Lee Waters MS issues stinging letter in defense of Llanelli’s MIU at Prince Philip Hospital

Following the decision to temporarily close the Minor Injuries Unit at Prince Philip Hospital overnight, the Llanelli MS Lee Waters issued a letter to the Healthboard, criticising their approach and accusing them of walking away from their commitments:

“The decision to withdraw overnight coverage at the Minor Injuries Unit at Prince Philip Hospital has been very badly received in Llanelli.

“It not only represents a breach of a commitment given to provide 24 hour care when the A&E unit was closed, but has also raised a series of questions about the approach of the Health Board and the perception that a managed decline has been taking place.

“I have been contacted by a number of members of staff who echo many of the points that were raised by the independent watchdog, Healthcare Inspectorate Wales, in their recent critical report of the Minor Injuries Unit.

“It does feel like rather than raising its game in response to the report the Health Board have instead decided simply to walk away from their commitments. Your board seem content with this. I am not.

“I have always tried to take a reasonable position when changes to the healthcare model have been proposed because I know the challenges that the system is facing are difficult. On this occasion, I do not believe there is a case for change, and I am fed up with the way the health board continually fails to lead the case for change. I am close to losing faith in the way change is managed.

“We are again told the reason that the overnight service cannot be maintained is a difficulty in recruiting which makes the service unsafe. We are now familiar with this argument from the Health Board. And yet, I understand no efforts have been made to recruit GPs to the service.

“I am told that following Healthcare Inspectorate Wales’ report, staff were informed that the unit would likely close at night by December 2023. This led to some doctors, who had been providing night cover for many years, seeking alternative employment. When the unit did not then close, no attempt was made to recruit new medical staff.

“In fact, I have also been told that the Health Board has made little effort to recruit doctors to the MIU since: medical vacancies are not being advertised and GPs who do submit CVs are not being contacted. Additionally, I am informed that the rate of pay has not changed for at least 8 years yet night cover is mainly locum which is very expensive. Consequently, this has increased the burden for existing staff. I’d be interested in your response to these very concerning claims.

“The recent Healthcare Inspectorate Wales report highlights poor management of the MIU and patient safety concerns. It notes that some patients, including surgical and orthopaedic patients, are waiting several days in the unit for transfers to Glangwili or Morriston, or for mental health and medical beds on clinically suitable wards at PPH.

“My understanding is that there seem to be no policies in place to facilitate timely transfers for these patients, and that these issues appear to stem from broader bed and ambulance pressures, rather than staff shortages within the MIU.

“My understanding is that, should the MIU close at 8pm, there is no detail as to what will happen to the patients awaiting beds and inter-hospital transfers when the MIU staff go home after their shift; especially as medical staff in PPH overnight are not qualified to look after paediatric, surgical or orthopaedic patients – this role is currently undertaken by GPs when on duty.

“I am aware, also, that there is no plan to create more beds in AMAU as a result of MIU overnight closure and this will have a knock-on effect to ambulance response times due to waiting to offload patients. Nor, I believe, is there any plan to reinstate PPH’s GP out-of-hours service which was closed on the basis that there would be a GP in the MIU.

“I share my constituents’ fears that having bank staff allocated to a clinical area would pose many issues and risks. What are the Health Board’s staffing plans given the circumstances outlined above?

“When I was first elected in 2016 a great deal was made of a new model for unscheduled care at Prince Philip Hospital. I supported the case for a £1.4m investment to re-develop emergency care services in Llanelli. You seem to have abandoned this model.

“I accept there are real challenges with staffing and supporting the system. But it is the job of the health board management to find a way, not to find a way out.

I would be grateful for a prompt response to the matters raised above and look forward to meeting with you tomorrow to discuss this further.

“Yours sincerely,

Lee Waters MS/AS.”