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How can we take pressure of A&E if community services are not there?


Cwm Taf Health Board have, along with other Health Boards across Wales, been running a campaign called "Choose well" to try and encourage patients to seek help from the most appropriate place and take the pressure off over stretched hospitals.
As the website states:
"Choose Well will help you decide if you need medical attention if you get sick. It explains what each NHS service does, and when it should be used. Choosing Well means that you and your family will get the best treatment. It also allows busy NHS services to help the people who need them most."
This includes trying to redirect people to their pharmacist, GP, Minor Injury Units, or out of hours service. All very sensible advice to try and keep A&E departments for those who really need them.
However, the system starts to fall apart when the community services are not actually there to back it up.
The Minor Injuries Unit at Llwynypia for example only works on quite limited hours, and people need to ring to make an appointment before attending - not something you want to do when you have cut your finger and it is bleeding profusely, or twisted your ankle and want to check if it is broken.
The out of hours emergency service is indeed very useful in many instances, but again it is limited, and people are phoning only to be told there are no appointments available.
As for GPs surgeries, then most are not geared up to treat accidents or injuries, and their hours are limited. In fact they are to become even more limited when the withdrawal of funding from April 1st means some who were holding early morning, evening and Saturday clinics will no longer be doing so.
A series of meetings across South Wales and Powys will feedback on Thursday 13th February on plans for a reorganisation of services including severe trauma care. This may see the removal of consultant led A&E services form the Royal Glamorgan.
We have argued all along that before that can happen the back up services in the community have o be in place. We are all for patients being directed to where they can be most effectively treated, but the alternatives all have to be in place. At the moment they certainly are not.

As the website states:


Karen Roberts
Campaign Manager RCT Welsh Liberal Democrats.

Choose Well is an ongoing

Choose Well is an ongoing national campaign designed to inform members of the public about the range of NHS and other services that are available as alternatives to attending the Emergency Department or dialling 999.

Some of those alternatives include GP surgeries, minor injury units and out of hours services.

Members of the public should make an appointment with their GP for non-urgent medical advice, examinations, prescriptions and treatment of most illnesses or injuries that will not go away.

Normal opening hours for GP surgeries are 8:00am until 6:30pm with five surgeries having opted to provide late evening appointments across the Cwm Taf area. A recent review of the late evening appointment service has shown there to be little demand so this service will be decommissioned as of 1 April 2014. Our intention is to redistribute this funding across all GP practices within the Cwm Taf area to ensure better and more equitable access for everyone.

GP surgeries have not been open for Saturday morning appointments since 31 March 2004.

The out of hours service in Cwm Taf is designed to deal with patients with urgent medical conditions only. Urgent medical conditions are those which cannot wait to be dealt with until the patient’s own GP surgery re-opens.

The out of hours service operates at those times when GP surgeries are not contracted to provide care – between 6.30pm and 8am weekdays and from 6.30pm Friday until 8am Monday.

Calls to the service, which is run by the health board, are taken at the call centre in Ty Elai and after an assessment of urgency, are passed to doctors, who ring the patient back to obtain further information. The options for care at this stage are telephone advice from the doctor, being advised to attend one of the GP emergency care centres within the Cwm Taf area, or being visited at home by a GP.

For members of the public who suffer a minor injury, Ysbyty Cwm Cynon operates a walk in minor injuries service whilst the minor injuries unit at Ysbyty Cwm Rhondda is piloting our Phone First! service. A minor injury is not a medical emergency.

The Phone First! telephone number – 01443 444075 - has been a success ever since it was first introduced in May 2012.

Patients who suffer a minor injury are able to phone ahead for a convenient appointment to be treated at the unit in Ysbyty Cwm Rhondda saving the need to wait at A&E. Ongoing evaluation of the Phone First! service consistently shows a positive response from members of the public who have used it.

Dr Quirke, Cwm Taf University Health Board’s deputy medical director, said: “We know our A&E departments, like others throughout Wales are under significant pressure at the moment. The Phone First! service is helping to address some of those pressures by ensuring patients with minor injuries are being treated by the right person, in the right place and at the right time.”

We continue to advise all patients with minor injuries to use the health board’s minor injury units at Ysbyty Cwm Cynon and Ysbyty Cwm Rhondda for speedy and effective treatment of their condition.

Allison Williams, Cwm Taf University Health board’s chief executive, said: ““We would encourage the public to use the full range of our health services, including GP surgeries, community pharmacies and our minor injuries units, where appropriate, to lessen demand on hospital and GP out-of-hours services.”

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