Following four months of consultation, the Project Board for the Acute Services Review in Mid and West Wales announced its recommendations earlier this week.
In a statement issued later, it was stressed that these recommendations were just the first step in what was a 10-year process of change, aimed at delivering world-class acute services for the region. In determining its recommendations, the Project Board said it had taken into account:
• The many views expressed by local people through public meetings and written responses to the consultation
• The response from statutory bodies, regional bodies and those that relate to more than one LHB area
• How the consultation proposals relate to other national initiatives and policy requirements
The Project Board's role was to make recommendations on a regional basis. The recommendations will now be considered by each Local Health Board across the region and will inform the statutory decision-making process accordingly.
Chris Martin, chairman of the project board, said: "The key challenge facing us in Mid and West Wales is how we can deliver high-quality care, across our region, in a safe and sustainable way. We laid out our proposals for meeting this challenge, we have listened to the comments that have been made, and we are now recommending a positive way forward." He added: "The consultation process itself has been a major step forward. This is the start of a vital debate about how we deliver the best possible care to the people of Mid and West Wales. So we were pleased that so many people and organisations - from across the region -gave us their views.
"Of course there have been a whole range of different opinions. But what is striking is that never before have so many people across our region been engaged in the debate about how we meet the challenges of providing 21st century healthcare."
Dr. Bruce Ferguson, one of the senior doctors on the project team, said: "There is still a long way to go in shaping the detail of what each individual service will look like in the future. But the project board has been very reassured by the degree of clinical and public support for the underlying principles: services working as networks, and joint working for overall benefit of the population. This in itself signals a very positive way forward in improving patient care."
RECOMMENDATIONS
Among the recommendations for Carmarthenshire, Ceredigion and Pembrokeshire are: The development of a single Service Delivery Unit for the three counties is approved.
Detailed proposals for the establishment of a single integrated Trust for the three counties (Dyfed) should be developed as soon as possible.
The integrated LHB commissioning processes as outlined in the consultation document should be implemented without delay and linked to the emerging proposals for Regional Commissioning as appropriate.
There needs to be a clear statement from the Welsh Assembly Government regarding the timing and process for consideration of the establishment of a single acute Trust across the three counties.
Further recommendations
The preferred acute hospital services configuration for Carmarthenshire, Ceredigion and Pembrokeshire cannot be determined until there is more detail on the supporting infrastructure that will be in place. This is needed in order to reassure the public regarding access and clinical risk management. The Project Board also therefore makes the following recommendations to LHBs:
A Planning Forum should be established and should include representation from:
The three existing Trusts or the integrated Trust (if approved) - clinical and managerial representation; Carmarthenshire, Ceredigion and Pembrokeshire LHBs (including primary care representation); the Dyfed Federation of Community Health Councils; patient representatives; Regional Office; Carmarthenshire, Ceredigion and Pembrokeshire Local Authorities; staff organisations; Welsh Ambulance Trust; other co-opted members as appropriate.
The Forum should link with the existing clinical networks, to take forward the speciality reviews and debate over the next five years.
With specific reference to Maternity and Child Health Services, the task will be to develop a detailed model for the delivery of an integrated paediatric and maternity service for the three counties (Dyfed) that addresses issues of clinical (including manpower) and financial viability.
The Planning Forum will take forward the further work necessary to confirm the hospital configuration for the three counties, subject to the outcome of the further work identified above, linking with other service change programmes to ensure co-ordination.