Approved 9th March 2012
Minutes of a meeting of the
Ceredigion Local Committee
Held at Waunfawr Hall, Aberystwyth
4th January 2012 at 2.00 p.m
Present:
Mr Alvin Jones, Chair
Mr Colin Saunders
Mrs Eirlys Davies
Dr Gabrielle Heathcote
Mrs Jean Harrison
Mr David Thomson
Mr Bill Messer
(AJ)
CS)
(ED)
(GH)
(JH)
(DT)
(BM)
Ms Glennis Gratwick, Vice Chair
Cllr Paul Hinge
Cllr Gareth Lloyd
Ms Lisa Francis,
Mrs Pat Challis
Cllr Alun Lloyd Jones
Mrs Shirley Oliver
(GG)
(PH)
(GL
(LS)
(PC)
(ALJ)
(SO)
In Attendance:
Mrs Gwen Clements ~ Assistant Ms Cathryn Brown ~ (DCO) (CB)
Mr Peter Llewelyn, Head of Strategic Partnership, HDHB (PL)
Mr Ashley Warlow, Chief Officer (AW)
Mrs Sue Henderson ~ Assistant
Mrs Margaret Baker, Betsi Cadwaladr CHC (MB)
Mrs Sian Marie James, Vice Chair, HDHB (SM)
Mr Chris Martin, Chair of HDHB (CM)
Mrs Linda Hughes, HDHB (LH)
Mrs Amanda Reid, CAVO (AR)
Mr Tony Wales, Pembrokeshire CHC (TW)
Mr Ian Bellingham, County Director, HDHB (IB)
Mr Brian Pullen, Ceredigion Locality Ambulance Officer (BP)
Mr Jason Williams, Air Ambulance (JW)
Apologies:
Mrs Ann Winfield
(AW)
Mr Gary Hicks, HDCHC Chair (GH2)
Mrs Gwyneth Jones
Members of the public:
Members of the Press:
Anthony Gedge, Cambrian News
(GJ)
Approved 9th March 2012
1
Chairs Remarks
Action
The Chair welcomed everyone and wished all a Happy New Year, and
formally welcomed Bill Messer back following a recent illness.
The Chair confirmed he had attended a meeting to discuss the Hywel Dda
Health Boards (HDHB) pre-consultation discussion document.
Declaration of Interest

2.
PH declared an interest in the Front of House Project, Bronglais as
he has two relatives employed by the HDHB.
Minutes from the previous meeting
The minutes were approved as correct.
3.
Matters Arising from the minutes
a) VSM & PPE – item 5
The Chair confirmed that the PPE & VSM committees would merge in
January 2012, as areas of their work overlap and it would help reduce
expenses.
b) EMI Residential Homes – item 6.b
Work is ongoing to provide extra EMI Residential beds at Awel Deg Nursing
Home, Llandysul and also a home in the North of Ceredigion.
c) Mental Health & Learning Disabilities – item 6.b
IB confirmed that interviews had taken place to recruit a permanent
substantive consultant based in Ceredigion, but unfortunately the candidate
withdrew and the position will be re-advertised
4.
The Welsh Ambulance Service Trust (WAST) / Air Ambulance
Welsh Ambulance Service
a) BP gave a brief presentation to the Committee and confirmed that a
request for 12 additional specialist paramedics has been put forward to
WAST for Ceredigion. Currently there is only one specialist paramedic in
Ceredigion he has his own vehicle and is equipped and able to administer
15 additional pain relieving drugs, which can reduce the number of
ambulance journeys and admissions into hospital. The specialist
paramedic is also available for other paramedics to call for assistance /
advice.
BP confirmed that he is looking into alternative transport for wheelchair
users attending outpatient appointments, and providing more paramedic
IB
Approved 9th March 2012
cars in the future.
Wales Air Ambulance
b) A presentation from JW was made to the committee, highlighting the
following points:
 The Air Ambulance is funded by charity. However the Paramedics
are provided by WAST
 The service cost £6 million per year, and each mission costs
approximately £1,400
 A 165 missions have taken place in HDHB area over the past six
months. (56 in Ceredigion)
 This service is only available for patients with life threatening
conditions.
 Research shows that there are better outcomes for severe trauma
cases if transferred speedily to specific care centres within the
golden hour and an average of 2 fewer days in hospital.
 There are three airbases in Wales, Swansea, Welshpool &
Caernarfon.
 Currently there are three aircrafts to cover Wales, (1 - Bolkow 105
and 2- EC135), however it is anticipated that the Bolkow will be
replaced with a new generation aircraft and suitable for HEMS, Level
1,2,3 critical care patients and night flying which is not currently
available.
 From all three Airbases a helicopter can be anywhere in Wales
within just 20 minutes.
 It is predicted that an additional 50 patient journeys will be required
per year in the future.
 Sufficient helipads would be required in HDHB to assist with future
demands.
5.
Visiting Scrutiny & Monitoring (VS&M) / Public & Patient Engagement
(PPE)
Please see 3.a)
VSM Minutes Item 7.3
IB requested that the HDHB be formally made aware of this complaint.
CB to follow up
6.
Hywel Dda Health Board
a) The Five Year Plan
The Chair confirmed that following a pre-meeting the committee agreed
 Colorectal services must be retained at Bronglais Hospital, especially
as there is a high occurrence of colorectal cancer relative to
population size in this area.
 A 2011 Royal College report suggests many emergency surgery
situations arise in abdominal areas, therefore it is paramount that
Bronglais Hospital retains its Colorectal Surgeon.
 If Bronglais have no Abdominal Surgeons on site this will impact on
CB
Approved 9th March 2012

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the A&E department which will inevitably become a minor injuries
unit and all future emergencies would be transferred south with long
transport journeys for all patients. The Deanery would no longer
consider Bronglais as a training hospital for Doctors.
Bronglais Hospital is the only District General Hospital in Mid Wales
and serves South Meirionydd Patients, Montgomery Patients and
Powys Patients together with Ceredigion Patients and it is vital it
retains the Core services Colorectal and Obstetric & Gynae
Consultants
There has been no recognition as to the long journey some patients
have to make into Ceredigion this would be lengthened to then travel
down to Carmarthenshire / Pembrokeshire.
The Royal College 2008 report highlights that Bronglais is a good
example of Gynaecological Care, the CHC has recently written to
the Royal College for an updated opinion and confirmation was
received that this is still the case. However, patients expecting twins
are not able to deliver at Bronglais Hospital and are expected to
deliver in Glangwili Hospital.
Concerns regarding ‘Care in The Community’, HDHB have not
produced costings and there is no evidence to suggest it is
sustainable. Social Services budget is already under great
pressure.
It was suggested that re-admission rates had increased.
IB to provide re-admission statistics
IB
Chris Martin confirmed that the principle is to provide one hospital over four
sites. However, this process will be discussed further with AW and GH
once the listening exercise is complete and the public have been given the
opportunity to discuss and debate their concerns.
Members requested that a brief presentation is made at each of the
listening events to encapture the patients views. It was also suggested that
more events be set up in the Tregaron & Lampeter rural areas. CM agreed
to follow this up.
GH stated that knowledge based source of information and data gathered
so far was incomplete. There is no reference to a business plan. We
understand the proposals are Clinician led, but there is no information who
they are and some Clinicians are not happy with the proposals. The remote
and rural models have not been seen, reflective so far of lack of depth, root,
substance and does not inspire trust at this crucial point.
There are lessons to be learnt from The Rochdale & Oldham model as the
resemblance is uncanny to the proposals being put forward by HDHB for
Bronglais Hospital in Ceredigion. To the point there is the same blue print
and Senior Managers involved. Information of outcomes following The Dr
Foster 2011 Hospital Guide highlighted a higher mortality rate for the
Pennine Acute Hospital Trust.
The population, geographic, cultural linguistic and other criteria relating to
CM
Approved 9th March 2012
the North East Greater Manchester area are very different to HDHB area
and it was considered very surprising that a similar methodology and model
were being proposed for Hywel Dda. Lessons should be learnt by what
happened at the planning and implementation stages and used as a point
of reference. Questions need to be asked before the consultation begins.
This is not a personal attack on Trevor Purt, but we should look at the
outcomes to ensure this does not occur in HDHB.
Equality Impact Assessments ~ CM confirmed that talks are ongoing with
neighbouring LHB to look past / future activities regarding. CM encouraged
patients in Gwynedd & Powys to contact their local LHB regarding services.
The HDHB welcomed the CHC help to reach out to hard to reach groups.
The CHC agreed to hold joint public meeting with the County Council to
engage with the local public.
CM asked if the committee could provide a written version of the points
raised. The chair agreed to do so but stated that it would form part of a
whole Hywel Dda response to which the Ceredigion committee would
contribute a response specifically relating to concerns in Ceredigion and
Mid Wales. The Chair also suggested that the 3 Health Boards covering the
Mid Wales area should meet as soon as possible to discuss what services
would be delivered in Bronglais to fulfil the needs of those living in the
Bronglais catchment area.
b) Mental Health & Learning Disabilities
Eirlys Davies & Gabrielle Heathcote were nominated to represent
Ceredigion CHC on the Mental Health Committee Group
c) Strategic Partnership Update
 Substance Misuse Services-Multi Agency Developments
A site visit took place on the 5th December which included Gwyneth Jones
from the CHC. In order to ensure that the current services in Cardigan can
continue whilst this development is being progressed, a further allocation of
£24,000 has been made to extend the rent on the current high street
premises
 Harm Reduction Group.
Naloxone temporarily reverses the effects of overdose and lasts between
20 minutes and an hour allowing time for the Ambulance to attend and will
be available in to patients in Ceredigion from February 12.
 Non Emergency Transport
A dedicated stretcher vehicle has been made available from the 12 th
December 2011 to the 31st March 2012 as a 12 week pilot to measure its
effectiveness at Bronglais. This service should prove invaluable over the
winter months
Approved 9th March 2012
 Link with Voluntary Sector
Work on the co-design of the Sector is complete and a final report has been
approved and formally launched through the Wales Council for Voluntary
Action.
d) Tregaron Hospital
IB confirmed that the Local Authority has taken the lead on the Cylch Caron
project .A schedule of resources is to be drawn up and submitted in order to
gain finances to move onto the next stage.
e) Aberaeron Development & Cardigan Development
Aberaeron & Cardigan developments are linked into the Clinical Services
Strategy. Progress has been made on securing the land in Cardigan.
7.
CM confirmed that Trevor Purt, HDHB is fully committed to investing in all
three developments in Ceredigion.
Reports from Members
No comments were made on the reports submitted.
8.
CHC Minutes
Planning Committee Meeting 22/11/11
No comments were received.
9
Consultations
Organ Donation – responses to be forwarded to Janet Waymont by 26/1/12
10
Clinical Programme Groups
There were no reports received from members
11
Local Correspondence
It was agreed to defer the correspondence to the next meeting.
12
Any other business
Amanda Reid, Health & Social Care Facilitator, from Ceredigion Association
of Voluntary Organisations (CAVO) introduced herself to the committee and
welcomed future involvement with the CHC.
13
Date of next meeting
Approved 9th March 2012
The next meeting was scheduled for Friday 9th March at 1pm venue to be
confirmed.
The meeting concluded at 4.30 pm