If you value the Accident and Emergency Department at the Royal Glamorgan Hospital and you haven’t thought about it closing down and the alternatives

If you value the Accident and Emergency Department at the Royal Glamorgan Hospital and you haven’t thought about it closing down and the alternatives if your children get ill, perhaps you should start now not when you have to travel from Cynon Valley to Bridgend when Prince Charles Hospital says there is no room. Cwm Taf Health Board has known this from 2014 as the letter below shows.


Why did the Welsh Government burden what was an overstretched Health Board with running the Princess of Wales Hospital when CTHB was unable to accomplish staffing commitments for the A&E Department Royal Glamorgan?


Now we have labour AMs and MPs and labour councillors protesting about the termination of the A&E Department at the Royal Glamorgan something that Welsh Labour Government knew about in 2014, why has it taken labour politicians so long to voice their opinions because there is an election due on Thursday, 6 May 2021 they want your vote again,

Why hasn’t Vaughan Gething AM Cabinet Secretary for Health intervened?


The changes mean:


  • Children who are very unwell or have a serious injury will need to be taken to either Prince Charles Hospital in Merthyr Tydfil, Princess of Wales Hospital in Bridgend or the University Hospital of Wales, Cardiff.
  • Only children with minor injuries can be seen in A&E at the Royal Glamorgan Hospital.
  • Children who are unwell should first see their GP for advice. A new Paediatric Assessment Unit (PAU) will be established at the Royal Glamorgan Hospital. The unit will accept referrals from your GP seven days a week until 8 pm and services will be led by a consultant paediatrician.
  • Day surgery and scheduled investigations will continue to be provided at the Royal Glamorgan Hospital.
  • The small minority of children who will need to stay in hospital overnight will need to be transferred to the most appropriate hospital.




Regional AM Suzy Davies and Bridgend MP Jamie Wallis say they are concerned that changes in emergency care at the Royal Glamorgan Hospital (RGH) could result in the A&E department at the Princess of Wales Hospital being overwhelmed.






The 2 FOI questions should have been answered by now


Mrs Allison Williams

Chief Executive

Cwm Taf Health Board


Ynysmeurig House

Navigation Park


CF45 4SN

22 April 2014

Dear Allison


I am writing to confirm formally the CHC position following the Cwm Taf

CHC Full Council meeting on 28 March 2014 at which we considered the outcome of the consultation on the South Wales Programme (SWP) and the responses to the consultation document. This letter also picks up on the discussions we have had subsequently with the Health Board following the Full Council meeting and provides an opportunity to raise formally the issues we have discussed.


Consultation process

I want to reiterate the CHC’s appreciation of the Health Board’s commitment to, and delivery of, a robust and wide-ranging consultation process. The CHC remains happy that the consultation process was sufficient and successful and in line with the requirements of the Welsh Government guidelines on Engagement and Consultation.


Croesewir gohebiaeth yn y Gymraeg a’r Saesneg


We welcome correspondence in English and Welsh

Cyngor Iechyd Cymuned Cwm Taf

Uned 10 Swyddfeydd Arforol

Teras Woodland


CF37 1DZ


Cwm Taf Community Health Council

Unit 10 Maritime Offices

Woodland Terrace, Maes-y-Coed


CF37 1DZ


Prif Swyddog / Chief Officer: Dr Paul Worthington

E-bost/E-mail: paul.worthington@cwmtafchc.org.uk

Caedeirydd / Chairman: Mel Jehu

Ffôn / Tel: 01443 405830


The CHC also welcomes the time and input from yourself, Dr Jones and

Health Board staff in coming to meet the CHC on SWP issues at a number of Full Council and Service Planning Committee meetings. This has helped us as a CHC to gain a good understanding of the issues, the options for the way forward, and in enabling robust dialogue on the Programme.


The outcome of the SWP

At the Full Council meeting on 28 March, the CHC considered:


• The correspondence exchange between Cwm Taf Health Board and the SWP in relation to the 10 recommendations considered by

Health Boards in February 2014


• The 19 March SWP media release which set out the agreement of all the health boards involved in the SWP to the recommendations, and which represents the final position reached by the SWP.


Areas of concern


Notwithstanding the comments above, Members have raised issues which reflect what we heard, discussed and considered during the consultation responses. There are some key elements of the SWP outcome which are of significant concern and in which we are disappointed:


• Consultant-led services: The potential loss of consultant-led A and E and in-patient paediatrics from Royal Glamorgan Hospital.

There was a clear message throughout the consultation – the people of Cwm Taf want to see both Prince Charles and Royal Glamorgan Hospitals continue to deliver these specialist services


• Neonatal services: Although a collaborative approach to neonatal provision is a positive step, what has been outlined is lacking in detail and Members were extremely concerned about the loss of consultant-led Obstetric services from RGH. Again, there was also a clear message from our local communities throughout the consultation – the people of Cwm Taf want to see both Prince

Charles and Royal Glamorgan Hospitals continue to deliver these services locally

On both of these issues, the Council were very cognisant of what the public had said during consultation and the concerns flagged up both during consultation and in the accompanying reports – especially the ORS Final Report and the Equality Impact Assessment – especially those relating to demography, local epidemiology and access issues.

The CHC must clearly reflect the views and represent the interests of patients, public and local communities in Cwm Taf as expressed in their response to the consultation. Equally, the CHC must base its decisions not just on the public voice, but on the evidence supplied and considered during and after the consultation. As the Chair of Cwm Taf CHC set out at the LHB Board meeting on 13 February, the CHC believe that Option 4 represents the most appropriate way forward for the Cwm Taf community.

The conclusions from both the evidence and the public consultation, we believe, are clear in relation to the services for our population. On the issues identified above, the Council is unable to support the loss of these consultant-led and in-patient services from Royal Glamorgan Hospital, and stands by its support for the 5-site model – as set out in Option 4 in the consultation – with both

Prince Charles and Royal Glamorgan Hospital included within the 5 sites. We believe this is a viable and appropriate alternative option.

At the CHC Full Council meeting on 28 March, it was agreed that these issues would be key determinants in whether or not the CHC would proceed to referral to the Minister.

As a result, this letter seeks formal clarification of whether Cwm Taf

Health Board is able to reassure the CHC on the continuation at the

Royal Glamorgan Hospital of the consultant-led A&E and in-patient obstetrics, paediatrics and neo-natal services.

As a CHC we appreciate the process which has brought the LHBs and the SWP to this point and recognise that any solution had to be a combined and collaboratively agreed approach, which has made the decision-making process more complex. We share the view also that delivery of the future shape of services must be on the basis of collaboration, and whilst recognising the support of health boards for the March 19th position, we believe that Option 4 represents an appropriate solution not just for the Cwm Taf population, but for the SWP as a whole.


Comments on the outcome

There are a number of key elements in the 19 March position that we would welcome:

• The case and reasons for the proposed service changes


• The need to ensure the delivery of safe, high quality and

sustainable services


• The emphasis on collaboration within the clinical alliances and the commitment to improved joint working


• The key role ascribed to Prince Charles Hospital as part of the 5 site model


• The work on local service models for emergency medicine, paediatric assessment and diagnostic services. The delivery of these will be critical to the sustainability of any future shape of services


• The need for work on greater collaboration in relation to ensuring robust and sustainable neonatal services


• The need for the Deanery to align training better for future service requirements and for an increased emphasis on the training of enhanced practitioners


At the same time, there are key areas – a number of which we raised at the Board meeting on 13 February – which we feel are fundamental to and critical to the underpinning of service change. However, we feel the

SWP position on some of these issues lacks detail on timescales and process. We still seek reassurance on these and would welcome your comments:

Making the Alliances work


• Medical training: we need clarity from the Deanery in relation to how the allocation of trainees to the Alliance will work in practice from this August onwards. We are firmly of the view that there should be a clear movement towards allocation by Alliance, rather than by hospital


• Organisational boundaries: CHC Members argued strongly for the value of ensuring a clear coterminosity of health board boundaries with the new Alliances. They believed there would be clear and demonstrable clinical, organisational and managerial benefits in achieving such alignment, and at an early stage. This would do much to mitigate the impact of service change. We

recognise this is a significant challenge, but believes it is a  challenge to which the South Wales Collaborative is capable of rising to


• Capital funding: in terms of achieving the alliance model, we would seek confirmation that all capital developments will be considered on the basis of the Alliance model to make best of existing capital stock in South Wales, and to ensure capital is being used as an enabler for the South Wales Programme. This has particular relevance for the development of the Diagnostic Hub model


• Impact on UHW: there remained a concern amongst the Council relating to the capacity restrictions of the University Hospital of

Wales to cope with what undoubtedly would be increased demand for specialist services; this may impact adversely on their ability to provide district general services to their local community, with a need for services potentially to move out of Cardiff

Listening to the views expressed during consultation


• Tackling social deprivation: There is a clear need to demonstrate commitment to our most deprived communities. The proposed outcome of the South Wales Programme will adversely and disproportionately impact upon the population of the Rhondda Valleys, which has real deprivation, ill health and access issues.

Welsh Government is committed to addressing poverty in terms of both narrowing inequalities in health and reducing low birth weight babies.

The SWP outcome also contained little in the way of tangible aims and commitments on improving primary and community care; we believe such enhancement and improvement is essential if the new shape of services is to be achieved. There is a pressing needfor Welsh Government to signal its commitment to the population of the Rhondda in demonstrable terms; to this end, there must be a real and significant investment into Primary Care not a recycling of existing monies.


• New models of emergency medical care: We firmly support the development of a beacon site for a new Acute Medicine service model. At the Health Board meeting on 13 February we discussed concerns related to the significant percentage of A & E cases which require emergency medicine services, and are often frail and elderly, and there is a clear need for a service that addresses these issues.

However, we feel the SWP position on this issue lacks detail on timescales and process. We would seek commitments to delivery and implementation of this model at an early juncture to ensure these models are in place ahead of or at the same time as any changes. Welsh Government will need to support actively this important initiative as a model for Wales.


• Paediatric assessment: We would also welcome the development of a service model for paediatric assessment.

However, the SWP position lacks detail and timescales on this also. We would seek the same commitments as for emergency medicine above.


• Neonatal services: These are a major concern; more underweight premature babies are born in the Rhondda than elsewhere in

Wales. It is therefore vital that any future model being delivered in

Royal Glamorgan Hospital is given every chance to succeed. For the new models of care being proposed, success will depend on support from Alliance partners, the neonatal network and the

Deanery. Welsh Government must declare their support publically and underwrite the one-off costs associated with this initiative


• Ambulance services: there were strong and consistent concerns expressed during consultation about the ability of the Ambulance service to respond to the needs of the future shape of services. In addition, the increasing flow of activity into UHW will almost certainly have an impact in terms of increased ambulance activity directed towards UHW. There is a need to look at how dedicated ambulance services – designed to directly support Cwm Taf – can be achieved. Indeed, there is a pressing need to ensure sufficient levels of ambulance support are available to support directly the new models of care in key hospitals which are not part of the 5 sites


• Access: Access to services from the most deprived communities within Cwm Taf with poor public transport infrastructure and low car ownership remains a concern. The CHC needs reassurances that whatever the change proposed patients and their families could be assured by any mitigating actions to address this significant issue



Clear actions and real additional monies will be vital in securing the commitment of Alliance Partners and the Deanery. There is an opportunity to develop services locally, strengthen primary care and deliver world class specialised services. The Minister needs to be fully behind this and make a public commitment at an early juncture – the issues addressed in the SWP are pressing.

In conclusion, we should re-iterate some of what the CHC representatives said at the 13 February meeting. We acknowledge that the Health Board has taken the matter very seriously and responsibly; and has had a very difficult decision to make. We recognise that the

Health Board has fully debated all the related issues and has clearly done so many times leading up to this point. However, in order to move forward, the CHC seeks a response to the issues set out above.


Yours sincerely


Mel Jehu Dr Paul Worthington

Chair Chief Officer

Cwm Taf Community Health Cwm Taf Community Health



Dr Paul Worthington

Chair Chief Officer

Cwm Taf Community Health Cwm Taf Community Health

Council Council

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