Friday, June 9, 2023
More services being delivered “to great effect” in the community, says top health board GP

More services being delivered “to great effect” in the community, says top health board GP

GROWING numbers of people are realising the benefits of being treated at home or in their communities rather than being admitted to hospital, a leading Hywel Dda GP has said.

Dr Sion James, Clinical Director for Primary Care in Ceredigion, said that many frail and elderly patients were currently being admitted to hospital when they didn’t need to be and were watching their condition deteriorate to the point where they ended up waiting in hospital beds for a place in a residential or nursing home.

The health board has officially launched a 12-week consultation, “Hywel Dda – Our Big NHS Change,” which is aimed at making provision of local health and care better for our communities.

We’re asking residents across Carmarthenshire, Ceredigion and Pembrokeshire, as well as the wider cross-border regions, to get involved and have your say on three proposals to improve the way we provide care for our population. Each proposal has been designed and tested by our clinicians to ensure that our services are safe, sustainable, accessible and kind for our generation and those to come.

Dr James added: “I think people fear change, but there are plenty of examples where we’ve demonstrated that providing services closer to home – often with the help of new technology – are better for people, and that we need to trust healthcare professionals to work with individuals within communities to provide care.

“Some of the challenges we’re seeing in community care include recruitment, as there are not enough GPs to go around, and while we are delivering more and more services to great effect in the community, we don’t really have the resources to take on any more without a real shift in resources from secondary care to primary care and community services.

“A lot of the time it’s very frustrating because we believe that people should be looked after at home, but then we’re forced to admit them [to hospital] because there are no other alternatives – that’s one of my big bugbears.

“The problem with that is that it isn’t the best place for them to be. People do deteriorate very quickly when they’re frail and elderly, they lose their function and then they become patients who are in hospital and waiting for placement in a nursing home or residential home. This Delayed Transfer of Care (DToC) puts further pressure on hospitals as they don’t always have enough beds for inpatients.”

Dr James called for a range of new and different alternatives to the traditional medical model in which patients are referred from their GP to secondary care settings such as hospitals.

He added: “It’s not about buildings or “bricks and mortar,” which is what people tend to focus on when we have these discussions; it’s about using people and the networks of teams that we have so that we’re able to keep people out of hospital and functioning independently. For example, we have a multidisciplinary team with district nurses, palliative care nurses and social workers who all meet regularly so that they can have conversations about people and get the best use of services for that individual.

“I think there’s a great realisation among patients, especially the elderly and frail, that they don’t want to go to hospital. I think they have a lot of experience of people going into hospital and perhaps seeing their physical condition deteriorating, plus they’re away from their family and they don’t want that. I’ve got a lady at the moment who is receiving care with the Acute Response Team (ART) at home and she’s delighted. She didn’t want to go to hospital and before that was the choice – go to hospital or don’t. Now the ART team are there, she’s getting fluids given to her at home and she’s very pleased.”

You can find out more about the consultation and the health board’s proposals, or tell us your views, by:

Completing the online questionnaire at:

Emailing us at:

Telephone: 01554 899 056

Coming to one of our drop-in events:

Tuesday 8th May 2pm – 7pm / St Peter’s Civic Hall, Carmarthen SA31 1PG

Friday 11th May 2pm – 7pm / Regency Hall, Saundersfoot SA69 9NG

Tuesday 15th May 2pm – 7pm / Letterston Memorial Hall, Letterston SA62 5RY

Friday 18th May 2pm – 7pm / Morlan Centre, Aberystwyth SY23 2HH

Tuesday 22nd May 2pm – 7pm / Selwyn Samuel Centre, Llanelli SA15 3AE

Thursday 24th May 2pm – 7pm / Llandybie Memorial Hall, Llandybie SA18 3UR

Monday 4th June 2pm-7pm / Rhys Pritchard Memorial Hall, Llandovery SA20 0DS

Monday 11th June 2pm-7pm / Penybanc Welfare Hall, Ammanford SA18 3QS

Thursday 14th June 2pm-7pm / City Hall, St.David’s SA62 6SD

Monday 18th June 2pm-7pm / Tysul Hall, Llandysul SA44 4HS

Tuesday 26th June 2pm-7pm / Pembrokeshire Archives Building, Haverfordwest SA61 2PE

Monday 2nd July 2pm-7pm / Victoria Hall, Lampeter SA48 7EE

Thursday 5th July 2pm-7pm / Pill Social Centre, Milford Haven SA73 2QT

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