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We're delighted to be able to offer a 'Virtual Wards' service to help bring your care closer to home. The Department of Health commissioned a project to assess the safety, effectiveness and acceptability of early medical abortions in community medical settings. After successfully proposing a business plan to the Health Board , with the full support of GP Dr Graham Thomas, the clinical supervisor in Cardiology, funding was secured thanks to generous donations from the community. “During the Covid crisis we had nowhere to hold clinics, as the beds had been reassigned for Covid patients. Myself and my colleague Hannah had to start doing home visits, where we would have to drag a scanner in full PPE into people’s homes.
The Walton Centre’s Consultant Spinal Surgeon Mr Narendra Kumar Rath is currently providing spinal clinics every other week in Holywell or Llandudno Community Hospitals. We will also keep communicating with you, and ensure that together we work out the best plan for your care. But don’t worry, the Virtual Ward won’t change any services you currently have that you need.
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"A second catheter laboratory is a very exciting development for cardiac services in North Wales. It is also the means by which the Board will address long standing challenges, including fragile services, unsustainable workforce and financial challenges, and an aging hospital estate . People with hearing difficulties across North Wales will find it easier to access specialist support in their GP surgery, thanks to investment in a new NHS service. “While we have been awaiting the results, we have had lots of staff from the virtual ward coming to the house. Her father, Lynn Mainwaring, who has dementia, had been suffering falls in recent months and staff from the virtual ward were able to offer their help after he was referred by his GP practice. However, COVID-19 is still in our communities and we need to keep people living and working in care homes as safe as possible.
Welsh Health Minister Eluned Morgan and Welsh Local Government Association leader Andrew Morgan have announced more than 500 extra step-down beds and community care packages for Wales this winter, to help people get care closer to home and free up hospital beds. From this, the Department of Health is working towards developing a protocol for provision of early medical abortions within a community medical setting. This will be drafted in accordance with Section 1 of the Abortion Act 1967, which gives the Secretary of State the power to approve a community medical setting as a ‘class of places’ that meets the requirements of the protocols for the provision of EMA in England. This, however, will not address the issue of moving early surgical procedures closer to home. Until the ‘class of place’ issue is resolved, abortion procedures will remain relatively inaccessible to some women. Both medical and surgical early abortion in a community setting is standard practice in other countries.
Virtual wards offer hands-on care closer to home
The ‘care closer to home’ vision is that acute services will still be an absolutely vital part of service provision, but it will be possible for an increasingly large proportion of the care pathway to be delivered outside of a hospital setting, making greater use of community-based services. Challenges to establishing ‘care closer to home’ in gynaecology have been identified including cost and cost-effectiveness, impact on allied services and workforce development ( Fig. 4 ). Nevertheless, it was agreed that closer collaboration between gynaecology, sexual and reproductive health services and primary care should be encouraged at all levels and various models were considered. To achieve quality provision closer to home will require provider organisations working in partnership using care pathways. Only thus can best-value woman-centric care be commissioned within a quality governance framework. Networking services and adhering to care pathways streamlines care and reduces unnecessary or inappropriate outpatient visits to improve outcomes.
We aim to provide holistic, patient-centred, high quality care through rapid assessment; multidisciplinary team involvement and effective partnership working between GPs and other primary care professionals; hospital staff, social care workers and our third sector colleagues. The House of Commons Science and Technology Committee undertook to review the scientific, medical and social changes in relation to abortion that have taken place since 1967 to inform Members of Parliament when considering options for changes in the law when reviewing the Human Fertilisation and Embryology Act in 2008. Consideration was given to where abortions could be carried out with a view to enabling a woman’s home to be considered appropriate for the administration of the second stage of medical abortion. This is the first time Welsh Government has set out a shared plan for health and social care. The aim is to see a shift from healthcare which focuses on treating people when they become unwell, to one that provides services which support people to stay well, lead healthier lifestyles and live independently for as long as possible. Of significance is the impact on training, both medical and nursing, of shifting out of contracts with NHS hospitals to community providers and the independent sector.
Care Inspectorate Wales
The Care Closer to Home team operates accross the Aneurin Bevan Health Board region with the aim of supporting both early discharge from hospital and hospital avoidance along identified pathways of care where care can be managed safely at or closer to home. Referrals are currently accepted from the paediatric wards at the Grange University Hospital and also from the Childrens Emergency Assessment Unit. Rebecca Evans and Huw Irranca-Davies visited the site of Maesteg Extra Care Scheme, a development of bungalows, extra care apartments and residential care bedrooms and a range of communal facilities including dining room, lounge, laundry room, salon, activity rooms and communal gardens. The scheme is due to be completed in November this year and will provide housing for older and vulnerable people in the local area.
Vaccinations and improved infection prevention and control practices have made visiting much safer. Patients will be allocated to the practice from the waiting list based on their clinical need for NHS orthodontic treatment. The Walton Centre, based in Liverpool, is working with the Health Board alongside the Robert Jones and Agnes Hunt NHS Foundation Trust to provide care for spinal patients in North Wales. The Virtual Ward is about making decisions based on what you, as an individual, wants; and what medical professionals feel will deliver the best quality of life for you in your own community.
Current legislation stipulates that, except in an emergency, an abortion must be conducted in an NHS hospital or a place approved by the Secretary of State. This takes no account of method of abortion; in 1967, only surgical methods under general anaesthesia were available. Current treatment regimes ensure that both early medical and surgical abortion procedures are very safe and effective.
The extremely comprehensive report recommended a raft of strategic aims, including improved access to NHS-funded early medical and surgical abortion, 2nd trimester abortion and extending locations for abortion services to community-based settings. Changing the way services are delivered and improving the environments will improve patient outcomes, quality of care and patient experience. By bringing together some services onto fewer sites, such as trauma, emergency surgery and A&E, the health board will also be able to improve standards. The multi-disciplinary teams bring together a wide range of healthcare professionals made up of GPs, hospital staff, therapists, nursing teams, pharmacists, social services and third sector colleagues. The virtual bit of a virtual ward is the way multi-disciplinary teams of health and care professionals plan each patient’s care, using digital technology to help them meet. In the Abortion Act , the Law is clear on requirements for where abortions can be undertaken.
Patients with spinal conditions can now access specialist care closer to their home as satellite clinics are introduced into North Wales for the first time. We have also invested in more staff to provide this community based care in people’s homes. The good news is we can now offer an alternative way of providing care which allows patients to stay home. Rather than a ward being made up of hospital beds, the patients’ own beds become part of a ‘Virtual Ward.’ Hands-on care to patients continues to be provided as before, but in the comfort and familiar surroundings of patients’ homes, rather than in a hospital.
Furthermore, if medical students are not exposed to women requesting abortion care and their many and varied reasons for doing so, they cannot make an informed personal choice as to whether they wish to participate at any level in such services in their future careers. Appropriate housing can support people to maintain their independence and can provide the right environment for people leaving hospital - reducing delays in discharging patients. It can also support older people, people with dementia or learning disabilities, or complex needs, and enable social services to provide them with more effective care. The proposals are set out in the Welsh Government’s long-term plan for the future of health and social care in Wales, A Healthier Wales, which focuses on providing more joined-up services, in community settings - removing many of the current frustrations expressed by those both using and working within the system.
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