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Health Minister pledges £170m extra a year for ‘transformation’ of how planned care services are delivered

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photo of woman lying in hospital bed

More than £170m extra a year is set to be invested in planned care across NHS Wales, Health Minister Eluned Morgan has announced at the inaugural Planned Care Summit.

The Minister hopes the rallying cry and additional funds will ‘build a planned care system that is bigger, better and more effective than we have seen before’.

Planned care is any treatment that doesn’t happen as an emergency and usually involves a prearranged appointment. Most patients are referred for planned care from their GP.

The funding will predominantly be focused on endoscopy, cataract, orthopaedic and diagnostic & imaging services, but will also go towards cancer and stroke services.

It is on top of the £25m extra a year for emergency departments announced in July.

Health boards are being urged to develop plans about how they can transform how their services are delivered and make best use of the funding available, which will be split equally between each health board based on population.

Speaking at the Planned Care Summit today (4 November), which the Health Minister organised after a meeting with the Royal College of Surgeons England, the Minister also outlined how £1million will go towards the creation of a Planned Care Innovation Fund.

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The fund, which will be open to applications from 30 November, is based on the principles of the Bevan Commission’s Exemplar programme, and is set out to support innovation and adoption across Wales, maximising the momentum, enthusiasm and opportunity for change this presents.

Thanks to the Welsh Government’s £248m investment in Covid recovery funding, Betsi Cadwaladr UHB have already seen further developments in their delivery of orthopaedics with the innovative implementation of virtual follow ups with patients, video group consultations, some joint replacements without an overnight stay and prehabilitation screening for patients before surgery helping to cut their recovery time.

While these may appear small innovations, it is hoped they have the potential to be rolled out across all health boards and their learning being applied to many different settings.

Newly appointed NHS Wales chief executive Judith Paget will outline at the summit the five goals that will transform planned care, which are:

  • Effective referrals into secondary care;
  • Access to specialist advice and guidance for primary care and paramedics;
  • Treat accordingly by ensuring that all care pathways are fit for purpose;
  • Follow ups to encourage individuals to manage their own conditions;
  • Measure what is important when looking at waiting lists.

She said: “We have provided an investment of £248m to support the acceleration of planned care recovery during this financial year. We are making an extra £170m a year available to health boards for them to radically transform and fundamentally change how planned care is delivered, to ensure the planned care programme is fit for purpose and is delivering what we need.

“We need to transform the way we deliver services. Many advancements and new ways of working have come online during the pandemic, but it is important to build on these and use the opportunity to create modern health and social services for the future.”

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Health Minister Eluned Morgan said: “The impact of the pandemic on planned care has been significant, resulting in a massive backlog of patients waiting for planned treatments. There are, we fear, also many patients who are yet to present to primary care with their illness.

“We need a whole system approach to how care is delivered and by investing £248m in Covid recovery, £170m in planned care and £42million in social care, we hope to put NHS Wales in a stronger position for future generations.

“We are calling for health boards to radically transform how planned care is delivered, as we want to not just recover from the pandemic, but to build a planned care system that is bigger, better and more effective than we have seen before.”

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Coronavirus

Covid measure-avoiding cinema threatens to disobey latest closure notice – branding First Minister a ‘grinch’

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The Welsh Government issued Swansea independent cinema and food outlet Cinema & Co with an order to close on public health grounds on Friday.

Swansea Council originally issued a closure notice for the business on Thursday 18 November saying the business had not completed a COVID risk assessment, staff had no training on how to prevent transmission of COVID-19 and there was no implementation of the COVID pass scheme.

It was also noted that there was no signage advising customers to wear face coverings and there was inadequate cleaning products to reduce the spread of COVID-19.

Business owner, Anna Redfern described the Welsh Government COVID pass law as “nonsensical” and “unnecessary”.  She also refused to comply with the council’s closure notice saying

The Council took Redfern to court to enforce the closure. Ms Redfern failed to attend court, while the judge asked for an adjournment to proceedings to query the act of law that the council was using to bring the closure notice.

Prior to the new court date, the Welsh Government has decided to act itself using enforcement parts of the Coronavirus legislation for the first time.

Under the Coronavirus Act 2020, the Welsh Minsters have powers to take action against specific premises where they consider the premises to present a risk to public health.

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In a statement, the Welsh Government said: “To support Swansea Council and to protect public health, Welsh Ministers have issued a direction under the Act for the closure of Cinema & Co in Swansea.

“Recently the Local Authority identified a series of breaches of the Coronavirus Regulations at the premises.

“The premises was previously served with a notice requiring it to close due to the risk to public health.

“As the owner has chosen not to comply with this legal requirement, Welsh Ministers have taken further enforcement action.

“The Welsh Government will not be commenting further on ongoing legal proceedings.”

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Council officers attended the cinema on Friday evening to close the Castle Street business once again, with the order prohibiting anyone from entering the building unless given approval from the court, the council or the Welsh Government.

There was a strong police presence to enforce the closure, although media reports indicate a small number of protestors remained inside the building, with some of those reportedly wearing Voice of Wales branded clothing.

The controversial organisation has been supportive of Ms Redfern’s anti-COVID pass stance, but while describing itself as a media organisation it has been dogged by allegations of being a far right, racist group – something that it strongly denies.

Ms Redfern herself also denies any link to racism or extremism, saying that her “life had become totally surreal” and that she was “being acted on by so many forces out of [her] control. Some very dark.”

In a statement on social media she said: “I absolutely reject any claims that I am in any way connected to far-right groups, far-left groups or any form of racism”

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Following the most recent closure notice, signed by Welsh Government First Minister Mark Drakeford himself, Cinema & Co described the First Minister as a “grinch” and vowed to disobey the order, organising a showing of the film The Grinch Who Stole Christmas” at the cinema on Sunday 28 November at 4pm.

The sold-out event was promoted on Cinema and Co’s social media showing the face of Mark Drakeford photoshopped into the grinch, accompanied by further anti-COVID pass slogans.

It is unclear as to what, if any further action the Police, Council or Welsh Government will take should the cinema breach the latest closure notice and reopen as promised.

A crowd-funder set up by former Brexit Party & Abolish the Welsh Assembly candidate Richard Taylor, has raised over £60,000 so far.

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Books & Literature

Nurse turns to verse to express pandemic woes

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An emergency department nurse has combined his passion for nursing and writing by creating heartfelt poems inspired by the Covid-19 pandemic.

Michael Jenkins has always been enthusiastic about poetry but never focused on writing until the start of the pandemic.

He felt this was the perfect opportunity to capture the emotions of not only the nursing staff but everyone involved in the NHS.

Writing poetry also acted as a coping mechanism for Michael to get through what has been one of the toughest times in the history of the NHS.

His first poem, Give me a Break!, was shared on his Facebook page, as well as a Covid support group, where he received rave reviews and an unprecedented amount of appreciation which came as a surprise to him.

“The more poems I started to write, the more attention and shares on social media I was receiving,” Michael said.

Rebecca Price, Emergency Department matron at Morriston Hospital, in Swansea, added: “Michael really does know how to dig deep into NHS staff’s hearts and reveal their true emotions in such a pressurised environment in what has been the toughest couple of years in the history of the NHS.”

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After 18 months of concentrating on the pandemic, Michael turned his attention to other subjects within nursing, in particular by writing a poem about living with dementia.

He added: “We have so many patients coming through the ED doors with dementia but with other conditions to treat.

“It can be very difficult for trained nurses to deal with patients who unfortunately suffer with the terrible illness of dementia.”

Michael’s poem about living with dementia was shared so widely on social media that it even caught the attention of the national charity Dementia UK.

The charity was so impressed it asked Michael if it could rebrand and share the poem on its social media platforms. It has since received a huge amount of praise and shares.

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Dementia UK said: “Michael’s poem has really resonated with all people involved with dementia and has been enjoyed so much.

“We are very appreciative he has taken the time to write such a beautiful poem.”

Several of the poems have since been displayed in ED to be read and enjoyed by members of staff, as well as patients.

Michael hopes the poems can provide a boost where needed and spread some positivity.

Below are two of the poems for your enjoyment.

Give Me A Break!

Patients laugh and patients cry
Patients live, some patients die
Staff will help, Staff will care
Staff with yelp, Staff will ware

Taking its toll on every single person
Reliving the day that’s for certain
Locked down, feeling trapped with no location
Nowhere to go but work and save the population

I never signed up for this’ I read
But we can’t say that or else they’d be dead
But please just give me some space
I’m also a part of this human race

I’ll moan, I’ll cry, I’ll scream and shout
But I know I’ll carry on without a doubt
Do we want some gratitude?
Or do we need a better attitude?

I don’t know I just want some time
Is that to be such a crime?
I’ve paid my fee to work my vocation
What’s that all about?

I’ll still head off without any hesitation
But please I pray to God for goodness sake
All I’m asking for….is give me a break!

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Living with Dementia

I got told I had dementia today,
But that’s fine I’m still me!
The same old person that you sit with
To drink a hot cup of tea.

I may not remember every last detail,
Or recognise your face.
But I will sure try to imagine,
Taking me back to my favourite place.

I may get confused and anxious,
And wander round my house.
I know I shouldn’t dwell on the past,
But I really miss my spouse.

Sometimes my mind is somewhere else,
Like on holidays from years ago.
Or dreaming of better times I’ve had,
Now I must learn to go with the flow.

I am still the same human being,
With a brain inside my head
It just takes a while to think of things,
Like when should I go to bed?

Please don’t judge my shouting,
Or if I somehow make you scared
It’s just my mind playing tricks on me,
Maybe I just need to be fed!

Some company is all I need
To play my favourite game,
Then maybe next time I see you,
I will remember your lovely name.

Now I will always cherish the memories,
Of all the times we share,
Please don’t stop coming to visit,
As I know you will always care.

I am still the same old person,
Just get a little jumbled up,
Now go get me that hot cuppa,
So I can sip from my favourite cup.

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Coronavirus

Community pharmacists boost the Covid booster vaccine campaign

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The drive to deliver Covid booster vaccines across Swansea Bay as rapidly as possible has itself been boosted by community pharmacies.

All 49 GP practices in Swansea and Neath Port Talbot joined the health board to deliver the first two doses of the vaccine.

But as they are now busy delivering flu vaccines on top of their usual services, community pharmacies have stepped up to help ensure the booster is available locally as well as in the main vaccination centres.

Their involvement follows a successful pilot earlier this year which saw four of them help deliver the first two doses.

Thirteen in the Swansea area, along with Vale of Neath Pharmacy in Glynneath, have now responded to the health board’s call for expressions of interest to take part in the booster programme.

One of the first to receive their booster in a pharmacy was Nigel Godfrey (pictured above), who lives near the Vale of Neath Pharmacy.

“It was fantastic,” said Mr Godfrey. “I was working from home so I could pop down to the pharmacy on my lunch break.

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“It was local, five minutes away. A lot more convenient than having to go to one of the mass vaccination centres.

“There was no waiting, I was in and out within five minutes.

“The pharmacist put me at ease and we went into a private room. There were no problems whatsoever.”

Mr Godfrey, aged 44, is entitled to the booster because of an underlying medical condition.

“But it will also protect my friends, family and colleagues, whoever I come into contact with,” he added.

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“It’s doing the right thing, not just for myself, but also those around me and the community.”

People eligible for the booster will be contacted directly with an appointment either in one of the pharmacies or in a health board vaccination centre.

Appointments are being sent out in chronological order, at least six months after the date people received their second dose.

Six months is the threshold at which those in priority groups become eligible for the booster, not an absolute date it must be given by.

Although there are no drop-in sessions, the health board has started a reserve list for people who are aged 40 or over, who had their second dose at least six months ago.

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They must also be available to attend one of the mass vaccination centres at short notice – within two hours.

As well as the MVCs, the health board employs local vaccination centres, converted shipping containers which can be taken into communities to save people who might otherwise struggle to get to an MVC.

With the pharmacies also on board, every effort is being made to ensure as many of those who are eligible for a booster can receive it as close to their home as possible.

“However, we appreciate that will not be the same for everyone,” said Swansea Bay’s Vaccine Equity Manager, Maxine Evans.

“We send invites to people living within a certain radius of the pharmacies to begin with and, if we have slots still available, we go further out.

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“We are flexible and if people cannot get to the pharmacies because they live too far away and do not have transport, they can phone the booking office to change the appointment.

“But when we have been to the pharmacies and spoken to patients, they were really grateful and happy with the fact that it was local and easy for them to get the booster there.”

Pharmacists too say they are happy to be involved with the booster programme.

Niki Watts of Vale of Neath Pharmacy said: “We decided to take part because we believe it’s important to help the health board get the population fully vaccinated as quickly as possible.

“We are located at the heart of the community so the patients find it easy to access.

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“We have good facilities, including a nice big car park right outside so the patients don’t have to walk very far, and our own dedicated consultation rooms where the vaccinations can take place in private.”

Eligibility for booster vaccines is determined nationally. It includes all adults aged 40 and over; frontline health and social care workers; people aged 16-49 with underlying health conditions putting them at higher risk of Covid-19; adult carers; and adult household contacts, aged 16 and over of anyone who is immunosuppressed.

Top of the eligibility list are people living in residential care homes for older adults. Swansea Bay has concluded its first sweep of 70 homes in the health board area – delivering more than 1,200 boosters to residents.

For various reasons, some were unable to receive the booster when the vaccinators were present, so return visits to each of the homes are now being arranged.

Georgina Assadi, health board Covid vaccine programme assistant service manager, said many of the vaccination team had not worked in the community before.

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“It was all new to them and some were a little anxious to begin with. But they all really enjoyed it because they knew they were providing protection to the most vulnerable people,” she added.

Lead image: Nigel Godfrey is given his booster by Niki Watts of Vale of Neath Pharmacy (Image: Swansea Bay NHS)

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