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Hywel Dda hospital cardiac care review criticised in report Hywel Dda hospital cardiac care review criticised in report
(35 minutes later)
Cardiac services face a shake-up at four district hospitals after a critical review prompted by a "number of anecdotal and untoward incident reports". Cardiac services face a shake-up at four district hospitals after a critical review by a panel of UK leading heart specialists.
Hywel Dda University Health Board (HDHB) commissioned the study amid "concerns" about standards affecting heart patients in Carmarthenshire, Ceredigion and Pembrokeshire. The report by the Royal College of Physicians calls for a specialist cardiac 'hub' to be established, based at Glangwili Hospital in Carmarthen.
The Royal College of Physicians said it was also concerned about the accuracy of data relating to death rates. Data on death rates at hospitals run by the Hywel Dda University Health Board has also been questioned
Officials say they are taking action. The board requested the review amid concerns over cardiac care.
Officials say they are now taking action on the report.
The four hospitals at the centre of the review are Bronglais at Aberystwyth, Withybush at Haverfordwest, Glangwili at Carmarthen, and Prince Philip at Llanelli.The four hospitals at the centre of the review are Bronglais at Aberystwyth, Withybush at Haverfordwest, Glangwili at Carmarthen, and Prince Philip at Llanelli.
The panel looked at a number of internal documents, including letters and emails and interviewed health board staff including cardiology consultants.The panel looked at a number of internal documents, including letters and emails and interviewed health board staff including cardiology consultants.
Health board medical director Dr Sue Fish said the review did not look at any specific issues "relating to individual patients and has not identified any parts of the service that are currently unsafe".Health board medical director Dr Sue Fish said the review did not look at any specific issues "relating to individual patients and has not identified any parts of the service that are currently unsafe".
'Mortality index''Mortality index'
The report said: "The review was prompted by a number of both anecdotal and untoward incident reports about the care of patients with acute cardiological problems (primarily cardiac type chest pain) being admitted to the district general hospitals (DGHs) in the HDHB area and in particular the interface between accident and emergency (A&E), the acute medicine units (AMUs) and specialist cardiology services.The report said: "The review was prompted by a number of both anecdotal and untoward incident reports about the care of patients with acute cardiological problems (primarily cardiac type chest pain) being admitted to the district general hospitals (DGHs) in the HDHB area and in particular the interface between accident and emergency (A&E), the acute medicine units (AMUs) and specialist cardiology services.
"There had also been concern about an apparently high risk adjusted mortality index (RAMI) for cardiology patients in one DGH, Withybush Hospital, and the collection of data throughout HDHB.""There had also been concern about an apparently high risk adjusted mortality index (RAMI) for cardiology patients in one DGH, Withybush Hospital, and the collection of data throughout HDHB."
It has issued a number of recommendations, including creating a "hub" for cardiology care at Glangwili hospital and saying any patients arriving at any A&E unit in the health board area should be transferred to Glangwili "immediately". Other recommendations are:It has issued a number of recommendations, including creating a "hub" for cardiology care at Glangwili hospital and saying any patients arriving at any A&E unit in the health board area should be transferred to Glangwili "immediately". Other recommendations are:
The review said two cardiologists from separate hospitals independently raised concerns, referring to the "poor service patients are receiving".The review said two cardiologists from separate hospitals independently raised concerns, referring to the "poor service patients are receiving".
'Firm decisions''Firm decisions'
The report said patients needing specialist treatment or surgery are sent to Morriston hospital in Swansea run by neighbouring Abertawe Bro Morgannwg Health Board with Morriston consultants "concerned that patients returning to hospitals in the Hywel Dda health board after surgery may get lost in the system with inadequate follow up".The report said patients needing specialist treatment or surgery are sent to Morriston hospital in Swansea run by neighbouring Abertawe Bro Morgannwg Health Board with Morriston consultants "concerned that patients returning to hospitals in the Hywel Dda health board after surgery may get lost in the system with inadequate follow up".
Health board medical director Dr Sue Fish said a clinically-led project board is being set up to "discuss the report and its recommendations in detail, formulating an action plan as a matter of urgency".Health board medical director Dr Sue Fish said a clinically-led project board is being set up to "discuss the report and its recommendations in detail, formulating an action plan as a matter of urgency".
She said: "The review did not look at any specific issues relating to individual patients and has not identified any parts of the service that are currently unsafe.She said: "The review did not look at any specific issues relating to individual patients and has not identified any parts of the service that are currently unsafe.
"We have been reviewing all deaths in our hospitals over several of years to ensure that lessons can be learned and patient care improved.""We have been reviewing all deaths in our hospitals over several of years to ensure that lessons can be learned and patient care improved."
She said the health board has undertaken a further review of RAMI data and "improved the management of clinical incidents and we are ensuring that we participate in National Clinical Audits".She said the health board has undertaken a further review of RAMI data and "improved the management of clinical incidents and we are ensuring that we participate in National Clinical Audits".
"It's important to stress that no decisions have been made as the project board will need to consider the recommendations with our expert clinicians before firm decisions on the best way forward are made," she said."It's important to stress that no decisions have been made as the project board will need to consider the recommendations with our expert clinicians before firm decisions on the best way forward are made," she said.