Introduction

Petition number: P-05-905

Petition title: Call for an Independent judicial Inquiry into the reorganisation of services within Cwm Taf Health Board

Text of petition: This petition calls on the Welsh Government to undertake a fully independent judicial inquiry into the management and implementation of the NHS South Wales programme at Cwm Taf Health Board and its impact on the services provided to the public of Rhondda Cynon Taff at the Royal Glamorgan Hospital.

Background

The South Wales Programme (SWP) was established in 2012 to consider the future of four hospital services which had been identified as increasingly fragile. These were consultant-led maternity services, neonatal care, inpatient paediatrics and emergency medicine (A&E).

The SWP is made up of five health boards – Abertawe Bro Morgannwg, Aneurin Bevan, Cardiff and Vale, Cwm Taf and Powys – working with the Welsh Ambulance Service, with the aim of creating safe and sustainable hospital services for people in South Wales and South Powys.

Although the work of the SWP focuses on four specific hospital services, the public consultation document (May 2013) highlights that the contribution of primary care, especially GPs and their teams, will be critical in providing the integrated care patients need.

We fully accept that in some areas we will need to strengthen our GP services, particularly in the out-of-hours period.

As part of the SWP, a series of clinical summits and conferences were held during 2012. It was concluded that to address recruitment issues, ensure services meet the necessary professional and clinical standards, and to provide safe, effective care to the sickest and most seriously injured patients, these services needed to be provided on fewer hospital sites than they currently were.

The ideas developed in the clinical conferences were put to the public and wider NHS during a 12 week engagement process between September and December 2012, and reportedly received broad, general support.

Following that engagement period, a further clinical conference was held in February 2013, as part of the preparations for a formal public consultation on the service changes. The formal public consultation ran for 8 weeks from 23 May to 19 July 2013.

Discussions were held with all partner organisations. All health boards supported the creation of three acute care alliances across south Wales and south Powys,  and agreed that consultant-led emergency medicine (A&E), maternity and neonatal care and inpatient children’s services should be provided at five centres. A March 2014 press release - South Wales Programme Board agrees next steps - notes that ‘this is consistent with the majority of responses to the public consultation’.

In relation to the Royal Glamorgan Hospital (RGH), it was agreed that:

·         Local service models in emergency medicine, paediatric assessment and maternity services will be developed at RGH to replace the traditional services.

·         Inpatient children’s services will not be delivered from the RGH site in the future but implementation will require a new local assessment service being in place as the changes occur, to ensure that children continue to have their care delivered safely, as locally as possible.

·         Consultant-led A&E services will not be delivered from the RGH site in the future but implementation will require the proposed new model for a local A&E service (non-consultant led) to be in place as the changes occur.

·         Maternity and neonatal services at RGH will work closely with other units within the alliances to deliver as much safe care as locally as possible. The final model of service at RGH will be determined through the transition and implementation planning process.

There has also been full agreement that RGH will become a beacon site for developing innovative models of care in acute medicine and diagnostic services. 

Implementation of the changes

In July 2018 the Health Minister responded to concerns about the slow pace of change in South Wales services. He said:

Your point about the South Wales Programme is well-made. It was clinician-led. There was agreement on what to do, and we have achieved a number of those things but, again, it usefully highlights the point about the pace and the scale of change. We have taken a long time not to deliver all of the programme, and that's one of the things we need to be able to get over and get around for the future, because the pace at which we're able to move frustrates everyone, it makes people anxious about whether change will really happen and it means that we don't deliver the improvements we recognise are necessary as quickly as possible. So, yes, the south Wales work is still being delivered, and key building blocks have happened, but I want to see much greater pace in the future for the change that we are talking about.

Welsh Government response to the petition

In reference to the Royal Glamorgan Hospital, the Welsh Government’s response states:

There were a number of outcomes to the consultation that were significant for the Royal Glamorgan Hospital including changes to the development of the hospital as a beacon site for acute medicine and the establishment of a Diagnostic Hub. These changes have been implemented. 

The response provides an update on changes in the hospital services consulted on under the South Wales Programme, and other specific areas highlighted but the petitioner, including primary care/GPs and out of hours services.

It highlights that the Health Board is developing an Integrated Healthcare Strategy which will set out its longer term strategic direction. This includes the wider implications of the April 2019 boundary change, where responsibility for healthcare services in Bridgend County Borough Council area transferred to the newly formed Cwm Taf Morgannwg University Health Board.