Posted: Tue 2nd Aug 2022

“Highly concerning report” into North Wales vascular services shows frontline staff and patients are being let down, says MS

News and Info from Deeside, Flintshire, North Wales
This article is old - Published: Tuesday, Aug 2nd, 2022

Frontline staff and patients in North Wales are being let down by the “double blow of mismanagement and the Welsh Government’s inability to get a grip” on vascular services, it’s been claimed. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Plaid Cymru Health spokesperson Rhun ap Iorwerth’s comments follow the latest critical report into vascular services run by Betsi Cadwaladr Health Board. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The report highlights concerns in relation to the management of aortic patients following the completion of a review of eleven patients’ notes. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

In March 2022, it was announced that complex cases requiring vascular services were being moved to Liverpool after two concerning safety incidents were identified. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

At the start of June, targeted intervention measures were introduced at Ysbyty Glan Clwyd.

This decision was made amid ongoing concerns relating to the health board in a number of areas – with a particular focus on the vascular service and the emergency department. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Ahead of a public meeting of the health board in August 4, a series of public reports and minutes have been released – which provides an update on vascular services in North Wales. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The report states that Betsi Cadwaladr has significantly supported investment in its vascular workforce. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

However it adds that the health board’s vascular improvement plan requires updating to ensure a consistent approach. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

It states: “Two never events in the service and other concerns relating to safety and sustainability resulted in Health Inspectorate Wales (HIW) designating the vascular network a service requiring significant improvement in March 2022. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“On 8 July 2022 the chair of the vascular quality panel raised safety concerns in relation to the management of aortic patients following the completion of a review of eleven patients’ notes. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“The executive medical director received three recommendations for immediate implementation. These were: ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

  • Reintroduction of dual consultant operating (for aortic patients only)
  • Involvement of a specialist centre in the multidisciplinary Team (MDT) meetings for all aortic cases
  • The recruitment of a vascular surgeon with aortic experience.

“The first and second recommendations were implemented that day and remain in force. The MDT is supported by Liverpool University Hospital Foundation Trust (LUHFT). ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“The fragility of the consultant rota led to the health board to consider contingency plans should the service not be able to be delivered as currently configured and these plans remain under close review. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“LUHFT have supported these plans to date and have supported out of hours provision for emergency surgery for one on-call period (due to consultant sickness and leave pressures) although no patients required treatment during this period. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“These arrangements have resulted in cancellation of some outpatient activity and non-urgent elective surgery.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Responding to the latest report, Mr ap Iorwerth said: “This is another highly concerning report into a health board which was taken out of special measures too early, and which has a litany of failures to its name. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Plaid Cymru has consistently raised its concerns about vascular services at Betsi since it was centralised in 2019, echoing the calls of medical professionals for the facilities at Ysbyty Gwynedd to be preserved. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“The Ysbyty Gwynedd service was excellent, with world class results. Poor decisions, that we and staff argued vigorously against, have ruined the service patients used to have. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Frontline staff and patients are being let down by the double blow of mismanagement and the Welsh Government’s inability to get a grip on the situation.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

In an update on vascular services in the region issued today, Health Minister Eluned Morgan said: “During July, a number of patient safety quality concerns have been raised by the vascular quality panel in relation to the management of aortic patients. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“These were escalated to the board and a number of additional safety measures have been reinstated for aortic patients from 8 July. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“In addition, there are immediate operational pressures due to consultant availability and nurse staffing in vascular services within the health board. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“The fragility of the service led to the health board to consider contingency plans should the service not be able to be delivered as currently configured with the primary concern being the ability to provide a safe service for the population of North Wales. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“As a result, meetings have taken place with the health board, Welsh Government officials and the national leadership team in NHS England to develop options for alternative service provision with English provider trusts. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“BCUHB has established an operational planning group, which meets three times a day to ensure oversight of these arrangements and to ensure that any patients that may need care delivered in a different way are managed safely and in a timely fashion. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“As a result of the immediate service challenges and following wider discussion with English providers, an agreement has been reached that, during August, some patients may be transferred to Royal Liverpool University Hospital or, as already happens for North Wales residents with major trauma injuries, Royal Stoke University Hospital.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​


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