PATTERN OF FUTURE PROVISION OF HOSPITAL SERVICES BY Part of unscheduled care network protocol driven admissions.

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PATTERN OF FUTURE PROVISION OF HOSPITAL SERVICES BY 2015 APPENDIX 1 Specialty PRINCESS OF WALES SINGLETON MORRISTON NEATH PORT TALBOT General Medicine and Emergency medical intake Yes Emergencies Acute stroke Short-term acute care < 5 days Part of unscheduled care network protocol driven admissions. A&E Yes : Minor Injury Ambulatory Care Integrated Assessment Units Yes : in conjunction with A&E Service Yes Undifferentiated Emergencies Acute stroke Short term acute care < 5 days Yes - trauma centre GPOOH transferred from Singleton Yes : in conjunction with A&E Service Part of unscheduled care network protocol driven admissions. : Minor Injury Ambulatory Care Diabetology / Endocrinology Yes inpatients and outpatients supporting other specialties with complex care and providing specialist support to Yes outpatient based providing specialist support to Yes inpatients and outpatients supporting other specialties with complex care Renal Inpatients Yes Renal Dialysis Yes Yes Yes outpatients providing specialist support to

Neurology and Neurophysiology Yes Neurorehabilitation Yes Centre of Excellence Dermatology Yes providing specialist support to and limited inpatients Gastroenterology/En doscopy Yes providing Centre of Excellence - Regional Skin Cancer Service for South West Wales and specialist support to Yes providing specialist support to Yes - emergency Yes - Planned Yes - emergency Yes - Planned Bariatric Surgery Yes Respiratory Yes acute service Medicine & bronchoscopes Obstetrics Yes acute service. Providing sleep services & bronchoscopes Yes obstetric led supporting Yes Providing sleep services Yes Obstetric led providing South West Wales Regional service for complex cases Supporting Midwife led care supporting

Gynaecology Yes Yes Paediatric Inpatients Yes Yes Children s Development Centre Yes TBC TBC Yes NICU Yes Level 2 Yes Level 3 HIV / AIDS Yes Yes ITU All levels Level 2 All Levels Level 1 Chronic Pain Yes supporting tertiary and complex services Day Surgery Yes Yes (except tertiary) Yes Yes community based service for ABMU Pre-assessment (if required) Yes Yes Yes Yes Radiology Rapid access & full range Rapid access & full range Complex diagnostics & full range Rapid access & full range

Medical Illustrations / Photography provided from Swansea Yes for SWW services Yes - for Regional services Clinical Yes Haematology Lymphoedema Yes Chemotherapy Treatments Clinical Oncology / Radiotherapy Yes Yes Yes Yes Palliative Care Yes Yes Cardiothoracic Yes Cardiology/CCU Yes Yes Cardiac Physiology Yes Yes Yes - specialist Post Operative Yes Cardiac ITU Major Trauma Yes Orthopaedics Fracture Clinic / Centre of Excellence Athroplasty surgery Centre of Excellence

Rheumatology General Surgery - Emergency General Surgery Elective Arthoplasty surgery / Joints for Hand Surgery Paediatric orthopaedics Fracture Clinic Joints / Spinal Infusion Suites / Day Infusion Suites / Day Cases Cases Yes Yes Yes Yes. High volume/low complexity Yes predominantly complex for 24 48 hour stay operations Yes. High volume/low complexity Urology Yes incl. level 2 Yes level 1-3 Yes incl. level 2 Centre of excellence for urodynamics Colorectal Surgery Yes Yes Breast Surgery Yes Yes Vascular Yes Yes Day case and OP Yes Yes Day case and OP Burns & Plastic Surgery Plastic surgery OPs Plastic day surgery (as part of Skin Cancer Treatment Centre) Yes Regional For emergency and in patients and OP

Neurosurgery Spinal Surgery Yes Orthogeriatrics Yes Yes ALAC Yes Possibly to collocate with neurosciences OMF Yes OP and Day case Yes Day case Yes all Yes Orthodontics & Restorative Dentistry ENT Yes Yes OP and 23 hr Yes OP Ophthalmology Yes IP, DC and OP Yes IP, DC and OP and complex inpatients Haematology Biochemistry (blood sciences) Multidisciplinary lab required for OOH service Rapid response lab required Point of care testing Microbiology and Cellular Path Rapid response lab required Point of care testing Microbiology and Cellular Path Paediatric Ophthalmology inpatients Transfer haematology at night from NPT Core Lab required at Morriston Public mortuary Point of care testing Yes OPs Rapid response lab required Biochemistry at night service

Biochemistry at night service

APPENDIX 2 ABERTAWE BRO MORGANNWG UNIVERSITY HEALTH BOARD CORPORATE OBJECTIVES FOR 2009-10 Objective Making Quality and Patient Safety Our Number One Priority Key Actions Lead By When Set improvement targets for MD Sept 2010 Reducing Mortality and a range of clinical outcome measures Implement Zero Tolerance Approach DN June 2010 to Healthcare Acquired Infections Develop performance measures and DN v 2010 improvement systems which utilise the patient voice and patient experience as a vehicle for change. Implement an Ambitious Quality and Safety Strategy to improve Safety and clinical quality: 1000 Lives Plus Strengthened clinical information systems Enhanced clinical audit Develop and implement a number of care pathways which capitalise on the opportunity to develop whole system care delivery models. MD/DN/DT&HS DW&OD MD/DN/DT&HS DPC&MHS/DAC Oct 2010 Sept 2010 Sept 2010 Objective - Developing and delivering an ambitious forward looking strategy Key Actions Lead By When Finalise Quality, Service, Workforce DP June 2010 and Financial Framework Effective communication and DP supported by May Sept 2010 engagement regarding Framework BS Development of detailed DP Sept 2010 Implementation plans Active Implementation of strategic DP supported by Sept 2010 onwards

Key Actions Lead By When plans D PC&MHS/DAC Implementation of Primary & DPC&MHS v 2010 Community Services Delivery Programme Reshaping the capital programme DP Sept 2010 Integration and consolidation of outputs of national work programmes (see Appendix 3 ) DP Sept 2010 Objective - Delivering as a high performing organisation Key Actions Lead By When Delivering key A.O.F. targets: Unscheduled Care RTT Waiting Times Cancer Stroke Continuing Health Care Delivering Financial Balance: Improving Productivity & Efficiency Introducing service line reporting Enhanced Procurement Strong budgetary control by Directorates/Localities Effective integrated workforce planning and controls DPC&MHS DAC DAC DAC DPC&MHS DPC&MHS DF DF DF DPC&MHS/DAC Dec 2010 Sept 2010 June 2010 Review key clinical interventions to ensuring they are appropriate, effective and adding value Review and Reduce Demand including : Activity caused by the system e.g., unnecessary diagnostic tests and outpatient follow ups DW&OD MD Sept 2010 DAC

Key Actions Lead By When Demand caused by the need to do DAC work again, e.g. post operative return to theatre, lost or incorrect diagnostic tests Work with partners to ensure only patients needing to be in hospital are admitted, maximising care outside hospital e.g. Ambulance Trust, GPs, CIIS Team, Social Services, Third Sector, Public Health DPC&MHS Objective - Development of capability, capacity and partnerships for delivery and change Key Actions Lead By When Completion of structural change DW&OD Develop and embed the DW&OD organisational culture and behaviours based on shared understanding of our underpinning values Pursue major OD programmes Board Executive Team CE supported by DW&OD/BS CE supported by DW&OD/BS April 2010 Clinical Leadership Middle/Senior Management Staff Engagement and Recognition MD/DN/DT&HS DW&OD DW&OD supported by BS Development of purposeful partnership and integrated working University of Swansea CE DPC&MHS June 2010 onwards Ongoing

Key Actions Lead By When DPC&MHS Ongoing Local Authorities Third Sector Strengthening relationship between secondary and primary care DPC&MHS/DAC Key CE - Chief Executive DPC&MHS - Director of Primary, Community and Mental Health Services MD - Medical Director DN - Director of Nursing DP - Director of Planning DF - Director of Finance DPH - Director of Public Health DT&HS - Director of Therapies & Health Sciences DW&OD - Director of Workforce & Organisational Development BS - Board Secretary