January 2014
Lives in Mbale
Influenza immunisation
Board briefing
MediWales Award
Chronic pain services
Medicine Honours for spring clean surgeon
Goodbye Dr Shah
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WE ARE A NO SMOKING HEALTH BOARD PLEASE DON’T SMOKE AT ANY OF OUR HOSPITALS
CONTENT
3.
12.
LIVES IN MBALE TRASFORMED BY WELSH VOLUNTEERS
HOUSE OF LORDS HONOUR FOR PRINCE CHARLES HOSPITAL SURGEON
13.
THANK YOU AND GOODBYE TO ABERFAN GP
5.
INFLUENZA IMMUNISATION CAMPAIGN 2013-14
10.
BETTER SERVICES FOR PATIENTS WITH CHRONIC PAIN
7.
BOARD BRIEFING
9.
STROKE PATIENT PASSPORT MEDIWALES AWARD
11.
SPRING CLEAN YOUR MEDICINE CABINET
15.
SUSPENDED SENTENCE FOR WOMEN WHO ATTACKED HOSPITAL STAFF
LIVES IN MBALE
transformed by Welsh volunteers
Picture: Two orphan boys at the Salem orphanage in Mbale, Uganda page 3
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IRST Minister Carwyn Jones learnt how volunteers from South Wales are helping to transform health and education services for people living in eastern Uganda on a visit to the country. He spent four days in the Mbale region in January visiting some projects run by PONT – Partnerships Overseas Networking Trust – including a motorbike ambulance scheme and work to train community health workers to recognise and treat signs of serious illness. The First Minister also visited the region’s main hospital, Mbale Regional Referral Hospital, which has strong links with staff based at Royal Glamorgan Hospital, in Llantrisant. Mr Jones said: “For more than a decade PONT and its volunteers have been having a transformative effect on the lives of the people of Mbale, helping to significantly improve health and education services.
“My visit to Uganda in January allowed me to see first hand the positive impact the people and communities of Wales have had on the country through various projects including health, education, and business links. “I’m very pleased that the Welsh Government, through our Wales for Africa programme, is able to support this work and I hope that my visit will draw attention to the commitment and hard work of everybody involved.”
The First Minister officially opened a new girl’s hostel attached to a local secondary school in Mbale, which was built with the support of Pontypridd High School. He visited the PONT engineering workshop in Mbale, which uses donated equipment from Tata Steel in South Wales and manufactures pushbike ambulances and mountain rescue stretchers and opened a latrine in the Namatala slum in Mbale - a community-led project with support from the University of South Wales. While in Uganda, Mr Jones met people who have benefited from the relationships established between Rhondda Cynon Taf and Mbale over the course of the decade PONT has been working in Uganda, as well as meeting some of the hundreds of volunteers from South Wales who have been making regular trips to Mbale. Among those was Martin Blakebrough, who is head of Kaleidoscope drug and alcohol service in Wales. Martin is on an eight-week placement as part of the Welsh Government-funded International Learning Opportunities programme and is giving organisational support to Uganda Women’s Concern Ministry, which works with women living with HIV and Aids. The First Minister’s visit came a year after a unique consortium was set up to share the PONT model of integrated primary – emergency health care work further across Uganda. Welsh charities PONT, Vale 4 Africa, Care for Uganda and the Gulu Mission Initiative were awarded a grant of £250,000 by UK Aid
(through THET – the Tropical Health and Education Trust) to train hundreds of community-based volunteer health workers in Ugandan villages. The four charities are working in four districts of Uganda – Mbale, Tororo, Luwero and Gulu –to develop primary healthcare and ensure sick and injured patients, including pregnant women with complications, get speedy access to hospital. The grant will train more than 700 Ugandan volunteers and support the provision of emergency motorbike ambulances, together with funds raised by a UK Midlands Rotary group. Dr Geoff Lloyd, a GP in Rhydyfelin, near Pontypridd, who founded PONT, which links Rhondda Cynon Taf with Mbale, said: “This was a great opportunity for the First Minister to see firsthand the huge amount of work going on in the Mbale region and the enthusiasm and energy of the hundreds of volunteers from South Wales who get involved with PONT every year. “This is a very exciting time for PONT; we are building new links in other parts of Uganda, which mean more communities will benefit from having access to community health workers and a motorbike ambulance. “PONT is much more than health – it’s about linking communities with communities. The First Minister has had an opportunity to see the breadth of work that’s been accomplished by these partnerships during his visit and the opportunities for further collaboration.” page 4
Influenza immunisation campaign 2013-14 Flu jab uptake - all Wales averages 67%
Patients aged 65 years an older
33%
49%
Patients aged 6 months to 64 years at risk
51%
39%
Healthy pregnant women
61%
56%
Pregnant women at risk
44%
40%
All pregnant women
60%
37%
Children aged 2 and 3 years
63%
53%
At risk children aged 2 and 3 years
47%
70%
Year 7 school children
30%
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46%
At ris children 2 and 3 acro Cwm
19%
66%
Patients aged 65 years and older across Cwm Taf
34%
Year 7 school children across Cwm Taf
65%
Patients aged 6 months to 64 years at risk across Cwm Taf
35%
81%
Cwm Taf
sk n aged years oss Taf
34% Healthy pregnant women across Cwm Taf
Flu jab uptake across Merthyr Tydfil and Rhondda Cynon Taf
54%
66%
31% Children aged 2 and 3 years across Cwm Taf
69%
58%
36%
Pregnant women at risk across Cwm Taf
42%
All pregnant women across Cwm Taf
64%
Immunised Not immunised
Data correct as of 14/01/14
BOARD BRIEFING Cwm Taf University Health Board held its latest public board meeting on January 15, 2014 at Ynysmeurig House, Abercynon. This briefing sets out the key areas of discussion and aims to ensure everyone is kept up to date with what’s happening in Cwm Taf. University health board status Cwm Taf formally became a university health board on December 12, 2013. Health Minister Mark Drakeford will attend an event at Keir Hardie Health Park later this month to officially launch Cwm Taf ’s new status. South Wales Programme The five health boards – Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff and Vale, Cwm Taf and Powys – and the Welsh Ambulance Services NHS Trust had been due to hold special meetings on December 12 to discuss recommendations about the outcome of the South Wales Programme consultation. However, these meetings were postponed at short notice by the South Wales Programme board to allow further work to be carried out. The South Wales Programme board is due to meet on Tuesday (January 21) after which further information about when health boards will reconvene to discuss its recommendations should be available. page 7
All information relating to the South Wales Programme is available at www.wales.nhs.uk/swp Three-year integrated plan 201417 It was noted during the morning board development session that a detailed update had been received and discussed on the three-year plan, which is being developed for the end of January submission to Welsh Government. The board agreed the approach being taken and arrangements for submission at the end of the month and that it would be discussed further at the Finance and Performance Committee. Progress will be reported at the February development board and a full version prior to final approval will be considered at the March board meeting. Together for Health delivery plans Cwm Taf has developed four Together for Health delivery plans, which relate to critically ill patients; heart failure; diabetes and oral health.
The plans highlight the action the health board will take over the next three years to improve the care for patients in each of the four areas and, in some cases, to improve services where gaps are identified. The delivery plans have now been approved and will be made available on the Cwm Taf website. Patient experience in Cwm Taf The results of the All Wales User Experience Framework, which asks patients 13 core questions about their impressions and understanding of their care, are being reported to the board. The questionnaire has been piloted across a number of ward areas within Cwm Taf since March 2013 and plans are in place for it to be rolled out across the health board by March 2014, in line with Welsh Government guidance. The priority areas include mental health, community services, pathology, radiology and GP practices. The results for Cwm Taf show that: • 84.1% of patients said people were always polite to them and a further 12.5% said people were usually polite to them;
• 76.8% said they always felt listened to and 15.1% said they usually felt listened to; • 84.1% felt they always had enough privacy and 11.4% usually felt they had enough privacy; • 79.7% said the place they were cared for was very clean and 19.2% said it was fairly clean; • 73.4% said they were involved in decisions about their care; • 75.3% said they always understood what was happening in their care and 16.6% said they usually did; • The majority of people who completed the questionnaire rated their experience a seven out of 10 or more. The full report is available here. Finance The health board started the year with a financial challenge of £40.5m. To date it has identified savings for around half of this amount and had been forecasting an end-of-year deficit of £20.8m. The Welsh Government confirmed additional non-recurring funding of £16.86m for Cwm Taf, some of which had already been assumed within the health board’s financial plans. Taking the additional funding from the government into account, the residual gap is £8.1m. Further work has been ongoing to identify how this gap can be reduced and his has enable Cwm Taf to revise the endof-year forecast to £5.5m. The Welsh Government has said it expects Cwm Taf to do everything possible to deliver a yearend break-even position for 201314; at the very worst, Cwm Taf must deliver a deficit no worse than £3.9m.
The health board must therefore continue the hard work to identify where savings can be made to enable it to meet the financial target set for the end of March 2014 and be in a stronger position going forward into next year. Performance The new integrated performance dashboard contained in this month’s board papers brings together indicators and targets related to the health board’s core business, including quality, performance, finance and workforce. Unscheduled care – performance against the four-hour A&E target had risen to 93.4% in November; there was also an improvement in ambulance handover times at A&E with 87.3% of patients handed over within 15 minutes but category A ambulance response times fell in November from 60% across the health board to 56.7%; Referral to treatment times have improved – the number of people waiting more than 52 weeks has fallen slightly. Twelve patients were cancelled in November because of a lack of beds – this low number reflects the improvements made in unscheduled care. Cancer targets – the health board has achieved the 31-day target and performance against the 62day target stands at 88%, which is a significant improvement on recent performance. Older people’s mental health services Cwm Taf has been working to improve mental health services for all adults living in Merthyr Tydfil and Rhondda Cynon Taf. A
first phase of work, which looked at services for people of working age, has been completed. A second phase of work concentrating on services for older people is now underway. Older people’s mental health services have traditionally been available for people over the age of 65. It is proposed that eligibility for the new services for Cwm Taf will be based on what best meets the needs of patients and not age. Dr Mark Winston, clinical director of adult mental health services, said:
“We want to provide a good service for older people – we’ve started that journey for younger adults, now we need to continue it for older adults. “We want to provide equity of access to services and to outcomes appropriate to the life stage of patients. “We would like to mirror the recovery model for young adults. The first aspect of that will be to rebalance services – we have far too many inpatient beds. “Crucial to this will be to develop good community-based services for older people – hospital liaison services and an enhanced crisis resolution service.” A number of areas of work have been identified as part of this work, which is called recovery model phase two: • Develop and enhance the role of the crisis team • Extend home treatment to inpage 8
•
• • • • •
clude all ages – this will help reduce admission rates and length of stay An “ageless” primary care mental health support service – this will offer general and age-appropriate services across the age spectrum Improve discharge efficiency Improve services to nursing home residents Develop additional day care services Improve services to primary care Address inequitable workloads at consultant and locality levels.
The next step will be a six-week engagement period with health board staff, Cwm Taf Community Health Council and the public about the ideas to improve older people’s mental health services. Child and adolescent mental health services
Success for Cwm Taf University Health Board at MediWales Innovations 2013 Award Ceremony INNOVATIVE passports which help stroke patients track their treatment and recovery have been awarded a prestigious award.
The annual report explains the tiered structure of CAMHS and some of the challenges facing the service. It is available here. The board papers for the January meeting are available here.
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The award recognizes the innovative work undertaken to produce a unique set of passports to help guide patients and their families through stroke care and rehabilitation. The interactive documents are designed to prevent patients feeling lost or abandoned by NHS and voluntary services, especially after they are discharged from hospital.
The first annual report about child and adolescent mental health services (CAMHS) provides detailed information about this small but specialised service area. Cwm Taf University Health Board provides CAMHS on behalf of Abertawe Bro Morgannwg, Cardiff and Vale and Cwm Taf health board areas; it also provides highly-specialised inpatient services at Ty Llydiard at the Princess of Wales Hospital, in Bridgend.
stroke at a ceremony on December 10 at Cardiff ’s National Museum.
THE speech and language department at Cwm Taf University Health Board is celebrating success after winning the MediWales NHS Awards 2013. The Life after Stroke team won the Judges’ Award for the NHS for the stroke patient passport which was presented to Dr Kathryn Head, the health board’s clinical lead and speech and language therapist for
The passports, which were developed by speech and language therapists with the help of stroke patients and their families, cover the early (hospital) treatment of a stroke, rehabilitation and life after a stroke. Maintained and owned by the patient, the three passports help the individual retain control of their care during their recovery from a stroke. They are now being piloted on a small number of patients from across the health board, following successful focus group work.
BETTER SERVICES FOR PATIENTS WITH CHRONIC PAIN NEW guidelines are being introduced in Cwm Taf University Health Board to improve services for patients with chronic non-malignant pain. A group led by specialist pain clinicians and the pharmacy’s pain lead has been set up to develop the new guidelines which will ensure patients are getting consistent and effective treatment.
On receiving the award Dr Head said: “The stroke patient passport is unique in being a tool that follows the patient throughout the stroke pathway and it has been developed to be accessible to individuals with communication difficulties. “The award recognises the dedication and collaborative work of the speech and language therapists, the multiagency team and stroke survivors.
“The passport puts patients back in control of their recovery and so far, has been very much welcomed as a tool that facilitates communication and engagement in the stroke recovery process.” Feedback from stroke patients across Wales indicated that when they left hospital they felt as though they fell through a black hole; that they felt abandoned; there was no support for carers and that services weren’t joined up. Dr Head said: “As part of the
Welsh Government’s Life after Stroke initiative, the health board saw we thought this was an opportunity to develop a resource for patients that covers the whole of their stroke journey, not just life after a stroke.” Kathy McLernon, a specialist speech and language therapist for acute stroke at Cwm Taf University Health Board, who designed the passports, said: “We had really good feedback from the focus group – one person said they wished they’d had this when they’d had their stroke. They said they’d have found things easier and would have known what to ask for. “We’ve found that often things are just done to stroke patient because they weren’t aware what to ask for but these passports will help.” The passports have been successfully piloted in Cwm Taf University Health Board and Dr Head hopes, with further collaboration and funding, they can be rolled out across Wales.
Gareth Tyrrell the Aseptic Service and Clinical Lead Pharmacist for Surgery said: “An increasing number of patients are seeking help for chronic pain - it’s not always easy for them to get the help they need and it can place pressure on the NHS. “Our aim has been to develop new, more accurate ways of assessing and treating types of chronic non-malignant pain and provide guidance about when patients should be referred to the chronic pain service. “This will allow patients in both primary care and hospital services to be referred to the most appropriate specialists for their needs. “This should ultimately mean they are treated more effectively and quickly within Cwm Taf ”. For further information contact Helen Williams, Senior Clinical Nurse Specialist on 01443 443469 or e-mail Helen.williams30fabb@wales.nhs.uk page 10
tals and died shortly afterwards. His family brought in a large recycling bag full of prescription medicines – there were four different types of blood pressure tablets in the bag, including a three-year supply of one and 50 packets of another. “All of this medicine would have been prescribed to relieve the symptoms of his heart disease and to prolong his life.
SPRING CLEAN YOUR MEDICINE CABINET People living throughout Cwm Taf are being urged to spring clean their medicine cabinets at the start of a major new campaign to help patients better understand and use their prescription medicines. People will be able to take their unwanted medicines to their local pharmacies in Merthyr Tydfil and Rhondda Cynon Taf from today, where they will also receive expert advice about their prescription medicines from their local pharmacist. Cwm Taf University Health Board is urging everyone who is prescribed medicines to take them if they can and to tell their GP or their pharmacist if they can’t. The Your Medicines, Your Health campaign highlights the important - often life-prolonging and even life-saving – role prescription medicines can play in a person’s health and wellbeing. page 11
Martin Davies, chief pharmacist for the Rhondda, in Cwm Taf University Health Board, said: “There are many reasons why people don’t take the medicines prescribed for their condition, but not taking your medicines, especially if you have a long-term condition, can have a detrimental impact on your health. “Last year, an elderly gentleman was admitted to one of our hospi-
“Unfortunately, this is not an uncommon event – we often see patients coming into hospital who haven’t been taking their medicines.” Mr Davies added: “There may
be many reasons why someone doesn’t take their medicines – they may have had an unwanted side-effect; they may not understand how to take them - the important thing is for people to talk to their doctor or their pharmacist if they aren’t taking them, instead of continuing to order their prescriptions and storing them in their bathroom cabinet or a kitchen drawer.
“The message to everyone is that medicines are important for your health – please take them if you can and tell us if you can’t.” From today, pharmacies throughout Merthyr Tydfil and Rhondda Cynon Taf will be helping people to spring clean their medicine cabinets. People can bring all their unwanted and unused prescription medicines, including creams, ointments, liquids, inhalers, pills and tablets into their local branch where they can also arrange to have a free medicines use review with their pharmacist. Medicines use reviews are available to people who regularly take more than two prescription medicines or to people who are taking medicines for a long-term illness, such as asthma, heart disease, osteoporosis or diabetes. Emma Hinks, Cwm Taf University Health Board’s Community Pharmacy Facilitator, said: “The review appointment with a pharmacist at your local pharmacy will focus on how you are getting on with your medicines. “It will help you to find out more about the medicines you’re taking and to pick up any problems you may be having with your medicines. “If you are unable to attend the pharmacy for a medicines use review appointment because you are housebound, your pharmacist may be able to visit you at home. “Remember you can ask your pharmacist questions at any time, but a review will give you both more time to concentrate on you and your medicines.”
LIFETIME ACHIEVEMENT HONOUR AT HOUSE OF LORDS FOR PRINCE CHARLES HOSPITAL SURGEON ORTHOPAEDIC surgeon Kodali Prasad has been presented with a lifetime achievement award at the House of Lords.
friends, colleagues and clinical, administrative and secretarial staff - at times it goes beyond the call of duty.
He was presented with the prestigious honour by Baroness Sandip Verma, the UK Minister for Energy, on behalf of the NRI Welfare Society of India (pictured above).
“It gives me great pleasure to be able to contribute to the positive image of Prince Charles Hospital and it is a great honour to play a small part in promoting the image of Wales, the UK and India.”
The unique international award recognises Dr Prasad’s “exemplary contributions in the medical field,” including his ongoing work in Prince Charles Hospital, in Merthyr Tydfil. Dr Prasad, who was born and educated in India, dedicated the award to the memory of his parents - Kodali Jagadamba and Kodali Venkateswara Rao - and thanked his family and colleagues for their support. He added: “I very much appreciate the support, suggestions, encouragement and help from close personal and professional
Dr Prasad has won numerous awards over the course of the last 18 months, travelling to India and Thailand to collect the honours. In his latest visit to India in October, he attended and took part in the 34th SICOT (Société Internationale de Chirurgie Orthopédique et de Traumatologie World Orthopaedic Congress. One of the eight presentations he took to the conference was pre-selected as one of the best oral papers at the four-day event in Hyderabad.
page 12
patients say thank you to aberfan gp and longstanding member of the community ABERFAN will say a fond farewell to their GP of 30 years when Dr Pankaj S Shah of Pantglas Surgery retires on New Year’s Eve.
practice single-handedly and was always on call for his 1,200 patients which, by any definition is no mean feat.
A farewell buffet was held at the surgery on December 19 when patients and staff had the opportunity to say goodbye to their doctor and thank him for his service and commitment to the community over the last three decades.
In 1989, an extension to the building enabled additional rooms to be built which were used by the practice nurses and Dr Shah’s wife Smita who set up well woman and family planning clinics. Dr Shah’s two sons have followed in his footsteps - Maulik is a GP in Swansea and Hemal works in
Dr Shah (pictured, left) arrived in South Wales from the Midlands in 1981 where he began his GP training in New Tredegar, Gwent.
London. As we all know, behind every GP is an avid receptionist and Cathy Thomas and Margaret Guppy are no exception to that rule. Cathy has worked at the practice for 13 years and Margaret for nine years and both have enjoyed the role immensely. Janett Bickley was the practice manager from 1988 to 2001 and she joined staff and patients to say farewell to Dr Shah.
In 1982, he joined the Nixon House practice in Merthyr Vale staying there for two years before leaving in 1984 to look for new premises for himself. He found premises at Aberfan Community Centre, where he set up Pantglas Surgery on his own. Dr Chillal joined Dr Shah for a few years but left in 1989 and Dr Shah returned to running the
From left to right: Maureen Hughes, patient, Jayne Grifiths (former practice nurse), Margaret James, practice nurse,Dr Shah, Cathy Thomas, Janett Bickley and patient Marjorie England. In front, Sheila Lewis, patient. page 13
Cathy Thomas and Janett Bickley pictured outside the surgery. Maureen Hughes, a patient at the practice since the mid-1980s, said: “Dr Shah will be missed in this community.He was always very accessible to his patients. He’s a quiet gentleman who knows his job. “My mother and great aunt were patients in the practice and my son is also a patient.” During the buffet, Dr Shah was presented with a framed illustration of Pantglas Surgery by Mrs Hughes (pictured).
Dr Shah said: “My patients live in a very close community and have been very supportive of me. “Staff at the practice are very caring and eager to help patients. “I have enjoyed working here and have many good memories. Time has gone very quickly and I have made a lot of friends.” Following retirement, Dr Shah now plans to do locum work and to play more golf to improve his handicap. Dr Chris Jones, chair of Cwm Taf University Health Board said: “Dr
Shah served the Aberfan community through thick and thin. Countless people will have benefitted from his gentle support and professional kindness. “The health board wishes Dr Shah and his family a healthy and happy retirement.” From January 1, 2014, the Pantglas surgery will be merged with Brookside surgery in Troedyrhiw but patients will still be seen in Aberfan for the foreseeable future.
page 14
SUSPENDED SENTENCE FOR WOMAN WHO ATTACKED HOSPITAL STAFF A PATIENT who assaulted three emergency care workers at Prince Charles Hospital’s emergency care centre has been given a 14-day suspended prison sentence. Felicity Winisworth, 37, from Little Free Street, in Brecon, was also ordered to pay compensation to her victims when she appeared before Merthyr Magistrates’ Court for sentencing on January 2. She had been convicted in her absence of the assaults and a public order offence at a trial at Merthyr Magistrates’ Court on December 5. The trial heard the attacks occurred as the three members of staff had been attempting to care for the 37-year-old woman when she attended the emergency care centre, in Merthyr Tydfil, on July 1. Instead they were subjected to a torrent of foul and abusive language and a series of vicious and unprovoked attacks while they were trying to provide care for a patient. Dave Lewis, Cwm Taf University Health Board’s violence and aggression case manager, said: “This incident caused a great deal of alarm and distress to members of the public and children who witnessed it – one of the assaults took place outside the children’s unit in full view of children and their parents.
page 15
“We take any act of abuse or violence towards our staff very seriously, whether it happens in a hospital; in a clinic or in a GP surgery. Our staff come to work to help others when they are sick and injured; they do not come to work to be verbally or physically abused.” Between January 1 and November 30 last year, 22 people were prosecuted through the courts for abusive or aggressive behaviour
towards NHS staff in the Cwm Taf area. Cwm Taf University Health Board also submitted 103 anti-social behaviour referrals to Rhondda Cynon Taf and Merthyr Tydfil community safety partnerships as a result of abusive or aggressive behaviour. In addition, 85 warning markers were placed on patients’ records to warn staff of the potential risk of violence from a patient. Patients were written to advising them of their unacceptable behaviour. And 62 code of conduct letters were sent to patients, advising them of their unacceptable behaviour.
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