An injection of modern planning for our NHS
PROVIDING the best possible care within the resources available is the laudable ambition of potentially the biggest change to NHS services in South Wales for decades.
Health chiefs admit there are challenges preventing that from happening. But they say they are confident they can overcome them.
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Those challenges are set out in Abertawe Bro Morgannwg University Health Board's Changing For The Better (C4B) programme, which describes its vision of the future of health care in Swansea, Neath Port Talbot and Bridgend.
One of the biggest challenges is the fact many services are still based on a healthcare system designed in 1962.
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This, C4B points out, was in an era when people still watched black and white TV. There were 240 pennies to the pound and man had yet to walk on the moon.
"It was also a time when life expectancy was shorter — it was unusual to live past your 70s — and there were fewer tests and treatments for illnesses like cancer or health conditions so people were less likely to survive them.
"Now medical and social care has improved and people live longer. This brings its own challenges, however, as patients are likely to need more care as they grow older and in many cases become frailer."
The NHS's average spend per year per patient for different age groups varies enormously. For those aged one to nine, for example, it's just £285 but for those aged 80 and upwards it's £3,358.
Chronic conditions like diabetes and obesity are also on the increase.
"So while NHS care is constantly evolving, the system it works within just isn't keeping up with changing and increasing demands," C4B says.
"We can't just tinker at the edges. We need to make substantial changes if we are to meet these healthcare challenges."
Another major issue is doctor shortages, particularly in paediatrics, emergency medicine (A&E) anaesthetics, general medicine and psychiatry. This, says ABMU, is making it very difficult to maintain safe medical teams.
"The doctor shortage has started to reach a crisis point and has forced some urgent changes," C4B states.
Neath Port Talbot Hospital has lost its acute medical services for that reason. It also led to the children's ward at Singleton merging with the one in Morriston in 2009 and caused disruption at Singleton's minor injury unit in 2008.
C4B also examines quality of care, pointing out that patients and families rightly expect the NHS to meet increasingly higher clinical and quality standards.
"We know that we do not always have the best outcomes every time at the moment. Creating expert teams who work effectively together is key to delivering better outcomes."
An example is the care of people suspected of having strokes. They are now assessed on two sites instead of four where specialist wards and treatments are available, leading to fewer deaths and long-term complications.
The last, but by no means the least, of the challenges facing ABMU and the NHS generally is money. C4B acknowledges that the NHS is not immune to the effects of the worldwide financial crisis.
According to the Wales Audit Office, there will be a funding gap of between £250 million and £445 million in Wales, just to allow health services to stand still.
"We can't afford to keep going as we are," is C4B's stark warning. "We will run out of money and some services will collapse.
"However experience has taught us that if we have services which are effective (they help people get better faster) and efficient (they don't waste money, staff or supplies) then they will also generally save money.
"A change in the way a service is run may not cost less up front. In some cases it may even mean additional investment."
paul.lewis@swwmedia.co.uk
01792 514694
Comments
by Lellybean
Wednesday, October 03 2012, 10:27PM
“The UK government caused the shortage of dr's available to service our NHS , when it restricted training places to Foreign Dr's years ago. we are now feeling the impact of that in Hospitals over the country.. It is a shame that they weren't a little wiser and put financial penalties on Dr's who trained here and then left to practise in other countries within 5-10 years post graduation...??? European working directives and improvements to Dr's hours also impacts on the level of rota cover over a 24 hour period causing further gaps in the system... They have tried going out to Dubai and other countries to try and attract Dr's back into the UK, but with little success....
I agree totally with modernisation of the NHS and centres of excellency, but the reality IS that we have an ageing population that community services are NOT geared up to and do not provide locally the help and care they need to prevent illness and admission to acute services... These are the people that will be mostly affected by these changes... They will be sick, miles from home and their families, their elderly relatives relying on family to take them to visit over the weeks and possibly months that they will be Hospital as the other factor that the WG has not factored in is how are we going to put in improved transport links to get these families to visit their relatives at the times allowed.... and the impact on our already stretches Ambulance service, will result in them spending many hours queuing in hospital corridors for limited suitable beds.... Wake up GP's and wake up S Wales....”
by Neathboy234
Sunday, September 30 2012, 9:52AM
“sochat no need to be abusive, we can talk about when goes on over the border as well, don't u know”
by sochat
Saturday, September 29 2012, 10:20PM
“jiffy you moron the NHS in Wales is managed by the Welsh assembly government.”
by Neathboy234
Saturday, September 29 2012, 10:50AM
“Jiffy I agree with U. Private firms will only carry out these services with the add on of a profit”
by Jiffy
Saturday, September 29 2012, 10:45AM
“The money woes are caused by a government who want to hive off many parts of the NHS to private companies who are only in it to make a profit.
We've seen our public transport go down the pan for exactly the same reasons. No amount of slimy worded PR releases can change the facts. This government is intent upon killing off the NHS and providing a nice incoming for their mates in the insurance and medical industries.
To believe otherwise is stupid.”
by Neathboy234
Saturday, September 29 2012, 9:19AM
“With an ageing population our health service is going to be under increasing strain. The best way of saving money is for everyone to make the biggest effort they can to stay fit and healthy. The government can help as well by increasing tax on high fat/surgery foods, booze and most of all fags. To be fair Osborn is raising the tax on on cigarettes by inflation plus 2% each year. i still don't think that is enough, it should be inflation at 10% at the very least”