Hywel Dda University Health Board is developing plans to provide more cancer care closer to where people live, but recruitment difficulties and shortages in consultant capacity mean some temporary changes to services have to be made.
The latest public board meeting last Thursday heard an update from the Oncology Programme Board, established last year to consider and propose a future service model for Hywel Dda which would provide cancer care close to where people live whenever safe and practicable to do so.
Progress to date has included:
• Funding for just more than two nurses has been agreed to support an out of hours chemotherapy advice line based in South Wales Cancer Centre to cover all patients within Hywel Dda University Health Board
• Agreement with MacMillan Cancer Support to fund four full time acute oncology nurses, a data manager and three sessions of consultant over the next three years. Posts in Withybush and Prince Phillip Hospitals will be in place later this year
• A subgroup has been established to develop the Chemotherapy Day Unit and oncology ward (Ward 10) at Withybush Hospital. Outline proposals have been agreed and there is close working between fundraisers and the University Health Board. A survey of inpatient cancer activity has also been undertaken to inform the refurbishment of Ward 10 and provide information for the development of acute oncology services across all sites
• Inconsistencies in nursing roles and professional development are being addressed between sites and cross site meetings between chemotherapy nursing staff have started
• Patients with gynaecological cancers previously being treated in Singleton are now receiving treatment within the Hywel Dda area at whichever is their closest hospital
The aim is to provide safe and long-term (sustainable) cancer services in an environment where there are difficulties in recruiting medical staff. The University Health Board is also working to address high consultant workloads, to reorganise to allow consultants to specialise in fewer cancer sites and working to improve accommodation where needed in local units at Bronglais and Withybush hospitals. A full plan is being brought to the board for consideration in the July 20 meeting.
In the meantime, the board heard that some operational changes were necessary until consultant cover was obtained. For example, Dr. Pudney consultant oncologist from Singleton Hospital was temporarily seconded to Withybush Hospital, but returned to her substantive post at the start of June. Until a replacement can be found, and in order to ensure patients receive continuity of care, Dr Pudney will run oncology clinics for breast cancer patients in Prince Philip Hospital, Llanelli, every other week. This means on alternate weeks, Pembrokeshire patients will need to travel to see Dr. Pudney. This doesn't affect patients seeing a breast surgeon or attending chemotherapy clinics, which continue in Withybush Hospital.
Interim medical director, Dr. Phil Kloer, said following the meeting: "I know this will be a difficult situation for patients and the community to accept, but we've had to make this temporary change in light of ongoing difficulties in obtaining consultants. We, along with the South West Wales Cancer Centre, continue to try and recruit both locums and substantive consultants and as soon as we appoint another specialist the clinic will return to Withybush Hospital every week. In the meantime, patients can be assured that they will continue to see Dr. Pudney, who will run both clinics herself."
Board members agreed the need for cancer services to provide more chemotherapy and outpatient clinics locally.
Dr. Kloer added: "We don't want people to have to travel for consultant oncology clinics, but equally we won't move chemotherapy or investigative tests from main hospitals as it is crucial we provide these locally. The long term vision is for oncologists to travel to sites to provide specialist clinics so vulnerable people don't have to travel."