Agenda item

To submit a report by the Betsi Cadwaladr University Health Board.

The Chair welcomed Mr Dyfed Edwards, Chair of the Betsi Cadwaladr University Health Board and Mr Paul Andrew – IC Director of Operations (West) – Betsi Cadwaladr University Health Board to the meeting.

Mr Paul Andrew gave a brief presentation to the Committee on the strong partnership between the Health Board and the Authority who has a shared focus on improving health, independence and wellbeing for the residents of Anglesey.

In considering the report, the following were points of discussion by the Committee:-

·         Reference was made to the disappointment locally that the four-bed St David’s Hospice provision in Penrhos Stanley Hospital has closed recently.  Questions were raised whether the four-bed unit will be transferred for extra bed provision at the hospital. Mr Andrew responded that the four-bedded area is providing therapies and other resources to patients currently at the hospital.  He noted that a one-bed resource is available in the Hospice in Llandudno. 

·         Reference was made to the resilience of both bridges across the Menai Straits.  Questions were raised whether the Health Board has action plans in place to address such a scenario that both bridges were closed in transferring patients, in emergencies, to Ysbyty Gwynedd.  Further questions raised whether a provision is available at Cefni Hospital and Penrhos Stanley Hospital and whether there is a need to invest in both these hospitals to address such a situation.  Mr Dyfed Edwards responded that the Health Board did respond to the consultation by Welsh Government highlighting the concerns that both bridges could close due to high winds or any other emergency.  He noted that many of the Health Boards staff live on the Island who need to cross the bridges to and from work daily.  He noted that the investment in provisions locally is important to afford patients to receive their treatment and support.  Mr Andrew said that there are business continuity plans (Tactical Control Group) in place if the scenario occurred that both bridges across the Menai Straits were to close. 

·         During the presentation it was reported that there is strong working relationship between the Health Board and this Council. Questions were raised as to the provision afforded by the Social Workers from the Local Authority whilst attending to patients at Ysbyty Gwynedd.  Mr Andrew responded that there has been a change in the model of working between health and social care since the last two years with Social Workers presence at the hospital.  He noted that it came apparent that not all patients needed to be seen by a Social Worker and bed-blocking occurred whilst waiting for the patient to be seen by a Social Worker.  The Head of Adults’ Services said that the AmAdref provision was undertaken with Social Workers attending to patients at Ysbyty Gwynedd to gauge the pathway of care an individual requires whilst returning home.  The Reablement Team also attends to patients at Ysbyty Gwynedd to ensure that patients receive the correct care package.  He expressed that it is important that the patients are safe whilst returning home and that they do not have to return to hospital.  He reported further that a Care Dashboard has been created to facilitate the requirements of an individual care needs and to ensure that people do not stay in hospital for longer than is required.

·         Questions were raised as to the work of the Community Teams in different areas of the Island.  The Head of Adults’ Services responded that Community Teams facilitate the pathway of care within the home for patients, with the main focus of prevention to avoid people having to be admitted to hospital if people are unable to be supported within their home environment.  Further questions were raised as to the obligations of terminating the arrangements with the Red Cross.  Mr Andrew responded that the Health Board considered that it was timely for the board to consider an alternative service and the funding arrangements has allowed the service to afford extended hours, and in-house provision has also been undertaken.  He noted that there has been positive feedback for the new provision.

·         Reference was made that there has been a lack of dental provision for children, and some dentists are not registering children.  Mr Andrew responded that a tendering process for dental provision is currently being undertaken by the Health Board, and it is hoped that a positive outcome will materialise from this process. 

·         Reference was made that the published data for waiting times for treatments by Welsh Government has been delayed due to Betsi Cadwaladr University Health Board not affording details within the specified timeframe.  Mr Dyfed Edwards responded that the Health Board has made mistakes in presenting data for waiting times and this has now been rectified, and such data will be published on the government’s website in due course.   

·         Questions were raised as to what measures will be taken for therapy and assessment for children with additional learning needs on Anglesey and what provision is in place to reduce waiting times.  Mr Andrew responded that he did not have the information and would have to come back with the details required. 

·         Questions were raised as to the Health Boards resilience in recruitment following the Senedd Elections in May.  Mr Edwards responded that there is uncertainty as to the possible change of government following the Senedd Elections.  .  He agreed that young people should be encouraged to have a career within the health service, and it is important that patients are comfortable with the local people that care for them. However, he expressed that without the support of workers from different countries patients would not have received the health care provision by the NHS and they should be thanked for their commitment and care for the patients of the Betsi Cadwaladr University Health Board.

·         Questions were raised as to the information sharing of details with the Local Authority and the Health Board.  Mr Andrew responded that linking information with the health provision and social care is paramount to assist the flow of patients from the hospital environment.  He noted that all six of the Local Authorities in the northwest through the Regional Partnership Board have agreed to sharing information to improve the services locally for patients who need support within the social care system. The Community Resilience Team is paramount in caring for patients within their homes and providing frailty support.

·         Questions raised as to the strategy in place to attract young people to the health service and whether there are clear targets in developing the workforce from people from Anglesey.  Mr Edwards responded that an open day was arranged in Ysbyty Gwynedd recently with over 100 people attending from the Northwest area.  He noted that a Memo of Understanding (MOU) will be signed between the Health Board and Coleg Llandrillo Menai to undertake training and workforce planning for the future of the Health Service for the next 5 to 10 years. He further said that it is encouraging that the established Medical School in Bangor University will provide generation of medical professional for the region.

·         Questions were raised as to how the Health Board is going to tackle the waiting times in the A+E department and people having to wait to be admitted to a Wards and Ambulances having to wait to transfer patients into the department. Mr Edwards responded that he agreed that patients are waiting too long in the A+E department and there is a need for better facilities for the health provision for people. He noted that people should also be informed of local support within their communities without having to attend the A+E department. 

·         Reference was made to the published LAIS report in February 2024 – Getting Urgent and Health Care.  The Chair outlined the concerns of patients in respect of waiting time and poor communication with patients.  He noted that the lack of dignity was also of concern with patients receiving medical treatment in corridors of hospitals.  Mr Edwards responded that the medical staff do not wish to care for patients in corridors as well, but due to the numbers of patients coming into A+E this situation has increased.  Mr Andrew expressed that Ambulances awaiting to discharge patients to the A+E is unacceptable, but the resulting backlog is that there is high numbers of patients in the department that are awaiting to be seen.

·         Reference was made that since closing the Cottage Hospitals across the region, there seems to be huge backlog of patients waiting for treatment.  Mr Edwards responded that capacity in the community is important in treating patients but with so many patients awaiting to be discharged from hospital this creates problems and the flow of patients in and out of hospital is creating the problems within A+E departments in every hospital.  He referred to the Môn Enhancement Care Team (MEC Team) on Anglesey who treat people with the home environment which is similar to the provision that Cottage Hospitals provided over the years. 

·         Reference was made to the rise in ketamine use and the increase of patients being admitted to hospital.  Questions were as to the work undertaken by the Health Board and other agencies to tackle the rise in ketamine use.  Mr Edwards responded that the Mental Health Team are working closely with other agencies and noted that he would provide details of the work undertaken in writing to the Authority.

The Chief Executive said that there is strong collaboration between the Local Authority and the Health Board to meet the needs of the residents of Anglesey.  Having a Community Health Centre in Holyhead would be important to improve patient care and it is hoped that when planning permission is granted, grants can be sought. He further said that agreement on Care Packages needs to be improved and quicker turnaround of who contributes financially towards such packages. He said that there is a lack of funding for this Authority to provide the service for patients and there is a need to be more efficient. 

It was RESOLVED to accept the presentation by the representatives from the Health Board.