Plaid Cymru Assembly Member for Arfon Siân Gwenllian is calling on the First Minister of Wales to ‘come clean’ about threats to emergency vascular services at Ysbyty Gwynedd Bangor and confirm when the decision was formally taken to remove the emergency service from the hospital.
Siân Gwenllian AM will raise the issue during First Minister’s Questions in the Senedd today, as concerns mount about the lack of transparency in the process of determining the future provision of vascular care at Ysbyty Gwynedd. The Betsi Cadwaladr Health Board is in special measures and the direct responsibility of the Welsh Labour Government.
Specific concerns have been raised about the decision-making process that led to the Health Board reneging on a promise to keep the world renowned emergency vascular service at the district hospital, despite opposition from patients, health professionals and local politicians.
Siân Gwenllian AM said: “My constituents and I have become increasingly alarmed at the way Betsi Cadwaladr Health Board has dealt with this issue, initiating sweeping public health reforms with little accountability.
“The First Minister must now come clean about how these decisions were taken and why the whole process has been tarred by broken promises, misleading statements and deliberate opaqueness from the outset.
“The responses which I have so far received from both the Welsh Labour Government and Betsi Cadwaladr Health Board have failed to address the serious concerns which I, and an increasing number of my constituents have.
“I’ve repeatedly asked for information about when exactly the decision to remove emergency services was taken. A letter sent to GPs in Feb 2018 sates clearly that emergency services will be retained at Ysbyty Gwynedd and records from the Board’s March meeting confirms this.
“We now understand that emergency vascular services will NOT be retained. I have been asking the Welsh Labour Government and the Health Board to show me the minutes which confirm this change of policy, but to date my questions have not been answered.
“The Health Board has also chosen to discount calls for an impact assessment into the effects of removing emergency vascular care from Ysbyty Gwynedd on patients living in the farthest corners of north west Wales.
“Consequently, far reaching reforms are being pushed through the back door with minimal public scrutiny and little or no transparency at the expense of patient care and ultimately, their safety.”
In an open letter from Mark Polin, Chairman, and Gary Doherty, Chief Executive of Betsi Cadwaladr University Health Board, said they want to provide reassurances that the changes to vascular services will provide “better outcomes for patients” in North Wales.
The letter read: “Our decision was made following full public consultation considered by the Board in 2013, which was extensively documented and reported at the time.
“Our current plan is fully in line with our decision in 2013. As has been seen across the NHS, changing vascular services is a long, complex process, but we have now built a state of the art vascular operating theatre with £2.3M investment from Welsh Government and have been able to attract six new vascular surgeons.
“The decision to change is in line with guidance from the Vascular Society of Great Britain which the whole of the NHS is required to implement, and reflects the national development of vascular surgery into a specialist, hi tech service that is provided in fewer, bigger centres. The majority of vascular services will remain locally. About 300 complex cases per year will take place in our specialist centre at Ysbyty Glan Clwyd, representing 20% of all the vascular activity. Outpatient appointments, diagnostic tests, less complex surgical procedures and support for renal dialysis patients will not change and will continue to be provided locally.
“Bringing the specialised surgery into one place allows us to invest in the latest equipment and technology and to attract new staff. Most importantly, this investment allows us to create a team who are doing the most complex cases every day and the evidence from elsewhere where this change has already taken place shows that patients get better outcomes as a result. Our current vascular service achieves world-class results for some of our procedures, but this is not the case for all of our vascular surgery. By developing a specialist centre of excellence we want all our vascular surgery to have the very best outcomes and to ensure we have a viable, modern vascular service for the future.
“Some correspondence has made reference to a ‘golden hour’. This is a clinical phrase that is used in trauma surgery, not vascular surgery, but we appreciate there are rightly concerns around emergency access and while new screening services mean we can spot many vascular conditions and treat them in a planned way, some of the 300 cases will be emergencies. Our current service is too stretched, individual hospitals cannot provide 24/7 emergency vascular care so out-of-hours it is provided at either Ysbyty Gwynedd or Wrexham Maelor Hospital on an alternating basis. This means emergency patients either travel to the site which is on call (so emergency patients from Gwynedd and Anglesey are travelling to Wrexham right now) or if they are too unwell to do so the on-call surgeon travels to them. This will continue to be the case with the new service – if patients are too unwell to travel to the specialist centre at Glan Clwyd Hospital the specialist will come to them.
“The Health Board is committed to providing services as near to patients as we can, but like the rest of the NHS we must change and develop in this speciality. Vascular surgery is now a recognised, highly specialised service and like other highly specialised services such as cancer and heart services it is provided in a smaller number of bigger specialist centres. We have invested millions of pounds in new equipment and have been able to attract new surgeons to North Wales who would not have come here if we did not have a modern, specialist vascular centre. The vast majority of patients will be seen and treated locally. North Wales patients (including emergency patients) are already travelling for treatment. Travelling to a specialist, centre of excellence will allow us to give the best outcomes to patients right now but will also make sure we have a vascular service in North Wales for future generations.”