The South Wales Programme and Ysbyty Ystrad Fawr

Next Wednesday the South Wales Programme will enter its consultation phase. The engagement phase explained the need to centralise some specialist services - Major A&E, Obstetrician-lead maternity and Paediatric inpatients, currently provided in 7 hospitals in the South Wales area - onto 4 or 5 sites. Three sites located near the three major centres of population in Wales - the University Hospital of Wales in Cardiff, Morriston Hospital in Swansea and the new Specialist and Critical Care Centre in Cwmbran - have been identified as fixed points in the plan. This leaves one or two other hospitals to be selected from the Princess of Wales Hospital in Bridgend, the Royal Glamorgan Hospital in Llantrisant and the Prince Charles Hospital in Merthyr.

The outcome of the process to select the sites will be made public next week, and will identify a preferred hospital configuration to provide these specialist hospital services across South Wales in future. It is important to understand that the process, in which healthcare professionals were closely involved at all times, did not involve any consideration of 'which hospital was best'. It was not a beauty contest. The selection process was designed to identify which configuration worked best in terms of the flow of patients across the region so as to provide the safest, most sustainable and accessible service. Ease of access for disadvantaged communities was taken into account when making this judgement, which involved a wide range of stakeholders, as well as doctors, nurses and therapists.

The Emergency Medicine consultants I worked with as Chair of the Emergency Medicine Clinical Reference Group genuinely believe that reorganising services in this way will improve the quality, safety and sustainability of emergency medical care. It is important to acknowledge that emergency care is in crisis across the whole of the UK at present, but also important to point out that while the effects of this are felt most acutely in Emergency Departments, the changes to correct this have to be made across the whole system of unscheduled care, from the GP service to social care. More effective Emergency Departments with better round-the-clock senior cover are just part of the picture.

Finally, I'd like to talk about the hospitals that don't get selected as centres for the specialist services I mentioned above. It is tempting to talk about these hospitals as being 'downgraded'. Tempting, but wrong. I'm 51 years old now, and entering the stage of my own life where I am more likely to need medical care. I live in Abergavenny, somewhere we already know will have a Local Hospital in future. As I grow older the care I need is much, much more likely to be provided by my local hospital - Nevill Hall. But if I have a serious specialist problem, like a stroke or a heart attack, I would prefer to be taken a little further away from where I live to get the my initial care delivered by the senior specialist on duty round the clock. Local hospitals have a bright future. If you want to know what one might look like, take a look at Ysbyty Ystrad Fawr in Caerphilly https://www.dropbox.com/s/u9j1p3ps0plqx7z/Ysbyty%20Ystrad%20Fawr.doc.