Some Betsi Cadwaladr vascular patients to be sent to two hospitals in England

Some vascular patients in North Wales will receive their treatment at the Royal Liverpool University Hospital – or the Royal Stoke University Hospital – expanding on a similar move earlier this year.

It comes after a series of meetings between Betsi Cadwaladr University Health, Welsh Government officials and the national leadership team in NHS England to develop options for alternative vascular service provision with English provider trust.

The North Wales health board is described as facing “immediate operational pressures due to consultant availability and nurse staffing” in the department.

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

Vascular services in Ysbyty Glan Clwyd have been under Targeted Intervention Measures since the start of June amid ongoing concerns about vascular services and the hospital’s emergency department.

Yesterday Wrexham.com reported that a new report into vascular services in the region highlighted “concerns in relation to the management of aortic patients following the completion of a review of 11 patients’ notes.”

It found that on On 8 July 2022 the Chair of the VQP raised safety concerns in relation to the management of aortic patients following the completion of a review of 11 patients’ notes.

The EMD received 3 recommendations for immediate implementation. These were the reintroduction of dual consultant operating (for aortic patients only), involvement of a specialist centre in the multidisciplinary Team (MDT) meetings for all aortic cases and the recruitment of a vascular surgeon with aortic experience.

There have also been two Never Events in the service and other concerns relating to safety and sustainability which have resulted in Healthcare Inspectorate Wales (HIW) designating the service a Service Requiring Significant Improvement in March 2022.

In a written update released yesterday, Health Minister Eluned Morgan said that some changes are “necessary to ensure a sustainable and safe service provision in particular in relation to vascular services in North Wales.”

She addresses 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.

Ms Morgan, said: “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.”

Commenting on the minister’s statement, Dr Nick Lyons, Executive Medical Director at Betsi Cadwaladr University Health Board said: “In response to feedback received from external reviews and our continual focus on patient safety, we have again reviewed the way we deliver care to patients on some of our vascular pathways.

“This includes contingency planning to ensure that there is no interruption of care for those needing aortic surgery.

“As a result, a very small number of patients each week may receive their surgery at the Royal Liverpool University Hospital – or the Royal Stoke University Hospital, as already happens for North Wales residents with major trauma injuries. Each patient will be contacted to discuss their care and will be supported as required.

“Very specialised care for some patients is already provided by specialist vascular centres in England and we work in partnership with them to manage complex cases. We are grateful for their continued support.

“These contingency plans recognise the operational challenges we are experiencing due to staff sickness absence combined with recruitment difficulties.

“We also have concerns about a small number of vascular surgical cases. This follows independent scrutiny by the Vascular Quality Panel, which the Health Board commissioned and established in response to the findings of the invited review by the Royal College of Surgeons, the second part of which was published in February this year.

“We expect these arrangements to remain in place until we are assured that the service is deliverable, robust and sustainable. The service will be kept under review and updates will be provided as appropriate.

“We remain committed to the model of a networked vascular service for North Wales and continue to work to secure its sustainability and deliverability.”