Between 19th February and 16th April 2021, Aneurin Bevan University Health Board, Cwm Taf Morgannwg University Health Board, Cardiff and Vale University Health Board and Powys Teaching Health Board, ran a public engagement on a proposal for the reorganisation of localised vascular services into a ‘hub and spoke’ model.
Clinicians agree that this is a sustainable delivery model that will provide the best outcomes to all patients within the region and best use of skill and staff as advised by the Vascular Society.
The engagement sought public feedback on the proposal to locate a vascular surgery hub for South East Wales at University Hospital of Wales, Cardiff, with main spoke hospital services maintained at Royal Gwent Hospital, Grange University Hospital, Royal Glamorgan Hospital, University Hospital Llandough and University Hospital Wales, and care wherever possible maintained closer to home.
110 people responded to the engagement via an online survey
There were 7 virtual public meetings with a total of 29 attendees
Proposals were discussed at a Third Sector meeting and a range of internal stakeholder meetings
Thank you to everyone who took the opportunity to provide feedback, through public engagement events, the online survey, by email or on social media.
Of those who took part in the online survey, 72% agree with the national evidence and recommendation from the clinical option appraisal that a hub and spoke model would improve vascular services and patient outcomes in South East Wales.
A number of common themes emerged from the feedback received in response to the engagement questions and in other formats, including comments made at the public and stakeholder events.
The following themes were identified:
Organisation and integration of network services
Respondents highlighted specific ideas or issues related to service provision and integration within the proposed network and in both hub and spokes. People wanted reassurance that the model was sufficient.
Location of hub and spoke
Questions were raised in relation to the locations of the hub and spokes and why these sites had been selected.
Accessibility and transport
Participants in the engagement expressed the importance of considering travel arrangements and parking at hospital sites.
Members of the public expressed concern around the impact of the COVID-19 pandemic on waiting times and the delivery of services.
Comments were raised about the scope of the engagement, how the public were being consulted and in what formats.
Impact on other services
The public questioned the impact of the model on existing services at University Hospital of Wales and to what extent future needs had been taken into consideration.
Respondents and participants voiced the importance of professional training and development opportunities for all staff in the network, as well as raising questions about how the South East Wales Vascular Network would be staffed.
Respondents highlighted the importance of communication and collaborative working across the four Health Board areas. Communication between patients and their families during inpatient stays was also reinforced.
Comments were made that expressed concern about inadequate funding for Health Boards and the financial implications of implementing a networked model in the region.
These themes are described in more detail in the full engagement report together with responses to the issues raised. This includes what actions would be taken to address the issues as part of ongoing development of the network. All of the feedback will be used to ensure future services are implemented appropriately with the right considerations, having a positive impact on patients, their families and NHS staff.
Community Health Councils and partner Health Boards have reviewed the findings of the engagement independently and supported the case to move forward with the programme of work, subject to the issues raised during the engagement being addressed in the next phase of work, as outlined in the report.
The formal planning of the South East Wales Vascular Network will now be implemented and the Health Boards will collaboratively establish the new hub and spoke model, including infrastructure and resource. Further updates will be provided as the service is developed.