Eluned Morgan MS, Minister for Health and Social Services
Vascular diseases cover any condition that affects the network of the blood vessels known as the vascular or circulatory system. The main aim of vascular services is to reconstruct, unlock or bypass arteries to restore blood flow to organs. These are often one-off procedures, mainly to reduce the risk of sudden death, prevent stroke, reduce the risk of amputation or improve function. Vascular services also provide support to patients with other problems such as kidney disease.
Collectively, Aneurin Bevan University Health Board, Cardiff and Vale University Health Board, and Cwm Taf Morgannwg University Health Board provide vascular services in South East Wales, which includes patients from Powys. With approximately 1,250 patients each year needing a vascular procedure across South East Wales, this is an important service.
Vascular services in South East Wales have faced a growing number of challenges for many years, including an increasing ageing population and a growing demand for services. Services in their existing format where all care is provided across three separate health boards were becoming increasingly unsustainable. The configuration of vascular services across the region has been discussed at length for many years, with various options explored, and a series of recommendations were put forward as part of a case for change.
Vascular surgery is becoming more specialised and the evidence shows that patients have better outcomes if they receive their treatment at larger specialist centres. The Royal Surgical Colleges and The Vascular Society of Great Britain & Ireland support the view that it is no longer desirable to provide urgent or emergency vascular surgery outside a fully centralised service or a formalised clinical network with a designated single arterial centre providing a 24/7 on-site service.
Following extensive work the health boards have agreed to establish a regional vascular service which will go live from 18 July 2022.
Following the establishment of the South East Wales Vascular Network (SEWVN) and redesign of South East Wales vascular services, all arterial surgery will be performed in a new Major Arterial Centre (the hub), located at the University Hospital of Wales in Cardiff.
The majority of care will happen closer to people’s homes in local non-arterial centres (the spokes) in Aneurin Bevan and Cwm Taf Morgannwg and will provide care such as pre-operative assessments, investigations, minor procedures and recovery care. These centres will work within the agreed clinical model, which includes several surgical and rehabilitation pathways, and a clear service specification. Speed of access to urgent vascular assessment and investigation will not be dependent on whether a patient enters at the Major Arterial Centre or a Non-Arterial Centre.
The Major Arterial Centre will treat all vascular emergencies requiring vascular or endovascular intervention, along with all vascular inpatient urgent care. It has dedicated vascular inpatient beds in a ward staffed by nurses with an interest in vascular surgery. It will be staffed by a vascular team comprising of vascular surgeons, vascular anaesthetists, vascular interventional radiologists, clinical nurse specialists, surgical care practitioner, podiatrists, tissue viability nurses, physiotherapists, occupational therapists, pharmacists, and members of the prosthetics team.
When patients begin their recovery and rehabilitation journey, their care will be provided from a hospital and community setting which is as close to their home as possible.
The health boards have been talking to NHS staff across South East Wales throughout the process of developing these plans and will continue to consult with staff during their implementation.
The launch of the SEWVN will improve patient outcomes, and ensure that services are sustainable and equitable for the population it serves across South East Wales. A tremendous amount of work and planning has gone into this, and collectively, the health boards are confident they now have the right model with the right support to build a robust service that is fit for the future.