The South Wales Programme was a large-scale consultation designed to address major challenges faced by many hospitals in recruiting and retaining highly skilled staff in certain speciality areas.

The consultation led to a number of significant outcomes for the Royal Glamorgan Hospital including the transfer of consultant-led maternity, inpatient paediatric services and emergency services to other hospitals in the region and developing the Hospital as a beacon site for innovative models of care in acute medicine and diagnostic services.

Some of these changes have already been delivered, including the development of our Freestanding Midwifery Unit at Royal Glamorgan Hospital and the transfer of consultant-led maternity and neonatal services to Princess of Wales Hospital and our new unit at Prince Charles Hospital. We have also invested in key services at the Royal Glamorgan Hospital, including the development of a £6m diagnostic hub, and a new 50-bed acute medicine unit.

Staff across the Health Board have worked exceptionally hard to continue to deliver consultant-led 24 hour emergency services and inpatient paediatric services from the Royal Glamorgan Hospital as well as the Princess of Wales and Prince Charles Hospitals. However, continuing and growing service and staffing pressures have meant that this situation is becoming increasingly unsustainable and safe services in their current configuration cannot be maintained beyond the immediate short term without unacceptable risks to patient safety.

The Health Board considered a number of options on how to progress the remaining recommendations of the South Wales Programme at its Board meeting on January 30th.

We are now working closely with staff, the public and all key partners to ensure they are fully engaged in developing our future model of care and working through all implications to ensure quality is central and strengthening community based services at every opportunity.

You can read the Board paper here

There have been a number of questions about the proposals so we have produced the below FAQs

What is happening?

The South Wales Programme was a large-scale consultation designed to address major challenges faced by many hospitals in recruiting and retaining highly skilled staff in certain speciality areas.

The consultation led to a number of changes for services in Royal Glamorgan Hospital including the transfer of consultant-led maternity, inpatient paediatric services and emergency medical services to other hospitals in the region and developing the Hospital as a beacon site for innovative models of care in acute medicine and diagnostic services.

Some of these changes have already been delivered, including the development of our Tirion Freestanding Midwifery Unit at Royal Glamorgan Hospital. The transfer of consultant-led maternity and neonatal services to Princess of Wales Hospital and our new unit at Prince Charles Hospital happened in March 2018. We have also invested in key services at the Royal Glamorgan Hospital, including the development of a £6m diagnostic hub and a new 50-bed acute medicine unit.

Staff across the Health Board have worked exceptionally hard to continue to deliver consultant-led 24 hour emergency services and inpatient paediatric services from the Royal Glamorgan Hospital as well as the Princess of Wales and Prince Charles Hospitals. However, continuing and growing service and staffing pressures have meant that this situation is becoming increasingly unsustainable and safe services in their current configuration cannot be maintained beyond the immediate short term without unacceptable risks to patient safety.

The Health Board has to now consider options on how to progress the remaining recommendations of the South Wales Programme. We outlined the developing options at our Board meeting on Thursday January 30th and it was agreed that detailed work and discussion will be done on a small number of possible solutions.

What are the timescales for these changes?

The Health Board considered a number of options on how to progress the remaining recommendations of the South Wales Programme at its Board meeting on Thursday January 30th. We are focusing on the further development, engagement and evaluation of two emerging proposals:

  • To provide a 24-hour Minor Injuries service
  • For the Emergency Department to be staffed by consultants for daytime hours (for example 8am-8pm) and for a separate Minor Injuries service overnight

It is clear urgent action will have to be taken in the coming months to address the growing challenges within the department at RGH.

How serious is the staffing challenge?

The situation is becoming increasingly unsustainable and safe services in their current form cannot be maintained beyond the immediate short term without unacceptable risks to patient safety.

According to national guidelines, there should be one consultant for around every 4,000 people. The UK average is around one consultant for every 7,000 people but in CTM we have one consultant for every 15,000. Across the UK there are about 1200 vacancies which makes recruitment difficult.

If we were to meet national standards, we should have around 40 consultants, however we have 8 consultants in the Princess of Wales Hospital, the equivalent of 4.5 consultants in Prince Charles Hospital and one in the Royal Glamorgan Hospital, who is retiring in April.

As staffing levels are below the national guidelines in all three departments it is extremely difficult to transfer staff across our sites without compromising safety elsewhere.

Why haven’t you been working to recruit more staff?

Recruitment shortages are a UK-wide challenge. Previously we tried to recruit both in the UK and abroad and taken measures to provide an attractive offer for doctors but unfortunately, as with other sites across the region, we have not been able to recruit the staff we need. We will continue to try to do this.

Is this about money? Why can’t you save money to fund more doctors?

This is not about saving money, this is about making sure we provide people will safe services and the risk to patient safety is now becoming unacceptable.  We simply do not have enough doctors to be able to staff our units – if we could recruit to these areas, we would. We already spend more money on the current model in RGH than in any other unit as we have to pay premium rates for locum and agency doctors.

Why do changes have to be made to RGH? Why can’t it be another hospital?

The South Wales Programme was a large-scale consultation designed to address major challenges faced by many hospitals in recruiting and retaining highly skilled staff in certain speciality areas.

The consultation led to a number of significant outcomes for the Royal Glamorgan Hospital, including changes to the emergency departments, and therefore we need to progress the work identified by this Programme.

Surely any proposal to change the service will raise safety concerns?

We take our responsibility to provide safe services with the utmost seriousness. This is why we are having to look at proposals for changes as the current situation is becoming unacceptable for patient safety.  This has been highlighted in the report published in November by Healthcare Inspectorate Wales and the Wales Audit Office.

We know there will be implications for any of the options we are considering and we will make sure we work with our staff, partners and communities to listen to any suggestions and concerns and work through these while putting patient safety and quality first.

Will we get to put forward our views on the plans?

We will make sure there are plenty of opportunities for our staff, partners and communities to have conversations about any proposals so we can listen to any suggestions and concerns. We need good workable ideas from everyone.

Lots of people in the area don’t have their own transport and have to take multiple buses to get to other hospitals, what will they do?

As part of our work, we will be working closely with our partners, including local authorities, to look at the implications of any proposals, including transport, and what we can do to support our communities and improve access to care. We will do everything we can to keep the numbers of people affected as small as possible and increase access to minor illness and injury services in the community.

Are you closing RGH?

No, absolutely not. We are not closing Royal Glamorgan Hospital and have no plans to do so. We will continue to invest in the hospital and deliver a wide range of services from the site. Any proposal we eventually agree has to secure the future of RGH as a major site for service provision.

We have trouble accessing other community services now. What are you doing about this?

We will be looking at what we can do to help people better access care within their communities. We will be identifying where we can strengthen or build on existing services alongside what else we might be able to provide so people can access the care they need.

Prince Charles Hospital and Princess of Wales Hospital are already really busy. How will they cope with the extra patients attending their units?

Any future plans will be led by clinicians from across the organisation. Teams from Princess of Wales and Prince Charles Hospitals will be involved in all of the discussions to make sure we fully prepare all of our services to manage any increases in demand.  It will be absolutely critical that the neighbouring units can take any further patients.

Has the Welsh Ambulance Service been involved in this work?

The Welsh Ambulance Service have been and will continue to be a key partner in all our discussions and modelling work around the proposals.

Where can I find out more or get involved?

We will be hosting a number of engagement events in the next few weeks and will be advertising these shortly. If you would like to leave your details at today’s event we can contact you about these. You can also follow us on social media or visit our website at cwmtafmorgannwg.wales

You can also email [email protected] with your views and suggestions.