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Heath chiefs consider moving patients from stretched hospital to another site

Singleton Hospital Swansea

HEALTH chiefs in Swansea have said they will consider moving some patients from the city’s most under-pressure hospital this winter to wards which are lying empty at another, in order to free up much-needed beds.

These would be patients who were medically fit for discharge, not acutely unwell ones – but there could still be a major challenge finding staff to care for them.

Swansea Bay University Health Board declared a so-called business continuity incident – triggered only in exceptional circumstances – at Morriston Hospital on November 29 because of extreme unscheduled care pressures.  More than 80 acutely unwell people were waiting for hospital beds. It said everything possible was being done to discharge patients who no longer needed acute medical care so that very ill patients could be admitted.

The health board currently has more than 200 patients who are medically fit for discharge but who are stuck in a hospital bed for reasons including no onward care being available. It also has empty wards at Singleton Hospital, Sketty.

A health board meeting on November 30 heard that concerns had previously been raised about the volume of patients at Morriston and whether this was linked to the temporary closure of beds at five wards at Singleton.

Independent board members on the quality and safety committee had asked whether the closure of the Singleton wards had happened too early and were clogging up the system elsewhere, and whether these empty wards were one answer to the current pressures at Morriston.

Interim chief executive Richard Evans said it was “a really fair point” and that as winter progressed, using empty space at Singleton as a “surge” facility for medically-fit-for-discharge patients would be considered.

“The challenge, as ever, is you might have the space but you don’t have the staff,” he said.

The five empty wards at Singleton are being remodelled as part of a wider programme to concentrate specific resources and expertise at Morriston, Singleton and Neath Port Talbot hospitals. There are also some temporary ward moves at Singleton linked to ongoing cladding work.

Under this “centres of excellence” model, Morriston is focusing on urgent and emergency care, complex care, specialist care and regional surgery. Singleton will be the centre of excellence for planned healthcare, women’s health, cancer care and diagnostic tests. The health board has previously said that the patients who would normally be looked after in the empty Singleton wards were at Morriston, as were the nursing staff.

Dr Evans said extra capacity and resources had been created at the front door in Morriston over the last 12 to 18 months as part of the changes. “Everything is co-located in one place,” he said.

Dr Evans also questioned whether a hospital bed anywhere was the best option for a patient who was medically fit for discharge. He said the health board was working closely with councils, which arrange social care, and others to help prevent hospital admissions. It also operates eight “virtual wards” to support patients at home.

A health board spokesman said a key reason for the move of some patients and staff from Singleton to Morriston was “unsustainable workforce” pressures, but also improving patient outcomes. He said beds at the five wards at Singleton had been reduced gradually, with the last of them closing at the end of September.