and locally in Powys, faces a number of challenges to maintain quality, safety, outcomes and financial sustainability for patients and communities. Waiting times for planned care increased during the COVID pandemic and remain high. Inflationary pressures affect the whole of the public sector, increasing the costs of service delivery. More people are living longer with multiple health conditions. And there are pressures on staffing, including that the proportion of people of working age is reducing.
Powys Teaching Health Board is therefore proposing some immediate steps to help maintain quality services within available resources.
Temporary Changes to opening hours of PTHB Minor Injury Units
Firstly, there we propose temporary changes to the opening hours for some PTHB Minor Injury Units.
It has proved increasingly difficult to staff the county’s minor injury units. There are frequent overnight and evening closures because appropriately trained staff are not available. This creates uncertainty for patients.
And, typically, around one to two people per night attends the MIU in Brecon or Llandrindod Wells, and in the significant majority of cases their care needs could wait until the morning or would be better addressed elsewhere – for example because they need the specialist resources in a major hospital A&E department. Whilst this does offer convenience for patients it does not offer the best use of precious NHS resources.
Following careful consideration of these challenges, the health board is proposing the following changes to opening hours of PTHB minor injury units:
|
|
Current Opening Hours |
Temporary Opening Hours from Autumn 2024 |
|
Brecon |
24 hours 7 days a week |
8am to 8pm 7 days a week |
|
Llandrindod Wells |
7am to midnight 7 days a week |
8am to 8pm 7 days a week |
|
Welshpool (no change) |
8am to 8pm 7 days a week |
8am to 8pm 7 days a week |
|
Ystradgynlais (no change) |
8.30am to 4pm Mon-Fri (except bank holidays) |
8.30am to 4pm Mon-Fri (except bank holidays) |
There will also be some temporary changes to staffing in all the health board’s minor injury units so that it has better alignment with service activity and demand.
Temporary Changes to the clinical model for inpatient beds in Powys Community Hospitals
Too many patients are spending too long in hospital. This increases the likelihood of “deconditioning” where patients lose muscle strength, lose the ability to take care of themselves, and become disoriented. This can make it more difficult to return to their previous levels of activity and functioning when they return home, and can increase the chances of readmission to hospital.
Also, it is difficult to reach out to all parts of a large rural county with the specialist skills needed for the best multi-disciplinary care, and there is too much reliance on very expensive agency staffing.
The health board is therefore proposing some changes to the clinical model for inpatient care in Powys community hospitals.
The number of community hospital beds and their locations remains unchanged across the county. Four hospitals will take on a more specialised focus to help ensure the best quality and outcomes for patients.
Bronllys and Llanidloes would be designated as our “Ready To Go Home” units. These would provide focused care and support for patients who are ready to return home but are waiting for a package of community care.
Brecon and Newtown would take on an expanded role to support patients who need more specialised inpatient rehabilitation in a community hospital setting. This builds on their existing role as our centres for stroke rehabilitation.
Overall, these changes aim to reduce unnecessary extended stays in hospital, so that patients are able to return to their home including a care home.
They also aim to help us bring patients back into Powys more quickly from hospitals in neighbouring counties.
Next Steps
These temporary changes would take place from Autumn 2024 for a period of six months.
Further information is available from www.haveyoursaypowys.wales/temporary including an issues paper, frequently asked questions, alternative formats (e.g. easy read), a survey to share your views, and an invitation to webinar sessions to find out more and ask questions. Members of the public without digital access will also be able to telephone to request a printed copy.
As part of this engagement, the health board is also keen to gather ideas and suggestions to help ensure that health services are safe and sustainable in the long term.
Released: 14/08/20224