1 DESIGNED TO DELIVER : SHAPING OUR ACUTE HOSPITALS IN MID AND WEST WALES

2 Our Aims: The best services available as close to peoples’ homes as possible Short waiting times for treatment Expert health care staff who understand what patients and their families need First class buildings and equipment

3 Why change? The population is getting older The pattern of disease is changing Many of our facilities are outdated Clinical standards are rising: we need to keep pace with developments Public expectations are changing Resources are finite and we need to improve the way we use them

4 Why change? Medicine and surgery are becoming more specialised Technology can bring specialist services closer to our communities Demand for emergency care is increasing Not all emergency care needs to be delivered in hospital Working hours and training arrangements for doctors and other staff are changing

5 What does sustainability mean? The provision of consistently safe clinical care : –to the best possible standard –in line with national policy and professional standards –meeting legal requirements –within available financial and human resources

6 Why the current situation is not sustainable: Clinical standards cannot continue to be met with the size of the populations served Lack of coordination between services and organisations The need to improve working hours for doctors in training and other NHS staff due to the European Working Time Directive Shortages of some specialist clinical skills

7 Designed to deliver: the founding principles Consistent, high quality care in all parts of Mid and West Wales Routine care closer to where you live Better care for people with long term illness Improved primary and community care Joined up services using skills and expertise to best effect

8 Key principles shaping our proposals: Using proven technology Best possible access to specialist care Faster and closer access to assessment and diagnosis of acute illness Efficient planned care that is not disrupted by emergency demands

9 What we propose for acute services Acute hospitals working together in three networks (Service Delivery Units) - Bro Morgannwg, Swansea and Dyfed A networked Service Delivery Unit in Powys which will deliver more acute care in local assessment and treatment centres linked to acute hospitals outside the county Specialist services will be provided on a networked basis across the three Service Delivery Units and Powys Highly specialised services, where provided in the region, will be delivered in Swansea

10 Networks will link different types of hospitals and primary care services District General Hospitals Linked District General Hospitals Local General Hospitals Elective Treatment Centres Primary Care Services and Resource Centres

11 What does this mean for Bro Morgannwg? Princess of Wales and Neath Port Talbot Hospitals working together as an integrated provider of acute hospital services for the community

12 What does this mean for Swansea? Swansea will develop a single site acute hospital supported by strengthened primary and community services to take routine care closer to patients in their communities

13 What does this mean for Powys? Powys will deliver more acute services locally, in partnership with a network of acute providers, through the development of shire based assessment and treatment centres(as detailed in Doing More, Doing Better)

14 What does this mean for Dyfed? OPTION 1 A new integrated acute hospital built in South Dyfed Bronglais Hospital will be a linked DGH The Prince Philip Hospital will become a local general hospital(LGH) and a dedicated centre for elective care supporting Dyfed and Swansea A network of improved primary and community care services and resource centres will be developed to reduce reliance on hospitals

15 What does this mean for Dyfed? OPTION 2 West Wales General Hospital will become the main acute DGH site for Dyfed Bronglais and Withybush will become linked DGHs Prince Philip Hospital will become a LGH and a dedicated centre for elective care supporting Dyfed and Swansea

16 What does this mean for health care organisations? A single Trust will be developed for Dyfed Bridgend LHB and Neath and Port Talbot LHB will develop joint arrangements for the commissioning of secondary care services Carmarthenshire, Ceredigion and Pembrokeshire LHBs will develop a single secondary care commissioning arrangement

17 What will this mean for patient care? More services provided locally by primary and secondary care working together Better care for people with long term illness such as diabetes or asthma Better access to quality specialist care Coordinated services with consistent standards for emergency and planned care

18 How long will all this change take to deliver? Most of the changes are about better systems of care for patients, much of which can be achieved through working differently and together throughout the Region This is a ten year programme of change that must start now to give patients early benefits

19 The Local Story What does this mean for the people of Bridgend County Borough?

20 A Brief History 1999 : Bro Morgannwg NHS Trust 2003: Bridgend Local Health Board Strong history of partnership working. Programme of continuous improvement. More patients treated than ever before with 80% of elective work as daycase.

21 Successes to Date Reablement Scheme (2001) Maternity Services Review (2003/04) 2004/05 Concordat between Bridgend, Vale and Neath Port Talbot LHBs and Bro Morgannwg Trust to reduce duplication

22 Successes to date Targets are already being met: –No one is waiting more than 12 months for treatment and no patient referred to Second Offer Scheme –80% of all elective patients in Bro Morgannwg NHS Trust are treated on a day case basis –80% of patients are already being seen/treated as an outpatient, inpatient or day cases within 5 months –95% of patients are being treated within 4 hours within the A&E Department

23 Successes to date Clinical Networks already established for Cancer and Cardiac Services New models of care introduced for Ophthalmology and Oral Maxillofacial Services Increased Orthopaedic surgical capacity at NPTH, to serve three Local Health Boards

24 Successes to date Closer working across PoWH and NPTH: –Concordat on services to reduce duplication of service: “one hospital, two sites” –MRI and Catheter Laboratory centralised at PoWH –Major Surgery, Breast Surgery and Orthopaedics focused on the Neath Port Talbot Hospital site –Investment in Digital Technology and PACS allows transfer of x-ray images between PoWH and NPTH –Improvement in cross-Trust services: Cardiology Rheumatology Dermatology General Surgery Orthopaedics

25 Modernisation of GP Services Links between Princess Of Wales Hospital and GP practices for Pathology test and X Ray results. New General Medical Services Contract New GP Out of Hours Service More “shared care” between hospital consultants and GPs

26 More changes to come Delivering integrated services: –To transform local services to develop a health and social care model that will address Chronic Diseases closer to the patient –Working across seven statutory organisations and the voluntary sector –Key workstreams identified to include Prevention and Self-Care, Care Pathways for Chronic Diseases, Intermediate Care/Community Hospitals, workforce redesign and IM&T

27 More changes to come Cont.. –To deliver local services for patients with conditions such as Diabetes, Heart and Respiratory problems –A more steamlined service where GPs and their teams work with other sectors –To achieve improved quality of care and avoid unnecessary hospital admissions

28 More changes to come Development of Clinical Decision Unit at PoWH Modernisation of Mental Health Services Continue investment in ICT, including electronic referrals and discharge correspondence, remote monitoring, integrated electronic patient records Ongoing replacement of Major Diagnostic Equipment Develop proposals to redevelop PoWH Develop NPTH as an Elective Centre

29 More changes to come Further development of Networks: –Best use of scarce expertise and resources –Merger of Pathology Services –Developing Networks for Vascular and Urology services Better utilisation of estates  Community hospitals  Primary Care premises

30 More changes to come Wherever possible, the majority of a patient’s care will continue to be provided as locally as possible to where they live, with patients having to travel further afield only when they need more complex or specialist elements of care

31 What Next? 3 month consultation until 26 th June Find out more… Involvement of stakeholder and public when there is any significant change Evolution not revolution!!

32 How can I find out more? The consultation document is available from your Local Health Board More details are also posted on Local Health Board and Trust websites Local public events will be held in each of the seven Local Health Boards. These will explain the implications for your area and answer any questions you may have

33 Local Contacts Chief Executive Bridgend Local Health Board North Court David Street Bridgend Industrial Estate Bridgend CF31 3TP Tel: Fax: Minicom: Website: Chief Officer Bridgend Community Health Council Suite B Britannic House Llandarcy Neath SA10 6JQ Tel: Tel

34 How do I make my comments? The consultation will run for a period of 12 weeks from 3 April 2006 and will end on Monday 26 June 2006, by which time any comments you wish to make must be sent to your Local Health Board If you have any alternative suggestions on how we can achieve the aims laid out at the beginning of the document, we would be very pleased to consider them together with any supporting evidence.

35 What happens after the consultation? At the end of the consultation process, each LHB and Community Health Council within the Region will consider all responses received from the public, NHS staff, health professionals and all other stakeholders If there is agreement on the proposals, this will be confirmed at the public meetings of the Local Health Boards and we will proceed to implementation If there is no agreement on the proposals, the detail of the consultation and the responses may be referred to the Minister for Health and Social Care for a decision

36 Implementation We are fully committed to the involvement of CHCs, staff and their representatives in shaping the processes for implementing any changes resulting from this consultation

37 YOUR VIEWS ARE VERY IMPORTANT TO US PLEASE MAKE SURE YOU HAVE YOUR SAY!