South East Wales Vascular Network to transform vascular care in the region

On Monday 18th July, the way vascular services are delivered in South East Wales will change to ensure the provision of high-quality, safe and effective care is maintained for the future. The transformation will affect Aneurin Bevan University Health Board, Cardiff and Vale University Health Board, Cwm Taf Morgannwg University Health Board and Powys Teaching Health Board areas.

Vascular services in South East Wales have faced a growing number of challenges for many years, including an increasing aging population and an increase in demand for vascular services. This means services were unsustainable for the future in their existing format. The configuration has been discussed at length for many years and multiple options explored.

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. The total number of patients likely to need a vascular procedure in South East Wales is approximately 1,250 each year.

Doctors have been discussing options in line with national guidance and best practice as far back as 2014. Although the Health Boards in the region have long standing relationships, the South East Wales Vascular Network was formally established to enhance collaboration and bolster plans for the future.

In early 2021, working closely with local Community Health Councils, Health Boards in the network facilitated an 8-week public engagement on the future of vascular services for South East Wales. The public were invited to learn about the prospective plans and share their views through various channels as plans were developed.

Of those of who took part in the online survey, nearly three quarters (72%) agreed with the national evidence and recommendation from the clinical option appraisal that a hub and spoke model would improve vascular services and patient outcomes. Following independent reviews of the findings, Community Health Councils and partner Health Boards supported the case to move forward and implement the proposed hub and spoke model.

The new hub and spoke model means all vascular surgery will be undertaken at the University Hospital of Wales as the hub, but the majority of care will happen closer to people’s homes in spoke hospitals. Spoke hospitals will be maintained at Grange University Hospital, Royal Gwent Hospital, Royal Glamorgan Hospital and Lakeside Wing at University Hospital of Wales. Lakeside Wing at University Hospital of Wales will be a temporary spoke hospital, with plans in place to move this to University Hospital Llandough. Spoke hospitals will provide care such as pre-operative assessments, investigations, minor procedures and recovery care.

Dr Dom Hurford, Medical Director at Cwm Taf Morgannwg University Health Board, the host organisation for the South East Wales Vascular Network, said: “The network is a fantastic venture that brings together teams from across three Health Boards to deliver high-quality care for all of our patients. Through centralising high risk and complex cases, we are bringing together expertise from across the region to share learning and further improve care. Rehabilitation locally is also key to the reorganisation of vascular services, ensuring patients can access pre-operative and follow-up care in spoke hospitals across the region. A tremendous amount of work and planning has gone into this, we are confident we now have the right model with the right support to build a robust service that is fit for the future.”

The hub and spoke model is recommended by The Vascular Society of Great Britain and Ireland for the organisation of vascular services, delivering the best outcomes for patients. This model has been successfully implemented across the UK.

Jon Boyle, President of The Vascular Society of Great Britain and Ireland, said: “The society supports the development of vascular networks to provide patient-centred and time critical care, and deliver the best outcomes for vascular patients.”

All patients who are currently affected have been informed and anyone receiving vascular care will be updated as part of the usual care process.