Programa de consulta de South Wales para el cambio en los servicios de diversos hospitales. + info: http://www.wales.nhs.uk/SWP/consultation-documents

1. The South Wales Programme
A public consultation about the
future of some hospital services for
people living in South Wales and
South Powys

2. Before we start …
This is the start of an eight-week CONSULTATION
Health boards are consulting on FOUR options
No decisions have been made
No hospitals will be closing or losing their A&E department
No staff will lose their jobs as a result of this change
Decisions will be based on EVIDENCE gathered so far and
FURTHER EVIDENCE to emerge from consultation
The evidence must point to IMPROVED OUTCOMES for patients

3. What do we want for South Wales and
South Powys?
We want all people living in South Wales and
South Powys to have access to the best possible
care whenever they need it, giving them the
best possible chance of surviving their injury or
illness and leading a full, independent life

4. The South Wales Programme
We are working together to address problems facing
our busy hospital services
Frontline clinicians – doctors, nurses, midwives,
therapists and paramedics – have been at the centre
of this work
We want to create a network of healthcare services
for South Wales and South Powys, which provides as
much care as locally as possible when safe to do so

5. What services are we talking about?
Consultant-led maternity and neonatal care
Inpatient children’s services
Emergency medicine (A&E) care for the
sickest and most seriously-injured patients

6. Where are these hospital services
currently provided in South Wales?
Powys

7. Why can’t we carry on
as we are?
Patients are not getting access to the best care and services
do not meet clinical standards
Senior doctors are not available at night or weekends
We do not have enough doctors to provide these services in
all hospitals – this is a UK problem but it’s worse in Wales
Some services are at risk of collapsing because of the
shortage of doctors

8. What’s the solution?
To provide the best care for all patients
all the time and to meet clinical
standards, these services need to be
provided in FOUR or FIVE hospitals
across South Wales

9. What does this mean?
All hospitals will continue to provide a wide
range of care for local people
The majority of A&E care will continue to be
provided locally, just as now
We will be creating a hospital system where
clinicians want to come and work

10. What does this mean?
The four services need to be provided
together on the same hospital sites
No hospitals will close but they will have
different roles in the future
No A&E departments will be lost but they
will provide different levels of care

11. Engagement
You understood why services need to change and a
majority supported the ideas for change
You’d like us to provide these services in as many
hospitals as we safely can
You were concerned about the impact on the Welsh
Ambulance Service; on people living in deprived
areas; on access and travel times and on public
transport

12. Engagement
We explained three hospitals are considered to be fixed
points because of the range of services
they already provide and the size of the
population they cover:
University Hospital Wales, Cardiff
Morriston Hospital, Swansea
Specialist and Critical Care Centre,
a new hospital to be built near Cwmbran

13. Engagement
Feedback from the public and our clinicians during
engagement was used to develop six benefit
criteria – the key issues against which all the options
were assessed:
Safety
Quality
Sustainability
Access
Equity
Strategic fit

14. Engagement
When we first spoke to you about our ideas for the
future, we said there were six possible scenarios
for the location of these services
But, after looking at issues such as access and
equity and the impact on the Welsh Ambulance
Service and other hospitals in South Wales, two
were ruled out:
Four sites: UHW, Morriston Hospital, SCCC and Princess of
Wales Hospital, Bridgend
Five sites: UHW, Morriston Hospital, SCCC, Princess of
Wales and Royal Glamorgan hospitals
These also got the lowest scores against the benefit criteria

15. The options for consultation
Option 1: UHW, Morriston Hospital, SCCC and Prince
Charles Hospital
Option 2: UHW, Morriston Hospital, SCCC and Royal
Glamorgan Hospital
Option 3: UHW, Morriston Hospital, SCCC, Prince
Charles and Princess of Wales hospitals
Option 4: UHW, Morriston Hospital, SCCC, Prince
Charles and Royal Glamorgan hospitals

16. The options for consultation:
option one
Powys
Morriston SCCC
UHW
Option one
PCH

17. The options for consultation:
option two
Powys
Morriston
Morriston SCCC
UHW
Option two
RGH
Powys

18. The options for consultation:
option three
Powys
Morriston SCCC
UHW
Option three
PCH
Option three
POW
Powys

19. The options for consultation:
option four
Powys
Morriston SCCC
UHW
Powys
Option four
PCH
Option four
RGH

20. The options
All the options have been assessed against the benefit
criteria – safety, quality, sustainability, access, equity
and strategic fit. We have also looked at their impact
on patients, the Welsh Ambulance Service,
NHS workforce and finance.
The option which has emerged from this process as the
best fit is a five-site model option three: UHW,
Morriston Hospital, SCCC, Prince Charles and
Princess of Wales hospitals

21. What does this mean for
pregnant women?
Women will continue to have the choice of a home
birth or a midwife-led birth centre as they do now
Antenatal clinics and postnatal care will be available
locally, as now
Consultant-led care for the one in three women who
need a doctor during birth, including a Caesarean
section, will be provided in FOUR or FIVE hospitals

22. What does this mean for
neonatal care?
Neonatal intensive care will be provided in three
hospitals: UHW, Morriston Hospital and SCCC
(Royal Gwent Hospital in the interim), as now
High dependency neonatal care will be available
in the FOUR or FIVE hospitals providing
consultant-led maternity care. This will improve
standards and safety

23. What does this mean for
children?
Most children, when they are
sick or injured, are safely
treated at home or in their local
community, without having to
spend the night in hospital.
Only the most seriously ill or
injured children – thankfully
small numbers – are admitted
to hospital.

24. What does this mean for
children?
A full range of outpatient, diagnostic and same or next
day clinics will continue to be provided locally, as now
We are continuing to investigate the best way to
provide local children’s assessment services
Inpatient care for the sickest and most seriously-
injured children will be based in FOUR or FIVE
hospitals. This will improve standards and safety

25. What does this mean for
emergency medicine (A&E)?
The majority of people
who currently come to
A&E departments do not
need the skills of highly-
trained emergency
medicine doctors.
DID YOU KNOW Our A&E
departments do different
jobs?

26. What does this mean for emergency
medicine (A&E)?
We want to increase the chance of people with the most
serious injuries and illnesses seeing a senior
doctor, who is experienced in emergency medicine,
when they come to hospital.
To do this, we need to provide consultant-led emergency
medicine care in FOUR or FIVE hospitals.

27. What does this mean for emergency
medicine (A&E)?
The majority of
people who are
acutely unwell or
who have a minor
injury will continue to
be cared for at their
local hospital,
as now.

28. Terry’s fallen off a ladder – where does
he go?
Bleeding from the head and unconscious?
Contact 999. Terry will go straight to UHW
in Cardiff by ambulance
A broken leg? Terry will go straight to his
nearest hospital of the FOUR or FIVE
providing consultant-led emergency
medicine care
Worried his ankle’s broken? Terry will go to
his local A&E department or minor injury
unit

29. The options
All the options have been assessed for their impact on
a range of factors, including impact on patients, the
Welsh Ambulance Service, NHS workforce
and finance.
The option which has emerged from this process as the
best fit is option three: UHW, Morriston Hospital,
SCCC, Prince Charles and Princess of Wales hospitals
BUT WHAT DO YOU THINK?

30. What about the other hospitals?
All our hospitals are
important and they will all
have an important role in
the future, but they won’t
be doing the same things

31. What does this mean?
We will provide as much care as locally as
possible when it is safe to do so
FOUR or FIVE hospitals will provide
consultant-led maternity and neonatal
care, inpatient children’s services and
emergency medicine
Other hospitals will provide other clinical
services

32. Considering equality in the South
Wales Programme
We want to make sure we consider the specific needs of all
people who use NHS services when making any changes
In particular we want to look at and minimise the impact on
different communities, especially the “protected
characteristic” groups
We want to work with you during this process

33. What happens next?
The consultation ends on
Friday July 19, 2013
The responses will be analysed and shared with
community health councils in September and health
boards will meet in October to make a decision
about the future of consultant-led maternity and
neonatal care, inpatient children’s services and
emergency medicine (A&E)

34. Tell us what you think
WRITE TO US: South Wales Programme
Feedback, PO Box 4368, Cardiff, CF14 8JN
EMAIL YOUR COMMENTS TO:
swpresponse@wales.nhs.uk
WRITE TO YOUR COMMUNITY HEALTH
COUNCIL: contact details available at
www.wales.nhs.uk/swp
QUESTIONNAIRE: Complete the questionnaire
in the consultation documents or at
www.wales.nhs.uk/swp
Q

35. Want more information?
Full details about the consultation, including dates of
public meetings across South Wales and South Powys,
are available on our websites:
www.wales.nhs.uk/swp
www.wales.nhs.uk/swp/hafan
0300 083 0020 (24-hour answer phone)
www.facebook.com/SouthWalesProgramme