A week is usually a long time in politics but during these unprecedented times, this has never been more true. There are fast moving developments every day and it is often very difficult to keep up, so here is an update on what has happened locally and in the whole of Wales over the last week.
In this update, I look at the local situation here in Powys including:
- What is happening to increase additional capacity at our community hospitals;
- The access to primary healthcare from GPs, optometrists, dentists and pharmacies
- Acute and specialist care
- Emotional support and wellbeing
- Support from the armed forces with the distribution of PPE
- The latest developments with supermarket deliveries
- National developments including the extension of the lockdown, testing, checking symptoms, the search for a vaccine, and the support for hospices
- A Framework for Recovery - A plan for lifting the restrictions
- The effect on the economy, business and farming
- Support for local government
Health & Social Care
The local situation here in Powys
On Friday, I spoke with Carol Shillabeer, CEO of Powys Teaching Health Board (PTHB), and senior members of her team during which they reiterated that Powys Teaching Health Board has a five point plan:-
- Powys Community Care: Increasing the beds and skills in Powys to provide local care, to reduce the need for acute hospital care, and to support people to return from acute hospital quickly and safely
- Powys Primary Care: Enabling local access to health and care within local communities, including rapid assessment for Coronavirus
- Acute and Specialist Care Partnerships: Strong relationships with neighbouring hospitals for access to acute and specialist care for the people of Powys
- Self Care, Families and Support: Supporting people to maintain their health and wellbeing
- Stay Home Save Lives: We all share a responsibility to reduce the spread of infection
Powys Community Care
A key part of Powys Teaching Health Board's local plan is to increase the number of beds available in local community hospitals. All hospitals and health & care centres here in Montgomeryshire including those in Llanidloes, Machynlleth, Newtown and Welshpool have a vital role to play. PTHB are putting in place 100 additional beds so that they can care for many more patients, sicker patients, in the county. Right now, many of the beds are empty but this is the right thing to do so that they are ready for the expected demand in the coming weeks. Find out more here: www.powysthb.wales.nhs.uk/news/52425
Powys Primary Care - GPs, Pharmacies, Dentists & Optometrists
Fewer attendances at A&E departments reduces the pressure on NHS staff, who are working hard to defeat Coronavirus. However, patients with health problems should not stay away because of concerns around Coronavirus. The advice from medical professionals remains the same: if you feel seriously unwell, be it a heart attack, stroke, or an injury, then you should still attend A&E for treatment, because a patient presenting with something serious could actually put more strain on resources – and risk their life – by delaying.
Primary care services in Powys also remain OPEN. Across the county, GP services, pharmacies, dentists and optometrists have needed to make temporary changes to respond to the extra challenges of Coronavirus. These changes aim to keep you safe, keep staff safe, and keep services running. It is really important that people continue to use local primary care services.
GP services across the county remain open. There may be some local changes to the way the provide this, including services such as telephone assessment. Please check with your practice for details. Find out more here: www.powysthb.wales.nhs.uk/news/52289
Some GP practices are working together to offer primary care assessment hubs – dedicated facilities for people with suspected or confirmed Coronavirus – so that you have rapid access to advice and support when you need it. Find out more: www.powysthb.wales.nhs.uk/news/52429
Eye care (optometrists) are working together to provide eye care hubs for urgent eye health advice and support. Find out more here: www.powysthb.wales.nhs.uk/news/52356
Community pharmacies changing their opening hours and reducing the number of people in store so that they can continue to provide vital high street services. Find out more here: www.powysthb.wales.nhs.uk/news/52337
Local dental services are also working together to provide telephone assessment, and to refer you to dental hubs for urgent and emergency dental care. Find out more here: www.powysthb.wales.nhs.uk/news/52341
During Coronavirus, it also remains vitally important that people receive appropriate care at the end of life, that we have appropriate dignity for the deceased, and that we can access support for grief and loss. Powys Teaching Health Board are putting in place a wide range of plans, which include working with partners to increase mortuary capacity in the county. Find out more from: www.powysthb.wales.nhs.uk/news/52381
Acute & Specialist Care
Some people with more serious illnesses will need to be admitted for specialist and critical care, with specialist teams and equipment to give them the best chance of recovery.
Patients with more serious complaints, worse symptoms of Coronavirus, or requiring intensive care, will continue to be treated in district general hospitals.
Welsh Government has made clear that across Wales there are no plans for field hospitals to provide critical care. Instead, the steps which Powys Teaching Board are taking locally to expand its own hospital capacity will help to free up vital district general hospital capacity for people who need it. Community sites will provide local care, including “step down” care for patients who are recovering. Find out more here: www.powysthb.wales.nhs.uk/news/52340
Changes to Health Services in Powys
Powys Teaching Health Board have needed to make some changes to local NHS services to keep you safe and keep staff safe. Some of these changes include:
- Reducing the number of visitors to help reduce the spread of infection – you can find out more at www.powysthb.wales.nhs.uk/news/52336
- Pausing routine and planned care appointments except where these relate to conditions that directly threaten life, limb or sight
- Putting in place more telephone and online services to reduce face-to-face contact which may spread infection
- Reorganising services to respond to staffing challenges when staff are self-isolating or shielding
- Reducing the number of people who can enter a building or facility at one time, to help with social distancing
- Introducing additional closed hours during the day to catch up on essential tasks such as cleaning, prescriptions, or phone calls to vulnerable patients
Powys Teaching Health Board also have an information line on 0345 602 7053 if you cannot find the answer through your normal route. This is open 9am to 5pm, seven days a week. You can also find out more by visiting their website here: www.powysthb.wales.nhs.uk/coronavirus
Relaxation of restrictions with specific medical needs
The Welsh Government has finally relaxed the restrictions for people with specific medical needs in Wales, two weeks after the guidance was amended in England. This is very welcome for the families who have people with specific medical needs, including individuals with learning disabilities or Autism. More information is available here: https://gov.wales/sites/default/files/publications/2020-04/the-health-protection-coronavirus-restrictions-wales-amendment-no-2-regulations-2020.pdf
Emotional & Mental Wellbeing
During an extended lockdown period, our emotional and mental wellbeing becomes ever more important. There is support available through Powys Teaching Health Board's free online Cognitive Behavioural Therapy platform provided by SilverCloud. Find out more here: www.powysthb.wales.nhs.uk/news/52391
A wide range of resources to support our mental, physical and social wellbeing are also available through a new national campaign led by Public Health Wales. The How Are You Doing? Campaign aims to support people in Wales to look after their wellbeing during the lockdown period. Find out more from Public Health Wales: https://phw.nhs.wales/howareyoudoing
Sadly, during times of crisis, incidents of domestic abuse increase. The Coronavirus crisis is an anxious time for all of us, but doubly so for those who are trapped in their homes with an abuser. We all need our homes to be a place of safety, not a place of fear, abuse and violence. Help is available, and the Live Fear Free helpline offers 24/7 support. Remember that travel to escape abuse is definitely essential travel. Find out more here: www.powysthb.wales.nhs.uk/news/52444
Working with the Army to Strengthen Supply Chain for PPE
In times of crisis, our Armed Forces always rise to the challenge by making themselves available to support our communities and defend them from threats. We need to take advantage of every asset at our disposal to save lives and relieve pressure on our NHS so I'm pleased that a partnership between Powys Teaching Health Board and UK Armed Forces is strengthening the supply chain for PPE in the county’s NHS.
Find out more about PTHB's partnership with the Army here: www.powysthb.wales.nhs.uk/news/52453
Extension of Lockdown
The UK Government has extended the period of lockdown. This decision was based on expert scientific analysis of the latest data on the Coronavirus outbreak across the UK. It has not been taken lightly. In his announcement the First Minister said “I am clear we cannot risk throwing away all the sacrifices we have made here in Wales over the last few weeks by lifting the restrictions too soon.”
The steps we can all take include:
• adopting self-isolation if you or your household have symptoms
• social distancing for everyone particularly those more vulnerable to infection, and
• shielding for people at the highest risk of serious illness from Coronavirus.
People who have been advised to shield for 12 weeks can access additional support, for example help with food and prescription deliveries; seek advice if symptoms get worse, and to access a self-isolation note if this is needed for employers.
Last week, I asked for feedback from people across Montgomeryshire on their experiences when trying to get supermarkets to deliver to their home. It is clear that experiences vary, depending on where people live and which supermarkets they are using. For example, someone identified as a vulnerable person in Aberbechan area has been able to get Sainsbury's weekly deliveries. Another resident has reported that only Tesco and Asda deliver to SY10 area (Llanrhaeadr Ym Mochnant). Someone in Machynlleth has struggled to get Tesco deliveries. Someone else in the SY15 area has said they haven't yet been able to get deliveries from Asda, Tesco, Sainsbury's nor Morrisons. Another resident has said that Tesco have limited their online orders to 80 items, which has caused problems for a family of 6. Someone else has found that Asda and Iceland have been really efficient with deliveries.
However, it seems that the supermarkets are working hard to increase the delivery slots available and also to cover more areas. The above situations may have changed already. Newtown Morrisons has reportedly increased the area it is delivering to - and now also covers from Carno to across the border. Morrisons in Welshpool have said that they are doing doorstep deliveries. The elderly and vulnerable can ring a dedicated hotline and the items will be delivered the following day by their staff.
Tesco have also said they have increased their drivers and their fleet - vulnerable customers can book a priority slot online. Information provided to me has said that if you don't currently have an account with Tesco but have received a letter from the NHS because you're classified as clinically vulnerable, you can create an account on their website or call Tesco on 0800 917 7359.
Aldi also have set up a Food Parcel delivery service - https://www.aldi.co.uk/food-parcels
These are all people's personal experiences and so it may vary for you, but I thought I'd share this information in case it is of assistance to you.
Montgomeryshire residents have also been positive and industrious in forming groups of volunteers to facilitate food shopping, collect prescriptions etc. You can find a list of local Facebook groups on the Powys County Council website - https://bit.ly/powyscommunity - or by all means call my office on 01686 610887 if you want to know about a group serving your area.
You can also contact Powys Community Connectors for more information on volunteer groups who can help you. Funded through the Powys Regional Partnership Board – the Powys Community Connectors have been quick to increase capacity to support vulnerable people. In a typical month they receive 200 referrals for community support. By 23 April they had already reached 1000 this month alone. They have provided a wide range of support including help with prescriptions, befriending, connecting people with local community networks, advice and support for people who are shielding, and providing support for mental and emotional wellbeing. The Community Health and Well-Being Coordination Service is available on 01597 868649 or firstname.lastname@example.org
Powys Teaching Health Board have also seen a tremendous response to the call for volunteers in the county. Hundreds of people have come forward with offers of help. As the impact of Coronavirus increases in the weeks ahead, they will be ready to deploy these volunteers into support roles across the county.
The COVID Symptom Tracker
A vital part of self care is using the online symptom checker to check symptoms. There has been an enthusiastic response in Powys to a new app to track COVID symptoms across the UK. The COVID Symptom Tracker - https://covid.joinzoe.com - helps the NHS to understand how people are feeling. It takes just 1 minute to report your health daily, even if you are feeling well.
Find out more from NHS 111 Wales: http://111.wales.nhs.uk/covid19
Here in Powys, the Health Board are implementing the national testing plan. This includes testing for symptomatic inpatients as well as for frontline NHS staff with symptoms. The approach to testing in Wales is very much led nationally, rather than locally by health boards.
I am pressing the Welsh Government to accelerate plans to extend its Coronavirus testing regime and to introduce community testing with a “test, track, and trace” (TTT) system for essential workers and their families.
A TTT system for England was announced at one of last week's Downing Street briefings and the Welsh Government must step up its efforts and introduce a similar extended testing scheme for essential workers.
I am also concerned about the decision to drop the targets for testing in Wales. I think it is vital that if we are to emerge from lockdown with the chances of a second or third spike being really suppressed, we need to have a very strong testing regime. It’s clear that there is capacity in the system that’s just not being used to test key frontline workers and community testing centres and drive-in centres across Wales are still not all fully operating. It is absolutely vital that our testing centres are operating at maximum capacity.
The UK Government has announced the creation of a Vaccine Taskforce which will aim to develop and manufacture vaccines to fight Covid-19. The taskforce will be undertaking enormous amounts of work to develop vaccines and will ensure no stone is left unturned. Of course, there is no guarantee of a success but this is an extremely positive announcement and I’m sure its results will be fruitful.
Support for Hospices
Although I have welcomed the Welsh Government’s announcement of additional support of up to £6.3 million funding for hospices in Wales following the UK Chancellor’s announcement of £750 million for frontline charities affected by the coronavirus outbreak, it is now essential that the Welsh Government should give hospices in Wales every penny of the funding they receive from the UK Government in consequence of the funding it has given to hospices in England.
Welsh Government funding for hospices as a percentage of expenditure is already lower in Wales than other UK nations - this has not changed for a decade and has been dropping in real terms.
I therefore praise our hospices for maintaining first-class services amidst this global pandemic, which has placed unprecedented pressures on them.
The UK Government announced £200 million of new money for hospices in England during the second quarter of 2020 and it is understood that the final allocation to the Welsh Government in consequence will be significantly more than £6.3 million.
However, hospices across Wales have expressed concern that this additional money will not be used by the Welsh Government to support and sustain essential hospice services in Wales.
This is unacceptable and as a matter of urgency the Welsh Government must speedily bring hospices out of the dark by publicly pledging that every single penny it receives in consequence of the £200 million for hospices in England reaches our hospices here in Wales.
Charitable hospices across Wales have been doubly hit by the Covid-19 pandemic with both an increase in need for end of life care and the challenge of sustaining their current service during a period where fundraising has almost completely come to a halt. Therefore, it’s high time that the Welsh Government quickly steps up to the plate.
A Framework for Recovery - A plan for lifting the restrictions
The Welsh Government has published its plan for lifting the restrictions entitled "A framework for recovery".
The plan outlines seven principles which will be used to review the current restrictions, and consider options for relaxing them.
These principles will act as a framework to test the potential risk and potential benefit of relaxing some current restrictions.
These principles include:
- To what extent would easing a restriction have a negative effect on containing the virus?
- Is the measure at the low end of risk of further infection?
- How can it be monitored and enforced?
- Is it capable of being rapidly reversed if it has unintended consequences?
- Is it a measure of relatively high positive economic benefit?
- Does it have a high impact on social and psychological well-being?
- Does the measure have a high positive equality impact?
As the number of cases and deaths from Covid-19 continues to plateau and fall it is prudent to begin to plan for an easing of restrictions. However, it is essential that this is done with great care and in concert with other parts of the UK in order to prevent confusion and protect people from unnecessary risk. We must learn from experiences elsewhere, listen to the science, and work carefully through the different approaches and how they could work in practice. No matter how we move forward it is already clear that we are going to need a huge upscaling of community testing to inform any decisions and monitor the impact of any loosening of the restrictions. As a start, the Welsh Government must act immediately ramp up testing capacity by adopting the UK and Scottish Government approach to an extension of testing to all key workers and their families.
Economy & Business
Supporting our Economy
We have all seen the devastating social and economic dimensions to the virus. During these challenging circumstances, I welcome both the UK and Welsh Governments having dialogue to exchange best practice and advice on how to mitigate the damage being caused. While a number of welcome measures have been introduced by the UK and Welsh Governments, most notably the Coronavirus Job Retention Scheme which pledges to pay 80% of workers’ wages if they are put on leave and the Economic Resilience Fund, I have been left somewhat concerned that the original aim of this £500 million fund is not being fulfilled because gaps of business support remain.
The Welsh Government must act swiftly to address the further business support needed, and address gaps which I believe have been overlooked in how the Economic Resilience Fund can support our Welsh economy to date. A plethora of our vitally important small businesses have contacted me, raising their fears over flaws with the fund’s criteria. At present, businesses that are not registered for VAT and those eligible for Business Rates Relief are excluded from the fund. Also, those who have irregular turnover; have recently become self-employed or are sole traders, and are therefore unable to produce the required accounts or tax returns are also ineligible for support and those businesses who pay business rates who don't come under the description of retail, hospitality or leisure, are also unable to obtain business rates support. Furthermore, many of the self-employed have seasonal trade businesses, meaning they are unable to produce the required accounts to be a recipient of the fund. Businesses that fall into these categories, are some our of businesses in most need of support.
Therefore, I welcome the announcement earlier this week of a £250 million ‘Future Fund’ for business start-ups and the tech sector in the UK. The Future Fund is pegged to launch in May, and will see the UK Government invest between £125,000 and £5m in qualifying start-ups. This is great news for the UK start-up sector. We now need to see what potential support the Welsh Government can offer to our businesses in Wales.
As time progresses, I would expect the Welsh Government to announce further wide-ranging packages to protect our businesses and self-employed so that when we get out of this pandemic, and we will, that Wales can fire on all her cylinders to ensure our economy can grow again. While immediate support is the priority, the package of financial assistance should not solely be a support package for the "here and now" to navigate the worst effects of the Coronavirus but also as a means to future proof the Welsh economy as we eventually move into a recovery phase, allowing businesses to adapt their business model, innovate through the use of technology, and ensure that they are in a strong position to capitalise upon the opportunities of future growth. I appreciate these are unprecedented times, but we must remember to look to the future.
Agriculture & Farming Sector
This week, a virtual briefing was held by NFU Cymru to explain the challenges which the agricultural sector is facing in light of the Covid-19 pandemic on the long term viability of their businesses. It is a matter of great regret that farmers are not eligible for the Economic Resilience Fund, and there has been very little detail on the bespoke package of support that might be brought forward by the Welsh Government for the agricultural sector. It is simply not good enough that the Welsh Government has yet to provide any clarification on specific support for an industry that is facing an uncertain future - including the dairy and red meat sectors, which are of course facing a number of incredible challenges. I believe that the Welsh Government should use the extra financial flexibility provided by the UK Government to rapidly amend the eligibility criteria for the Economic Resilience Fund, or to bring forward an urgent bespoke package so that our farmers can continue with their work in helping to feed the nation during this concerning time.
Support for Local Government
I and my colleagues believe that the Welsh Government should consider establishing a capitalisation fund to assist local authorities in managing the impact of Covid-19 (Coronavirus) and the services provided.
Despite the Welsh Government receiving an additional £95 million from the UK Government after English local councils received a boost of £1.6 billion to fight Covid-19, the Welsh Government has yet to announce if or how that money will be given to councils in Wales. Currently, Councils in Wales are predicting that they will lose £33 million a month from loss of income due to Covid-19.
Local authorities provide many of the essential non-medical services we all rely on, supporting the most vulnerable through social care, through community support and enabling schooling for key workers. We cannot afford to let the effect of this virus damage their ability to run as effectively and efficiently as they can.