FRESH calls have been made for the restoration of full vascular services at Ysbyty Gwynedd after publication of what one MS has described as a “damning” report.
2019 saw a process of centralising vascular services at Bodelwyddan’s Ysbyty Glan Clwyd by creating a “Centre of Excellence” to treat issues relating to the veins, arteries and general circulation.
The move sparked widespread criticism from groups including the North Wales Community Health Council, however, with the previous service at Ysbyty Gwynedd in Bangor having been described as “world class.”
The decision to centralise services at Glan Clwyd saw only some vascular procedures retained at Ysbyty Gwynedd and Wrexham Maelor.
But after a recently commissioned independent report by the Royal College of Surgeons of England made 22 recommendations to ensure the continued safety of patients – with nine deemed to be urgent – further opposition has been raised to the controversial move.
The Betsi Cadwaladr University Health Board said the report recognised “an excellent foundation” to continue the improvement of vascular services, adding that while there were “no red flags” progress has already been made to address many of the areas highlighted for improvement.
Issues raised included:
“Consistent reports” that the 18-bed capacity of the Glan Clwyd site vascular ward was “insufficient for the demand.”
Demand on vascular bed capacity at Glan Clwyd said to have been “significantly impacted” by the lack of arrangements in place for non-complex vascular activity at Ysbyty Gwynedd and Wrexham Maelor.
And “inconsistent understanding” amongst staff at Ysbyty Gwynedd and Maelor “regarding the availability and accessibility of the consultant vascular surgeons assigned to the site.”
The health board added that the report had provided an “objective prespective on the service” during the “difficult circumstances” presented by Covid-19 and welcomed its findings.
But Arfon MS, Sian Gwenllian, has called for the restoration of full vascular services at Gwynedd’s main hospital, claiming that the “damning” report highlighted “the substantial decline in the care of patients since the change came into effect two years ago.”
“The fact that the report contains nine recommendations that need urgent attention is recognition that the new arrangements simply do not work,” she added.
“There are not enough beds and not enough staff at Glan Clwyd – this reinforces what I’m hearing on the ground with staff unable to refer patients for emergency care – and patients suffering as a result.
“It’s very clear by now that disbanding a world famous vascular unit at Ysbyty Gwynedd was a huge mistake and that this was done for dubious reasons and in a way which has lead the public to lose all confidence in the health board.
“The new Labour Health Minister, Eluned Morgan, needs to intervene urgently – there is only one credible solution – and that is to re-instate the service in full at Ysbyty Gwynedd.”
But in response Professor Arpan Guha, the Acting Executive Medical Director, said: “The review reiterates the urgency at which we needed to act to put in place an appropriate hub and spoke model so as to avoid compromising patient safety, which was a significant risk at the time.
“We’re pleased that the overwhelming commitment from all involved to improve the service has been recognised and that “an excellent foundation” is in place to continue the development and improvement of vascular services in North Wales.
“The report details that the service now has a robust surgical on-call arrangement, appropriate pathways for emergency and complex vascular intervention and no “red flags” in relation to mortality, readmission and length of stays.”
Prof Guha added that the review provided an opportunity to “review and clarify” the further work needed to achieve “the outstanding service our patients and communities deserve.”
“We recognise that more work is needed, in particular to continue to develop our pathways for vascular and diabetic patients so that we can deliver the best outcomes in the right place,” he concluded.
“We remain committed to providing appropriate vascular services at all three acute hospitals in North Wales. Work is underway to strengthen the delivery of services at our spoke sites, as well as team working throughout the vascular network.”
A Welsh Government spokesperson said: “We were pleased Betsi Cadwaladr University Health Board asked the Royal College of Surgeons to undertake this external review of the service.
“We expect the health board to have appropriate referral pathways in place so all patients can access treatment and support.”