Creating the Cardigan integrated care centre

Source: NHE May/June 2019

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre being built for the district.

This September we will open the doors to our first ever Integrated Care Centre in Cardigan – the second largest town in the county of Ceredigion – and in doing so we will mark the culmination of many hundreds of hours of logistical and planning work to address the question of how we deliver sustainable health and social care services as close to people’s homes as possible, with all of the challenges of geography, transport and an ageing population that that entails. In every sense, we will be opening the doors to the future.

To understand the story behind this flagship development is to look at the historical context of healthcare delivery in these remote parts of west Wales. The official opening of the nearby Cardigan and District Memorial Hospital took place on 3 July 1922 by the wife of the then prime minister, Dame Margaret Lloyd George. In its first year of operation, 160 patients were seen and treated, giving an early indication of the value of the service to the district. Further alterations to the building enabled additional services to be provided, which included maternity, outpatient clinics and an operating theatre, as well as a number of inpatient beds.

The vision of providing care closer to home first established all those years ago remains the fundamental principle of service provision in the area. Last year, our health board carried out the single biggest public consultation in Wales on how we transform our clinical services to meet the stark challenges we face in providing healthcare in the 21st century, with integrated community primary care and social services underpinning the recommendations subsequently adopted by the board.

While Cardigan’s development was outside the scope of that consultation, it has nevertheless become very pertinent for us in terms of how we describe integration and transformation.

Our 20-year healthcare strategy, ‘A Healthier Mid and West Wales,’ establishes a parity of esteem between physical health, mental health, and learning disabilities across the age span. In Cardigan, we will be providing a suite of services to reflect the needs of the local population, including community dental and pharmacy services; a GP / nurse led minor injuries walk-in service with telemedicine links to the emergency department; radiology and diagnostics; a phlebotomy service; and an outpatient suite with consulting rooms and clinical treatment facilities for pre-assessment and outpatient consultations by visiting clinicians and social workers. 

We will also provide disease-specific services for heart failure, motor neurone disease clinics, and COPD services; enhanced telemedicine equipment in clinical areas providing remote access to specialists from across the professions; rehabilitation services, providing opportunities for intensive and slow stream rehabilitation to restore function and improve independence, supported by therapists, nurses and social care staff within the Community Resource Team; mental health and learning disabilities services; a base for the local Community Resource Team in south Ceredigion; and third sector services.

This is an ambitious step forward for our health board and not one which we have taken overnight. There have been many challenges along the way and we’ve had to work very hard to make sure that we’ve got it right first time.

In particular, the hard work and commitment from our staff, and the support of many stakeholders – particularly our local communities – has been a critical part of our journey, and it is with these groups in mind that we move on to the next stage of delivering on our ambition of providing safe, sustainable, integrated care for our local population.


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