Hywel Dda University Health Board has accepted an initial external report confirming the safety and improvements made to healthcare provision for women and children during the last year, as well as highlighting areas for further improvement.

The Royal College of Paediatrics and Child Health, who in conjunction with other colleges and a lay member, reviewed service changes in the south of the Hywel Dda area, presented their headline findings to a full meeting of the University Health Board held in Llanelli last Thursday.

Speaking at the meeting, Dr. John Trounce, a member of the review team and a consultant paediatrician, said: “We found services in general to be safe with improving outcomes and better compliance with professional standards. There is no clinical sense in reversing the major decisions of reconfiguration made one year ago.

“A top priority in this review has been patient safety. There has been a lot of anxiety, but this has largely been a perception and we did not find as a result of service change, significant adverse clinical outcomes for patients.”

The initial report has stated that the labour ward at Glangwili Hospital, Carmarthen, is not fit for purpose, with D.r Trounce confirming this was a comment in relation to the need to upgrade and expand accommodation and not a description of the care provided.

“The feedback from patients has generally been very supportive of the care received,” he said. “There is a lot of enthusiasm by staff for the services they provide and the phase two development, and there is an urgent need to progress this as the environment has a knock-on affect on patient care.”

Board members accepted the report and agreed the following next steps:

• to work with senior clinical staff to develop an action plan, ready for the next Health Board meeting in November, that will address all the recommendations

• phase two of the capital development project at Glangwili Hospital to be progressed in the interim, with chief executive Steve Moore appointed as the senior lead for the project and a target for a business case for the Welsh Government to be ready early next year, with any other immediate improvements to the ward environment as it currently stands to be made where they can be

• to proceed with an organisational development plan for staff in women and children’s services to improve and better integrate midwifery teams and develop clinical leadership within the service

Chief executive Steve Moore said: “This is a hugely important moment for the health board in this journey. It is important to note the comments made on our community paediatric services as well as hospital based services as we need to do a lot more in the community and ensure we do not miss the voice of families who may be struggling. This has to be part of our reflection and subsequent action plan.

“I am thankful to the five colleges involved for this external review and we need to trust their external and expert clinical view, and recognise the recommendations they have made. I want to reiterate our commitment to being open and transparent with our staff and community and encourage people with concerns to continue to work with us, including getting involved in our ongoing engagement programme.”

Chair Bernardine Rees added: “We acknowledge that for our staff and patients, these changes have been significant and therefore our response will need to be significant and I look forward to us now working through the recommendations to agree next steps. We are also grateful to those women and families who have shared experiences, both as part of the review, and following media coverage this week and we will share these responses with our staff, of whom we are immensely proud.”

The initial report, and subsequent full report from the Royal College of Paediatrics and Child Health, and the next steps will be developed by the health board in the coming weeks, and will be part of discussions at the Let’s Talk Health events. More information on these events can be found here - www.hywelddahb.wales.nhs.uk/letstalkhealth with dates for the next round due to be announced soon.