FOUR areas of focus into the care provided by the Aneurin Bevan University Health Board (ABUHB) have been highlighted in the Welsh healthcare watchdog’s annual report.

Healthcare Inspectorate Wales (HIW) carried out a total of 32 inspections, investigations and visits at facilities between April 1, 2016 and March 31, 2017.

While inspectors praised the care and the workforce at ABUHB sites, the watchdog identified areas which require further attention.

“Our work did however highlight the following issues that require further attention,” stated the report.

“The need for regular documented checks of emergency medication and equipment across all services. 

“The need for regular review of policies and procedures and risk assessments, for example fire and health and safety in primary care settings and ensuring they are communicated and understood by staff.

“The need to eliminate inconsistencies within service areas.

“The arrangements for ensuring the recommendations HIW makes are implemented in a timely way.”

The report also stated: “Overall the inspections this year found that kind and respectful care is being provided to patients by a passionate and committed workforce.

“Good leadership and management was noted on several occasions.”

Of the 32 recorded visits in the yearlong timeframe, the majority were for dental practice inspections – 12 in total and which included one follow-up.

There were six learning disability inspections, five Mental Health Acts (MHA) visits, four general practices inspections, two mental health inspections and two hospital inspections – one of which was a follow-up – and one death in custody investigation.

However, the inspectorate found that the death in custody was not linked to the healthcare team at HMP Usk’s inaction in providing care and treatment.

“HIW undertook one clinical review to support the work of the Prison and Probation Ombudsman in relation to death in custody incidents,” stated the report.

“The root cause of death was cancer of the kidney which had spread to his bones and lungs at the time of presentation.

“The death was foreseeable only after the diagnosis had been made, but it was sadly not preventable.

“The healthcare team at HMP Usk strove to provide effective and compassionate care and, within the confines of the system they worked within, they achieved this.

“Sadly, there were inadequacies in the pain-relief and dignity experienced by towards the end of life.

“The main reason for this was the failure of the prison service to transfer to a unit able to provide appropriate 24 hour a day end of life care.

“The problems encountered with providing end of life care were compounded by inappropriate discharges from hospital which stem from a lack of understanding of the limitations of the care facilities available at HMP Usk.

“It is clear that the health board and HMP clinical staff face challenges in situations like this however it is disappointing that these issues are still present given that they were also identified in a review concluded in 2015/16.

“Furthermore unless action is taken to resolve this situation the deficiencies in the care received, highlighted in both cases, are likely to be repeated again in the future.”

A spokesman for Aneurin Bevan University Health Board said: " We always welcome HIW reports as they provide us with an independent assessment that we can learn from, and act upon, to make further improvements to the care and services we provide to our patients.

“This annual report reflects the ongoing work we have been undertaking with HIW during the last year. It is positive that the report recognises the progress that we have already made in a number of areas.

“In those areas where further improvements are required, the Health Board has already taken action to address these and we will continue to progress our work to always ensure that our care and services are of the highest standards for the people we serve.”