Llanelli Star - - FRONT PAGE - Ian Lewis @IanLewis80 [email protected]­ 07790 591150

PA­TIENTS have told health chiefs that they are be­ing forced to wait too long for ap­point­ments at Car­marthen’s Glang­wili and Llanelli’s Prince Philip hos­pi­tals for di­a­betic, po­di­a­try and den­tistry ap­point­ments.

Some peo­ple have to face their long-awaited ap­point­ments be­ing can­celled at short no­tice, the health board has ad­mit­ted.

There was also con­cern among some pa­tients that the emo­tional im­pact of be­ing di­ag­nosed with di­a­betes was not fully ex­plained to them by the hos­pi­tal, de­spite it be­ing a life-long and life-chang­ing chronic con­di­tion, they were left to feel that they were man­ag­ing it alone.

Hy­wel Dda Univer­sity Health Board Com­mu­nity Coun­cil sur­veyed pa­tients at di­a­betic clin­ics in all its hos­pi­tals in­clud­ing Withy­bush in Haver­ford­west and Bronglais in Aberys­t­wyth.

The com­mu­nity coun­cil aims to in­de­pen­dently and with­out bias rep­re­sent the in­ter­ests of pa­tients and the pub­lic in the way that NHS ser­vices are planned and pro­vided across the coun­ties of Car­marthen­shire, Ceredi­gion and Pem­brokeshire.

Out of 42 pa­tients sur­veyed on a par­tic­u­lar day in Fe­bru­ary, around half had waited up to a month for an ap­poin­ment, while the re­main­ing pa­tients re­ported wait­ing any­where be­tween four and nine months-plus to be seen by a di­a­betic con­sul­tant.

The find­ings pub­lished in a re­port this week by the health board said: “Pa­tients we spoke to at Bronglais and Withy­bush hos­pi­tal di­a­betic out­pa­tient clinic said they had re­ceived timely ac­cess to com­mu­nity ser­vices. How­ever some of the pa­tients seen in Glang­wili and Prince Philip hos­pi­tals felt they had waited too long for po­di­a­try, den­tistry and di­a­betic ap­point­ments. Peo­ple also told us that ap­point­ments were can­celled at short no­tice.

“Out of the 42 pa­tients we spoke to, 29 said they didn’t feel they had waited too long to be seen, how­ever 13 peo­ple felt they had waited too long.”

In a let­ter re­spond­ing to the com­mu­nity health coucil find­ings, Mandy Rayani, direc­tor of nurs­ing, qual­ity and pa­tient ex­pe­ri­ence said “cur­rently the 36-week wait­ing time tar­get for di­a­betes re­fer­ral to treat­ment has been achieved with the long­est wait at 35 weeks.”

The re­port added: “Most peo­ple we spoke to were happy to travel to a hos­pi­tal for their di­a­betic ap­point­ments, but this de­pended on how far away they lived from the hos­pi­tal. Peo­ple who lived fur­ther away pre­ferred to be seen more lo­cally ei­ther at their GP surgery or lo­cal com­mu­nity hos­pi­tal.”

An­other as­pect of the sur­vey saw pa­tients quizzed over how the NHS staff helped them to un­der­stand how to man­age their di­a­betes.

The board said it found: “Most peo­ple we spoke to were happy with the sup­port and ad­vice they were given by staff on how to man­age their di­a­betes.

“How­ever one per­son from Prince Philip Hos­pi­tal clinic com­plained there was no in­flam­ma­tory bowel dis­ease nurse and the pa­tient felt the con­sul­tant was dis­mis­sive.

“One per­son said they were not aware of any psy­chi­atric sup­port and more help should be avail­able to sup­port pa­tients and their fam­i­lies with day to day prob­lems.”

The re­port added: “Pa­tients also told us that they were not given full in­for­ma­tion on how di­a­betes could af­fect pa­tients emo­tion­ally. One pa­tient stated that one of the most dif­fi­cult things to come to terms with is the fact that di­a­betes is a life-long con­di­tion and felt low af­ter the di­ag­no­sis.

“Pa­tients also noted that they were not treated holis­ti­cally and this was un­help­ful if they had a num­ber of long-term con­di­tions that all had to be man­aged.

“Their care could be split into dif­fer­ent spe­cial­ties but they had to man­age their whole sit­u­a­tion them­selves and this could be dif­fi­cult.”

In light of the re­sponses and de­spite “most peo­ple” be­ing happy with the sup­port of­fered, the health board said it will now aim to “en­sure all pa­tients un­der­stand and know where to get in­for­ma­tion about di­a­betes and other re­lated ser­vices”, along with “pa­tients know­ing how to get emo­tional and psy­cho­log­i­cal sup­port from health­care teams.”

The snapshot of di­a­betic care was just one of the ser­vices sur­veyed by the health board com­mu­nity coun­cil.

Oth­ers were car­ried out into what pa­tients thought of ser­vices at Prince Philip’s phle­botomy clinic and the An­ti­och Cen­tre in Llanelli’s Cop­per­works Road.

This is a church-run com­mu­nity cen­tre hir­ing rooms to var­i­ous groups and hos­pi­tal for blood tests, in a bid to ease con­ges­tion at the hos­pi­tal.

Once again a snapshot was taken over the course of one day last Novem­ber, at both the phle­botomy clinic at the hos­pi­tal and the An­ti­och Cen­tre.

The CHC re­port said on the day of the visit it heard from 80 peo­ple in the phle­botomy clinic and 30 peo­ple at the An­ti­och Cen­tre.

The sur­vey fo­cused on what peo­ple ac­cess­ing the ser­vice thought about wait­ing times to be seen and whether GPs are sign­post­ing peo­ple to the ser­vice at the An­ti­och Cen­tre as a hos­pi­tal al­ter­na­tive.

At the phle­botomy clinic wait­ing times pre­dom­i­nat­ley var­ied be­tween 10 and 25 min­utes to be seen.

How­ever, the re­port did con­cede that car park­ing was a con­cern when at­tend­ing a blood test with some ex­pe­ri­enc­ing long wait­ing pe­ri­ods at the clinic and one pa­tient re­sort­ing to trav­el­ling to Glang­wili in Car­marthen.

It stated: “A few pa­tients told us they typ­i­cally had to wait be­tween 40 min­utes and two-and-a-half hours to be seen.

“One pa­tient told us that the clinic and one of the car parks both open at the same time at 9am, which causes a prob­lem be­cause then a num­ber of peo­ple can all turn up to the clinic at the same time mak­ing it feel very busy.

“One pa­tient told us that they have pre­vi­ously trav­elled to Glang­wili Gen­eral Hos­pi­tal for a blood test be­cause the wait­ing time is so long at Prince Philip Hos­pi­tal.”

Wait­ing times at the An­ti­och Cen­tre were lower but feed­back sug­gested it needed to be ad­ver­tised bet­ter within the com­mu­nity as some­where for blood tests.

Fi­nally the CHC took a snapshot look at the Cadog Ward at Car­marthen’s Glang­wili Hos­pi­tal which has 19 beds and de­scribed as “very busy.”

The re­port stated nine pa­tients were sur­veyed, most of them be­ing treated for chronic med­i­cal con­di­tions.

It added: “Some peo­ple had ar­rived on the ward hav­ing been ad­mit­ted from the emer­gency depart­ment. We heard that some peo­ple had waited a long time to be seen by a doc­tor or nurse be­fore be­ing ad­mit­ted to a ward.

“Even though some peo­ple had waited a long time, peo­ple were very pos­i­tive about the care they re­ceived in the emer­gency depart­ment.

“They told us staff were car­ing and help­ful.” But the re­port added while the ward was clean, it was often busy and lacked a sense of calm some­times.

Re­gard­ing food on the ward, in turn a snapshot of food across the hos­pi­tal, the re­port found pa­tients had mixed views about their food and drink, adding: “Some peo­ple told us they liked the food. We heard that oth­ers thought it could be bet­ter (and) some peo­ple told us they would like to be able to choose their por­tion size as it was often too much for them.”

The CHC found pa­tients were “very grate­ful for the care they re­ceived while in hos­pi­tal, and so they didn’t want to make a fuss or com­plain about the food.”

An um­brella to th­ese snapshot find­ings was the is­sue of how the health board com­mu­ni­cated with pa­tients, this was ex­am­ined over a pe­riod of months be­tween July and Novem­ber last year.

In terms of ap­point­ments and how they were is­sued and man­aged by the health board, there were mixed re­ac­tions from pa­tients. The CHC said: “We know from our in­de­pen­dent com­plaints ad­vo­cacy ser­vice, that poor com­mu­ni­ca­tion is often a fac­tor when peo­ple have con­cerns about the NHS. Mis­un­der­stand­ings may in­crease the risk of po­ten­tial harm, lead to a lack of con­fi­dence by pa­tients and waste valu­able NHS re­sources.

“We know from our en­gage­ment with peo­ple, that they can be­come con­fused and frus­trated when try­ing to ac­cess in­for­ma­tion about their health or treat­ment. We asked peo­ple across Hy­wel Dda to tell us about their ex­pe­ri­ence of NHS com­mu­ni­ca­tion good and bad, also to give us their sug­ges­tions on how it might im­prove.”

The re­port found that in some cases pa­tients felt they weren’t be­ing lis­tened to and par­tic­u­larly in dif­fi­cult cir­cum­stances where bad news needed to be bro­ken to a pa­tient, there was a lack of em­pa­thy flagged up by some pa­tients and their ex­pe­ri­ences.

The re­port said: “Ref­er­ence was made that not all staff were able to dis­play an ap­pro­pri­ate level of em­pa­thy with the pa­tient dur­ing dif­fi­cult times.

“It was high­lighted that some staff ap­pear to have lim­ited roles once di­ag­no­sis had taken place and were not able to as­sist or sign­post peo­ple to the most ap­pro­pri­ate ser­vice or or­gan­i­sa­tion.”

Wait­ing times and re­fer­rals also left some pa­tients feel­ing lost, as the re­port stated: “Some peo­ple told us they were dis­ap­pointed re­gard­ing com­mu­ni­ca­tion around wait­ing times and would like to have bet­ter and more com­mu­ni­ca­tion re­gard­ing the times they would have to wait to be seen or re­ferred for treat­ment.”

This also ap­plied to can­celled op­er­a­tions or pro­ce­dures, with some pa­tients ar­gu­ing they were not in­formed of changes.

Ap­point­ments across clin­ics and department­s was an­other sore point high­lighted by pa­tients with the CHC re­port sum­maris­ing that “there were nu­mer­ous and var­ied views from peo­ple re­gard­ing the com­mu­ni­ca­tion en­coun­tered, in or­der to ar­range and change ap­point­ments.

“There were sub­stan­tial num­bers of neg­a­tive views sur­round­ing ap­point­ments and their sys­tems com­pared to lim­ited pos­i­tive views.

“In pri­mary care GP surg­eries, in par­tic­u­lar, were men­tioned by a sig­nif­i­cant num­ber of peo­ple we spoke with.

“We also heard from many peo­ple who pro­vided ex­am­ples of poor ad­min­is­tra­tion re­gard­ing their ap­point­ment let­ters, with co-or­di­na­tion of their ap­point­ment times when they lived con­sid­er­able dis­tances from the place they needed to at­tend.”

Di­rectly linked to ap­point­ments was the is­sue of trans­port, again a ma­jor con­cern for pa­tients. The watch­dog found “many peo­ple had en­coun­tered is­sues re­gard­ing trans­port, es­pe­cially when need­ing to at­tend ap­point­ments a sig­nif­i­cant dis­tance out­side their lo­cal area.

“Many peo­ple felt that there should be im­proved or­gan­i­sa­tion sur­round­ing trans­port and that on oc­ca­sions long jour­neys could be elim­i­nated by hav­ing rou­tine tests car­ried out in a lo­cal set­ting, prior to a more spe­cialised ap­point­ment.”

Bet­ter com­mu­ni­ca­tion with the pa­tient re­gard­ing jour­ney times was an­other area of con­cern that peo­ple told the health coun­cil about.

Tech­nol­ogy and how that could be used to con­tact and li­aise with pa­tients was also wel­comed by some pa­tients.

The CHC said: “Many peo­ple sug­gested that more health­care ser­vices and ad­vice should be avail­able on­line, in or­der to re­duce pres­sure on NHS staff and department­s.

“Those peo­ple who were com­fort­able us­ing tech­nol­ogy, felt that the NHS should use more var­ied meth­ods to com­mu­ni­cate with pa­tients pro­vid­ing as much in­for­ma­tion and ac­cess to ser­vices as pos­si­ble.”

Pa­tients have had their say

Pic­ture: Robert Me­len

and raised is­sues about ser­vices pro­vided at Prince Philip Hos­pi­tal.

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