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Giving elderly people a Cwtch after a fall is keeping them out of hospital

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Giving elderly people in Swansea a cwtch after they have suffered a fall is helping to keep them out of hospital.

But this isn’t a cwtch in the Welsh sense, though a hug may be part of it.

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Traditionally, when older people have fallen, the advice is not to move them, and not to give them any food or drink until an ambulance arrives.

However, this view has now changed. Leaving them where they fell can in fact cause serious physical problems – and may lead to them needing hospital admission when the fall itself might not have.

This is especially true with ambulance times becoming unavoidably longer, meaning some people are left on the floor for many hours.

An education programme known as Cwtch has been introduced in nursing homes in Swansea and will be rolled out to those in Neath Port Talbot.

It has already won an award just five weeks after being launched and the initial feedback from nursing homes has been overwhelmingly positive.

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Debra Clee at Morriston Hospital (Image: Swansea Bay NHS)

The initiative is the brainchild of Debra Clee, an emergency nurse practitioner who recently joined the Older Persons Assessment Service, or OPAS, at Morriston after more than 20 years as an A&E nurse.

“We are trying to change the narrative out there and say that if they can be moved then we need to move them,” Debra said.

“We are finding that they are being admitted, not because of the fall but because of the long lie, as we call it.

“When you hear stories about someone never recovering from a fall, often it’s not the injury itself but being left on a hard surface for a very long time.

“This can cause acute kidney problems, it can give them pneumonia, it can cause muscle tissue to break down.

“If they are not being given anything to eat or drink they can become dehydrated. By the time they come to us they are not fit for surgery, if it’s needed, and are quite unwell.”

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So Debra came up with the five main principles underlying Cwtch to try to stop these and other problems occurring:

  • Can you move them?
  • Will it harm them (any new neck or back pain)?
  • Treat (wounds/pain relief).
  • Cup of tea (in most cases they can eat or drink).
  • Help (when to call).

“We are going into nursing homes rather than residential homes as they have qualified staff who can assess the patients.

“There are circumstances when they should not be moved. But even then we say you can give them painkillers and something to eat or drink.

“In many cases they can be helped up, maybe given a cup of tea and put into bed with some paracetamol.

“Within a few hours or by the next morning they could be up and about again. If necessary, a GP can be called to see them or they can be taken to the Minor Injury Unit or to us here in OPAS.

“Very often this can be done by car. But if they are left on the floor for hours then they will definitely need an ambulance and quite likely admission to hospital.”

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OPAS is a multidisciplinary service established in 2018, made up of healthcare professionals specialising in the care of elderly people.

During its opening hours, it can see older people who may otherwise have faced a long, sometimes very distressing wait in A&E.

It is based in a hub located alongside Morriston’s Emergency Department and has six spaces for patients as well as a therapy area.

Patients can have tests carried out and be seen by a senior clinician. In many cases this avoids the need for hospital admission.

Debra joined OPAS in December and the idea for Cwtch came around during a discussion with consultant geriatrician Dr Liz Davies.

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“I said we needed to do something. We see it all the time – these elderly people coming in after being on the floor for hours. Times need to change because it’s getting worse.

“And Dr Davies said – do something. Put some training together and get out there. So that’s what I did.”

A little more than a month after it was introduced, Cwtch picked up Best Presentation Award from the British Geriatric Society for Wales.

The presentation was made by geriatric registrar Dr Alex Burgess.

Dr David Burberry, one of the OPAS consultant geriatricians, said: “Deb has been an inspirational addition to the OPAS team since she joined us in December.

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“We are immensely proud of the work that both she and Alex Burgess have already undertaken to improve the care of older people across Swansea Bay.

“We are looking forward to seeing how this project develops in the coming months.”

Lead image: OPAS emergency nurse practitioner Debra Clee (Image: Swansea bay NHS)

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Sport

New Townhill all weather-pitch is ready for kick-off

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A new all-weather pitch that will benefit thousands of players in the years to come has been fitted at the Phoenix Centre in Townhill.

Swansea Council provided the funding that also included an upgrade to the floodlights at the popular venue.

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The council is also improving the nearby multi-use-games-area as part of the project that represents an investment of up to £300,000.

The centre’s former pitch was laid around 20 years ago and was well used by the community including local sporting clubs.

Council Cabinet Member for Investment, Regeneration and Tourism, Robert Francis-Davies, visited the site this week to check on progress that has also seen new netting and fencing installed.

He said: “Sport is such an important part of so many peoples’ lives so I’m really pleased we’ve able to use part of the council’s Economic Recovery Fund to make these improvements.

“The council recognises sport has huge physical, mental health and general wellbeing benefits and that is why we do all we can to provide modern and accessible facilities for all.

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“This pitch will benefit thousands of players of all ages and is just the latest all-weather pitch we have funded or provided support towards in recent years following on from investments at Penyrheol, Morriston, Pentrehafod, Gowerton, Bishopston, the Elba Sports Complex and at Dylan Thomas Community School.”

The work at the Phoenix Centre was carried out by Blakedown Sport and Play and old pitch has been recycled by a company working in the golf industry.

The Phoenix Centre is a flagship community enterprise centre run and managed by Hill Community Development Trust.

Manager Leanne Dower said: “We are very much looking forward to welcoming our existing and new users to this great new facility.

“The pitch will create opportunities for local children to try a variety of sports and have a safe space to play. We are very grateful to all involved for supporting us.”

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(Lead image: Swansea Council)

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Construction

Construction work soon to start on Swansea’s ‘living building’ at former Oxford Street Woolworths site

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With main construction work due to start in the coming weeks, city leaders have visited the Swansea site where a major new ‘living building’ project will soon be taking shape.

Cllr Rob Stewart, Swansea Council Leader, and Julie James, the Welsh Government’s Minister for Climate Change, were talked through details and timescales for the development, which will be located at the former Woolworths unit on Oxford Street.

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Earmarked for completion by the end of 2023, Swansea-based Hacer Developments is behind the scheme, which is one of the first of its kind in the UK.

Made up of the former Woolworths unit and a new adjoining 13-storey structure, the ‘living building’ will include green walls and green roofs, an educational facility, retail, offices, a landscaped courtyard, rooftop solar panels, battery storage and gardens. Pobl Group will manage 50 affordable apartments forming part of the scheme.

Other scheme features include an urban farm-style greenhouse set over four floors. Plants and vegetables will be grown in water and fed by waste pumped from fish tanks at the bottom of the building.

A green walkway including seating through the building will link Oxford Street to a new public space leading to the 71/72 Kingsway scheme being developed by Swansea Council.

Cllr Rob Stewart, Swansea Council Leader, and Julie James, the Welsh Government’s Minister for Climate Change, were talked through details and timescales for the development, which will be located at the former Woolworths unit on Oxford Street. (Image: Swansea Council)

Stripping-out and demolition works have now been completed at the ‘living building’ site, paving the way for main construction to begin.

The visit also included a tour of the new 33-apartment building at the city’s Copr Bay district developed by Swansea Council, which is set for completion this summer.

To be run by Pobl Group and located close to the new bridge over Oystermouth Road, the affordable apartments will cater for local people working in the city centre, with a particular focus on key workers. 

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Climate Change Minister Julie James said: “What we have seen through this work is an excellent example of the affordable homes we need to build in Wales.

“These new homes in the heart of Swansea city centre will make a huge difference to the quality of living for so many people.

“We need to see more projects like this delivered across the country as we strive to become a stronger, greener, fairer Wales.”

Cllr Stewart said: “Led by Hacer Developments, the exciting ‘living building’ scheme follows on from our work to transform the look and feel of The Kingsway.

“It will create jobs for local people while helping Swansea in its drive to become a net zero city, complementing the nearby office development at the former Oceana nightclub site that will be carbon zero in operation.

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“The residential element of the scheme will also meet the city’s accommodation needs by creating more affordable living opportunities in the city centre. This is also the case for the apartment building at the Copr Bay district developed by the council, which will benefit from excellent links with the new coastal park adjacent to Swansea Arena.”

Carwyn Davies, Managing Director of Hacer Developments, said: “We’re delighted that main construction work will soon start on the highly innovative ‘living building’ project, but it wouldn’t be possible without the support of the many partners involved, including Swansea Council, the Welsh Government, Pobl, the Development Bank of Wales, Swansea University and Cardiff University  – as well as our fantastic design and site team.”

The visit also included a tour of the new 33-apartment building at the city’s Copr Bay district developed by Swansea Council, which is set for completion this summer. (Image: Swansea Council)

Claire Tristham, Director of Developments at Pobl Group, said: “Pobl has a growing reputation for delivering forward-thinking housing solutions that push the boundaries.

“We are excited to be working with Hacer on this innovative project that will deliver much-needed, high-quality, affordable homes for Swansea and support the council’s wider regeneration plans for the city centre.

“Support from the council and Welsh Government has been critically important to this development, so we were delighted to able to welcome the Minister on site to officially launch the start of work on this truly unique project.”

The ‘living building’ is being funded by a mixture of private sector funding and funding from the Welsh Government’s Innovative Housing Programme, Pobl and the Development Bank of Wales.

Set to accommodate 600 workers, the nearby office development at the former Oceana nightclub site – due for completion in the summer of 2023 – is being funded by Swansea Council and the Swansea Bay City Deal. It is also being supported by the European Regional Development Site through the Welsh Government.

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The Copr Bay phase one district has been developed by Swansea Council, supported by development managers RivingtonHark. Buckingham Group Contracting Ltd is leading on its construction.

(Lead image: Swansea Council)

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Swansea Bay NHS

Health board unveil plans for three more operating theatres at Singleton Hospital

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Plans to expand the number of operating theatres at Singleton Hospital by 50% to help tackle surgical waiting lists are going before Swansea Bay University Health Board.

The hospital currently has six theatres, but the new plans will add another three.

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The planned new theatres are modular in design so they can be erected quickly and less expensively than traditional builds. The Board is being asked to approve the plans at its next meeting later today (Thursday 26 May).

The theatres will be the latest in a number of additional modular theatres being introduced to Swansea Bay hospitals.

Neath Port Talbot Hospital is having three new theatres to enable it to become the £25m Centre of Excellence for Orthopaedics.

The Day Surgery Unit (on a site opposite the main Singleton Hospital building) is also having an additional theatre.

The exiting six theatres at Singleton undertake procedures for gynaecology; ophthalmology; colorectal; general surgery; planned obstetric cases; breast surgery, orthopaedics and some plastic surgery.

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The three planned new theatres will provide additional activity for plastic surgery; general surgery, Ear, Nose and Throat, and oral maxillofacial surgery.

Singleton Hospital (Image: Swansea Bay NHS)

These three additional theatres at Singleton are expected to undertake an extra 2,190 operations a year.

The health board say that key to this work will be the introduction of a new four-bedded Post Anaesthesia Care Unit (PACU) at Singleton which will allow surgery to go ahead that could only have taken place in Morriston previously.

If the plans for the additional theatres are approved by the Board, the work is likely to be commissioned in 2023/2024.

Swansea Bay UHB Chief Executive, Mark Hackett, said: “We are only too aware of the pain and discomfort being endured by people on our lists who are waiting too long for the treatments they need.

“We are doing all we can to increase capacity to tackle these long lists.

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“Expanding our operating theatres at Singleton and Neath Port Talbot will be important steps forward.

“This is in line with our strategic Changing for the Future plans to improve both unscheduled and planned care, and develop each of our three main hospitals as centres of excellence.”

The future plans mean that Morriston Hospital will become a centre of excellence for urgent and emergency care, specialist care and regional surgical services for Swansea Bay, including complex medical interventions.

Singleton Hospital will become a centre of excellence for planned care, cancer care and diagnostics.

Neath Port Talbot Hospital will become a centre of excellence for orthopaedic and spinal care, diagnostics, rehabilitation and rheumatology.

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The health board say that by concentrating different skills, resources and specialisms on each site, each hospital will become a ‘powerhouse’ for these services, providing specialist treatments to a higher standard.

(Lead image: Swansea Bay NHS)

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