The Chief Executive presented the above report, part of which introduced the representatives present from the above University Health Board (CTF UHB).

In attendance from the Health Board were Paul Mears, Chief Executive, Emrys Elias, Chairperson and Anthony Gibson, Group Director, Bridgend ILG.

Mr. Mears, Chief Executive expressed how pleased he was to be able to attend today and give Members an update on work ongoing presently in the Health Board. As Council would appreciate, work had been constant with staff under extreme pressure throughout the course of the pandemic to the present time.

The presentation today would obviously cover COVID-19 and planning around our recovery of elective surgical work and planning for winter work that we're doing in partnership working with Council colleagues locally in Bridgend. The Chief Executive, Cwm Taf, also intended give an update on maternity and neonatal services, the Community Hospital, Maestegand CAMHS.

There was now a peak phase once more being experienced in relation to COVID, in the form of the omicron variant which was beginning to take hold in Wales. It had presently not had such a significant impact in terms of hospital admissions as of yet here in CTM, and indeed the community transmission rates of omicron in our area was still relatively low. However, as with other variants of the illness the Health Service had to look at its capacity over the next few weeks and months to make sure that there was adequate cover to cope with any implications that the strain may bring, ie admittance to hospital and bed capacity etc. This strain of the illness, will probably take off very quickly as it is doing already in parts of England, he added.

Obviously, a key part of the response to COVID is the testing regime. There we have had a very big demand for our PCR testing. That's pretty stable at the moment, and the plan is to carry on obviously with the testing capacity that we have across our health border area, to ensure that we are giving access as quickly as possible to people who may suspect they have symptoms, to be able to get them tested. And backing up that is obviously the contact tracing that comes behind the testing.

It was also important to make sure that we are able to track and trace people who have come in contact with individuals who have tested positive for COVID.

In terms of vaccination, the Chief Executive of Cwm Taf stated that across its areas, 159,000 booster jabs had been given, which represented 49.59% of the eligible population that comprised the Health Board. Welsh Government though had given a directive in the past couple of days, that we should be offering the jab to all eligible people across Wales.

So by the end of December, the aim is to have everyone offered a jab in the Cwm Taf location, and the Chief Executive felt that it was important to distinguish between offering the jab, against actually getting one in people’s arms, which was the aim.

Obviously, the rationale behind ramping up the vaccination booster campaign is to try and tackle the rise of the Omicron variant. We know that the vaccine does provide additional protection against the variant, and clearly, we're trying to vaccinate as many people as possible to minimise the impact on health services, of people’s illness. He said that many Members will be aware from the media, that we are not yet completely sure what the impact on hospital admissions will be from the new variant. There is though a possibility that the new variant may result in a significant strain once more in terms of resource on the Health Service.

The Chief Executive, Cwm Taf, explained that additional vaccination centres were now operating from the end of this week. These would be operating from 7:00 AM till 10:00 PM, seven days a week. This, however, was also requiring Cwm Taf to increase its staffing capacity quite significantly, to be able to provide a service at a time when such staff are also obviously very weary due to there being no significant let-up in the pandemic and illness to members of society. He added that the military would also help support this booster vaccination programme.

The only exception being to the opening of further vaccination centres, would be Christmas Day and Boxing Day. Due to these extra opening hours and further Centres opening, we were able to add an additional 10,000 appointments last week and we've had further increases this week, as we have been able to get more staff on hand to be able to help expand the vaccination workforce.

The Chief Executive Cwm Taf thanked BCBC for their assistance in providing much administrative support to the efforts surrounding vaccination, by providing staff to assist here. He also urged Councillors to engage with their constituents, to get as many in the community vaccinated, as soon as possible, across all age bands. Hopefully, through this joined-up approach, everyone over 18 years of age will have been offered the booster jab by end of December.

Due to the ongoing pressures of Covid-19 and the challenges the illness had brought about, sadly there was now a significant backlog of patients  waiting for planned procedures and operations.

With support from Welsh Government, efforts were under way to try and cover this backlog. This year, Cwm Taf had received an additional £16 m from Welsh Government to support this.

However, the Health Service were confronted continually with a significant challenge in terms of trying to juggle the competing demands of managing urgent support for Covid patients, against supporting patients with other illnesses and disease, which had been a massive issue since the inception of the illness.

There remained the problem of people having dates for major surgery, with these having to be cancelled last minute due to an influx into hospital of Covid patients due to new strains of variants emerging, with this being on top of the challenges relating to patients that required primary care; people getting appointment with their GP for other more general illnesses and people feeling the mental strain brought about by the illness, such as those living alone and experiencing isolation, particularly in periods where there had been lockdowns.

In some areas, such as in the Rhondda, Primary Care Centres had been introduced, in order to take some of the strain that had been imposed upon the Health Service by the pandemic. It had been difficult for patients also to actually see a GP for an appointment, with them first having to be assessed over the telephone. What had assisted here however, was the fact that the GP Out of Hours services that was formerly just in Bridgend, had now been extended right across the Cwm Taf area. It was therefore easier to get an appointment to see a GP, though patients may have to travel for this as opposed to seeing their own GP at their local practice. Though this service had also been extended and was now a 24-hour service 

Added to this explained the Chief Executive, Cwm Taf, was the support of our Acute Care team in the community who were a home-based service. So if you were a patient, that had been assessed by a GP as needing some additional support such as, for example, input from a geriatrician or needed to be supervised whilst at home, specialist nurses were available in the community to visit patients (at their homes) and actually look after them there, so as to avoid bringing them into hospital. These were of course patients, who could be adequately treated at home without needing to come into a care establishment/environment.

The Chief Executive, Cwm Taf also commended the partnership work that continued to be developed between themselves and the 3 local authorities of Merthyr, RCT and BCBC. This had built upon the work achieved in recent times, concentrating upon further integration of services for the local population and bringing together health and social care in a much more joined up manner across the 3 localities. Work was ongoing here, he was pleased to confirm, including as a future joint workstream, tackling together the decarbonisation agenda, combined management arrangements between Health and Social Care and health inequalities, such as those experienced in more deprived areas.

The Chief Executive, Cwm Taf, then touched upon some of the improvement work that has been taking place in maternity services, including within the Princess of Wales Hospital, Bridgend. Further training and development of staff undertaken had helped to achieve this, he added

Further work was also ongoing in our neonatal services, which was due to be reported on in the spring. This was an area where Cwm Taf had significant effort and increased support from clinicians across the Health Board, to look at how it could further improve the neonatal services for our most vulnerable. This was initially being looked at in the Prince Charles Hospital in Merthyr, with improvements then being extended to the Princess of Wales Hospital in Bridgend.

The Chief Executive, Cwm Taf advised that the work that had been carried in neonatal services would be the subject of a review, which would be published in January next year.

A program of work was currently underway in the Community Hospital in Maesteg. Work had been required to the roof, as that was in a poor state of repair. These works had now been completed. Invitations to tender would soon be initiated, for work on the inpatient beds and issues regarding capacity.

Cwm Taf had been in consultation with Welsh government for a further funding resource in respect of the above, because the original envelope of funding that was allocated for this work was now not going to be sufficient, given cost inflation that has taken place over the past year or so.

Cwm Taf would be updating the local community, including Ward Members and other stakeholders to ensure that they are kept abreast of developments and the progress here, including the outcome of conversations with Welsh Government.

Finally, the Chief Executive shared some information with Members on CAMHS, which was an NHS service that assesses and treats young people with emotional, behavioural or mental health difficulties. CAMHS support covers depression, problems with food and eating, self-harm, abuse, violence or anger, bipolar disorder, schizophrenia and anxiety, among other difficulties.

This service was primarily hosted in the Bridgend locality, where there had been a significant increase in demand in recent times, both prior to and since the pandemic. Areas of growth now had to be created to better support these young people and their problems due to this increase in demand, which had not shown any sign of reducing. The impact of the pandemic had obviously not helped them with their problems, but more predictably had exacerbated them. There had been a noticeable spike, the Chief Executive advised, in young people with eating disorders not just in terms of numbers, but also in the acuteness of their problems here. A special service had now been established in order to provide increased support to this particular category of patient. 

Work was ongoing with local colleges, in order to try and make sure that children and young people experiencing problems such as those listed above, were provided with counselling support and safeguarding arrangements through the local authority, where this was considered necessary.

At the Prince of Wales Hospital site in Bridgend, there was a specialist Tier 4 centre that provided support for young people with CAMHS issues, including eating disorders.

The Mayor thanked the representatives from Cwm Taf for their submission and then opened up the floor for questions to the Invitees.

 A Member referred to Maesteg Community Hospital and his concern that there was a delay there in terms of moving things forward with regards to the works that were being proposed there. He was also concerned with the fact that there were rumours circulating to the effect that the hospital was going to be closed. He therefore asked for an update on this.

He was also aware that there was a proposal to develop a dialysis service in the Bridgend County Borough and he asked if this was intended to be Consultant or Nurse Practitioner led.

The Chief Executive, Cwm Taf assured the Member, that there was a commitment to the continued operation of the Maesteg Community Hospital and a range of health care services it provides there. These would be services that best serve the interests of both the Llynfi population as well as that of the needs of some of the wider County Borough residents.

The Chief Executive, Cwm Taf advised that discussions were ongoing with Swansea Bay Health Board who were providing dialysis support to people who required this in the Bridgend area through specialist health services. A number of options were presently on the table for Bridgend moving forward, namely an off-site Dialysis Unit separate to the Princess of Wales Hospital, as well as an Outpatients facility. The Unit would be nurse led but also be supported by a daily Consultant input, so basically a mixed model. AS this would be built by a private contractor, there was no firm information as of yet where this would be placed in the County Borough.

A Member noted that the Ty Llydiard CAMHS support service was a Tier 4. She asked what Tier 4 signified.

The Chief Executive, Cwm Taf confirmed that Tier 4 was the highest level of CAMHS patient in-care support and Ty Llydiard provided support for young people in South Wales to the edge of South West Wales, so it was therefore classed as a cross-regional high level support centre.

A Member confirmed that in 2019 he had met with the then Chairperson of Cwm Taf regarding the lack of primary care provision in the Valleys Gateway area (off Junction 36). He had confirmed that consultation would take place regarding a possible proposal to extend Tyn-y-Coed Surgery in Sarn, to take account of the lack of this provision and in view of the fact that this area of the County Borough had increased in terms of its growth in population.

In view of the fact that the Member had contacted Cwm Taf directly on this matter, the Chief Executive of Cwm Taf confirmed that he would speak to the Councillor on this issue, outside of the meeting.

A Member asked if people who were classed as housebound would have their Covid booster jab administered at home by a Nurse Practitioner.

The Chief Executive, Cwm Taf advised that all housebound people in the County Borough would receive their booster jab by the end of December, through home visits, either from GP’s or Nurse Practitioners. However, priority would be given to those that were actually housebound in the true sense of the word, as in some cases individuals who claimed to be housebound, were in fact able through the support of others, to visit their GP practice or centres such as the one in Ravenscourt for the booster.  

The Leader concluded debate on this important topic, by thanking the Chief Executive and his colleagues for accepting the invite to today’s meeting and providing such an informative and comprehensive update on the work of Cwm Taf Morgannwg University Health Board. These sentiments were echoed by the Mayor, prior to the guests retiring from the meeting.

RESOLVED:                          That the report of the Chief Executive and the presentation given by representatives of Cwm Taf Morgannwg University Health Board, be noted.