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Sea-change needed to provide best care for emergency patients – A&E Consultant 

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Sea-change needed to provide best care for emergency patients – A&E Consultant 

Posted By Robert Lloyd

A Senior A&E Consultant at Withybush General Hospital has thrown her support behind ambitious proposals by Hywel Dda to develop a new major hospital with state of the art facilities between Pembrokeshire and Carmarthenshire.

With just two weeks to go until Hywel Dda’s Big NHS Change consultation ends, Dr Nicola Drake said she was “very positive” about the proposals, which would mark a “sea-change” shift in the way Emergency Care could be provided in the future and prevent patients with urgent care needs from having to wait to be seen at busy A&E departments.

Hywel Dda’s Medical Director, Dr Phil Kloer, also said that around 40 per cent of patients who were currently occupying beds in the health board’s four hospitals wouldn’t need to be there if community and primary care services were also radically overhauled under the consultation proposals.

Dr Drake added: “As an A&E consultant I’m quite biased towards whatever system is in place that best helps us to see and treat patients with emergency care needs, which is why I’m very supportive of the proposals that the health board is putting forward.

“We’ve got to change, it’s as simple as that.  Under the current system, within Accident and Emergency, we are doing everything humanly possible to see and treat patients who come to us with life-threatening emergencies, but far too often they’re turning up in an ambulance and there just isn’t a space for them.

So we can treat them and stabilise them and then they have to wait, basically, somewhere in the A&E department or in the back of an ambulance until an inpatient bed becomes available elsewhere in the hospital.  The problem is that those hospital beds have often already been taken up by people who have been admitted, and in many cases are actually well enough to be discharged, but who don’t have a nursing home place or care plan in place to help them when they’re discharged because of the way the existing health and social care system works.

“I know the plans [for a new hospital] are causing a lot of concern locally and l completely understand why some residents would feel worried or angry about their local A&E department moving further away from them, but I can’t emphasise enough that what we’re talking about here is a whole-system change – a complete transformation not just of emergency care, but also the way that people access it. It’s not just about Hywel Dda changing – the Welsh Ambulance Service Trust (WAST) and the Wales Air Ambulance, as well as neighbouring health boards, would also have a big part to play.

“So that’s the challenge we all face – we’ve got to change and I think the plans that the health board have put forward represent the best, safest and most accessible way of doing that.”

As well as the benefit to patients of having more senior clinical decision-makers at the front door of a single A&E department in west Wales, the health board’s ambition is to be able to provide more specialist services in a new major hospital – these currently have to be commissioned elsewhere – which, together with a cutting edge research and learning environment, would significantly help in attracting more doctors, nurses and support service staff to come and work in the area.

Hywel Dda’s Executive Medical Director & Director of Clinical Strategy, Dr Phil Kloer, added: “In terms of new roles it’s not just the doctors we’re trying to attract to Hywel Dda; this is about our whole multi- agency workforce too, so we would expect new roles for nurses, therapists, physician associates and others, including paramedics, to take on leadership roles – leading care where the doctor isn’t really needed there on a daily basis.”

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