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How Swansea Bay University Health Board is dealing with ‘targeted intervention’ measures

Stock Picture of a hospital (Pic: RDNE Stock Project via Pexels)

SWANSEA Bay University Health Board is making progress on many treatment targets set by the Welsh Government after ministers increased their oversight of the organisation, a meeting heard.

The health board was put into “targeted intervention” – a level below the most serious “special measures” – during the winter for cancer care, urgent and emergency care, planned care, healthcare-associated infections, and child and adolescent mental health services. It can move back down a level of monitoring if it hits and maintains certain criteria for three months.

Chief operating officer Deb Lewis told board members at a meeting on May 23 that it was not far off meeting a target of treating 60% of cancer patients within 62 days of the disease first being suspected after “quite a poor performance” in January and February. She said prostate cancer patients would be dealt with “at a rate of knots” due to an increase in treatment capacity at Swansea’s Morriston Hospital.

Mrs Lewis said feedback from the Welsh Government on planned care was largely positive and that the health board was “at the top of the pack” in Wales. She cited a number of achieved targets, but said a diagnostic endoscopy one was an issue.

On urgent and emergency care, Mrs Lewis said improvements had been made reducing the number of ambulance handovers of more than an hour. “The challenge for us is patients we don’t bring in within an hour wait far too long outside the department,” she said.

On child and adolescent mental health services, she said the only target being missed was carrying out 80% of all assessments within 28 days of referral. She said this had been due to a shortage of staff, and that she anticipated compliance “fairly soon”.

On healthcare-associated infections, Mrs Lewis said the only outlier was a bacterial infection called C-difficile. She said there were about 20 such hospital-acquired cases per month against a target of 10 per month reducing to no more than six.

Independent board member Reena Owen said hospital-acquired infections were a worry for her because of a link, she said, with the age of the health board’s buildings. “Is there any opportunity within targeted intervention to get some additional capital investment in our estate to sort out some of these issues?” she asked.

Board members heard that capital funding bids totalling £9.5 million have been submitted, and that there were other factors linked to acquired infections including hand hygiene.

It is not unusual for Welsh ministers to place health boards in what are now five different levels of monitoring, and Hywel Dda and Aneurin Bevan health boards were put under increased scrutiny this winter along with Swansea Bay, which covers Swansea and Neath Port Talbot.

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Asked about the effect of targeted intervention on staff, a spokeswoman for the union BMA Cymru said its negotiating committee at Swansea Bay had regularly voiced concerns about capacity, particularly in emergency care where it said doctors have consistently struggled to meet high demand due to several vacant posts. “Thankfully due to regular dialogue with management, the concerns of doctors have been listened to and the health board is now actively recruiting more staff,” she said.

Tanya Bull, head of health at another union, Unison Cymru, said being placed under monitoring or targeted intervention could be challenging for staff as it could affect morale and focus decision-making on one particular area, with the risk that this came at the detriment of another.

She added: “This can place pressure on staff more widely across health boards and creates the perception that they need to do more and work harder when we know that, in reality, NHS staff are already near to breaking point.”