Hospital A&E downgrade 'urgently needed' over doctor shortage

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Media captionProtesters oppose planned A&E downgrade

Doctor shortages mean "urgent action" is needed to speed up plans to downgrade a hospital's A&E department, bosses have said.

About 200 protesters lobbied Cwm Taf Morgannwg health board, which agreed to work on plans to close Royal Glamorgan Hospital's A&E completely or overnight.

A decision to centralise emergency care in fewer hospitals was made in 2015, but a final decision is yet to be made.

Cwm Taf said action was needed to avoid "unacceptable risk to patient safety".

But the health board agreed to "leave no stone unturned" in seeing if anything could be done to keep the current A&E set-up as it is.

Nevertheless, severe staff shortages meant arrangements could not continue without compromising patient safety,

On Thursday, Rhondda MP Chris Bryant chaired a meeting with health chiefs discussing the hospital's future at Penygraig's Ysgol Nantgwyn.

Resident Phil Hughes, of Ton Pentre, said: "Not to have a fully functioning A&E is not acceptable.

"It's a danger to the health and wellbeing of the Rhondda residents.

"We ought to know how they have come to this decision."

Mike Green, of Penygraig, said: "I've got a bad heart and if I need to go quick it's the best place to go, it's quicker for me.

"We should have somewhere within a good distance, and if we have to go to Merthyr - what is it an hour?"

Mr Green said he had used the hospital's A&E department on several occasions and it had "saved my life."

Image caption Erica Taylor and Ann-Marie are both concerned about having to travel to Methyr Tydfil

Earlier on Thursday, a group protested outside a meeting of the health board in Abercynon, Rhondda Cynon Taff.

Erica Taylor, from Pontypridd, added: "We have to travel to the Royal Glamorgan as it is. If we have to travel further to Prince Charles or to Bridgend it's out of the area and that could be dangerous for people who are ill."

Ann-Marie, from Porth, Rhondda, said they were getting ignored: "It's a deprived area and we need it the most.

"If there's a shortage of consultants, why can't they come from other hospitals? My father is asthmatic and many a time we've had to rush him to hospital. If people are going to have to travel from Porth down to Ponty and up to Merthyr, lives are going to be lost."

Clive Ball, who lives in Talbot Green, said: "I can't understand why we weren't consulted about this since we are the public and we are the owners of the NHS."

Image caption Protesters do not want to see the A&E closure go ahead

What's the problem?

On Christmas Day and Boxing Day, ambulances had to be diverted from the Royal Glamorgan, near Llantrisant, Rhondda Cynon Taff, to Prince Charles Hospital in Merthyr Tydfil because of a lack of doctors.

Staffing levels at all Cwm Taf Morgannwg's A&E units - at the Royal Glamorgan, Prince Charles Hospital and the Princess of Wales Bridgend - are well below UK-wide standards.

The situation at the Royal Glamorgan worsened recently with the resignation of its only full-time A&E consultant.

The health board said this "expected retirement", along with a shortage of middle-grade doctors, meant three A&E services could not be "sustained beyond the immediate short-term".

What are the proposals?

The health board has been asked to "approve further consideration" of two favoured options - keeping things as they are has already been rejected.

The first would close the consultant-led A&E service at the Royal Glamorgan, leaving it with a 24-hour nurse-led minor injuries unit (MIU).

The second option would be to close the hospital's A&E overnight, but keep an MIU open.

Both involve looking at alternative ways for GPs and paramedics to admit patients directly on to wards in the absence of A&E.

The health board will also focus on developing the Royal Glamorgan as a specialist centre for outpatient and diagnostic services.

Is this a new plan?

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Image caption Plans to rearrange some south Wales services have been in the pipeline since 2014

In 2014, five south Wales health boards devised a plan to address concerns that maternity care, neonatal care, children's hospital care and emergency medicine were spread too thinly across too many hospitals.

After a public consultation, health boards and community health councils finally agreed on a series of recommendations.

These included closing A&E at the Royal Glamorgan, but as yet no changes have been made.

In the Cwm Taf area, consultant-led maternity care has been centralised at Prince Charles Hospital. Changes to children's hospital care have also been repeatedly postponed.

What is the health board saying?

Image caption Dr Nick Lyons says an assessment is needed on how closing the Royal Glamorgan's A&E unit would affect other hospitals

Dr Nick Lyons, medical director of Cwm Taf Morgannwg, said most doctors in the Royal Glamorgan's A&E department were temporary staff which brought "very real safety issues" because the health board could not ensure training and development or "effective team working".

"What we need is a safe service that you can rely on, you can trust, and when you most need it can respond to your needs and treat you effectively. At the moment I can't deliver that [at the Royal Glamorgan]," he added.

He said it was "easy with hindsight to say perhaps decisions should have been made earlier... but now we need to do that catch up and do things properly".

Cathy Moss, from patient watchdog Cwm Taf Morgannwg Community Health Council, said it was involved in "detailed discussions" with the health board and would "ensure the public are kept informed".

What was the reaction like?

When the plan was being discussed between 2012 and 2014 , there was considerable public and political reaction.

Last Friday, concerns were once again raised by politicians, with the plans branded as "terrible news" and "completely unacceptable".

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