People could die if hospital unit’s hours are cut, says health charity boss
Martin Shipton
The chief executive of a mental health charity says she fears lives could be lost if opening hours are cut at a hospital minor injuries unit in west Wales’ largest town.
Residents will have to make lengthy journeys to Morriston Hospital in Swansea or Glangwili Hospital in Carmarthen if hours are reduced at the minor injuries unit (MIU) at Prince Philip Hospital in Llanelli from November 1.
The current proposal by Hywel Dda University Health Board is to shut the MIU from 8pm until 8am every day for a period of six months, but locals fear the reduction in hours could become permanent.
Safety concerns
According to the health board, the proposal to adjust the opening hours of the unit is due to patient safety concerns, raised both by Healthcare Inspectorate Wales seeking assurances following an inspection in June 2023, and from staff working at the unit.
The concern is said to relate to the frequent inability to find suitably qualified doctors to cover the GP-led service, particularly in evening and overnight sessions. This, says the health board, has led to the service being led instead by Emergency Nurse Practitioners who, while extremely skilled at dealing with minor injuries, are not able to provide suitable care to patients who require a GP.
But Jen Caton, the CEO of Llanelli Mind, has now voiced her concerns about the plan.
Staffing levels
In a strongly worded statement sent to Nation.Cymru she writes: “When I heard the closure of MIU Prince Philip Llanelli from November 1. I was very concerned for our service users who use our services but also on a personal level for myself, family and friends.
“We all use what we are comfortable with. I have lived in Llanelli and surrounding areas for over 50 years and watched with admiration the new build of Prince Philip which opened in 1990.
“Prince Philip Hospital is on the edge of the town, a busy, modern and well-equipped hospital, with car parking facilities, an MIU and an AMAU [Acute Medical Assessment Unit], a new day surgical ward, a psychiatric ward and a specialist breast clinic ward to name but a few.
“Over the last 12 months I have seen notices on social platforms informing the public that there was no service due to staffing levels in MIU Llanelli. People needed to travel to Carmarthen to be seen in an emergency. So to hear this news of closure my thoughts spiralled, I knew it would be a matter of time regarding the MIU at Prince Philip Hospital closing at night, which is planned from November 1.
“Once again the people of Llanelli are not listened to. Carmarthen hospital is more than 20 miles away for vulnerable people to travel, where we have little public transport after 5pm.
“Prince Philip is still where the Crisis mental health team are based, and it worries me that this might have an impact on access to mental health support when people need it the most. How many lives might we lose?
“At present, I know to access the Crisis team, members of the public could be directed to MIU by 111#2, taken by police or ambulance, or walk in themselves.
“Regardless of which route you take, you need to be triaged by the triage nurse in MIU prior to being seen by the Crisis team.
Future access
She continued: “I wonder what the plan is for future access to the Crisis teams and mental health support during the night time, given we do not have a Sanctuary service in Llanelli either?
“Last year we supported over 1,500 individual referrals and engaged with over 6,000 clients. Many of these people cannot manage their thoughts at night.
“Historically when we ran our Llanelli Twilight service we would often receive many of our out of hours calls after services closed down, having been open from 9am to 5pm.Nnight time for people who struggle with their mental health and emotional wellbeing is often described as torture, and suicidal thoughts and unhelpful behaviours emerge.
“Last week Mind Cymru asked us to share what’s happening on the ground in mental health services in Llanelli with Sarah Murphy MS, the Minister for Mental Health, ahead of the next meeting of Wales Alliance for Mental Health, which we have done.
“Obviously we know Llanelli is the largest town in Carmarthenshire and has already witnessed the loss of core funded services – including moving the Twilight Sanctuary which was the pilot project for Wales, from Llanelli, where it had the greatest need, to Carmarthen. Llanelli is now facing the night time closure of the MIU. This will have a significant impact on those trying to access crisis mental health support within Llanelli and surrounding villages in the area.”
Negative experiences
Ms Caton said service users were reporting that 111 option 2 was not working effectively: “Experiences can vary depending on the operators that deliver the service,” she stated. “However, this is in isolation to the negative experiences. Service users do not feel listened to. They feel their mental health is deemed not important.
“They are not given adequate time on the phone creating the relationship / rapport to listen. They are not given relevant information to make informed choices with regard to their mental health at the time of ringing or signposted back to us when they are in need of support at the time, usually out of hours.
“I know there are many stakeholder or service user engagement events and that at these meetings people with poor mental health and their families and friends don’t want to be pushed from pillar to post, They want easy access, I know most people want 111 option 2 to mimic the pilot Llanelli Twilight Sanctuary service, a welcoming environment and a place of safety.
“Although there is still a Sanctuary in Carmarthen, which can be accessed, many cannot travel the 20+ miles to see someone face to face and the telephone triage proves a hurdle when they try and call, meaning they will be expecting a call back with an appointment time for a telephone call with a practitioner.
“The transport budget for Carmarthen Sanctuary to take people home was used up at the beginning of quarter 2. One of our vulnerable young females caught the train down to Carmarthen but missed the last train back and had to wait in the train station until the early morning train.
“Carmarthen Sanctuary operates 5pm – 2am, Thursday to Sunday, which is great for those who live in Carmarthen or for people who can drive, but many people say they need someone to talk to from Monday to Wednesday when there is a total gap.
“111 option 2 is not able to bridge this gap and our service users need something, as they feel that they have lost a support network. I do not know if people have put in any plans to support people in a mental health crisis.”
Ms Caton said she hoped very much that the closure plan would be reconsidered.
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