More senior medical staff are needed “at the front door” to improve patient care an emergency medicine consultant at Glangwili Hospital has said. Hywel Dda Health Board has highlighted the views of Mr Jeremy Williams, as senior consultant and clinical director for unscheduled care. He said more senior medical staff would also improve flow through the hosptial and reduce waiting times for those in need of emergency medical trheatment. Mr Williams added that “large numbers of patients were coming to the Emergency Units who could be better dealt with if services were structured differently.” The health board officially launched a 12-week consultation, Hywel Dda – Our Big NHS Change, on April 19. “We’re asking residents across Carmarthenshire, Ceredigion and Pembrokeshire, as well as the wider cross-border regions, to get involved and have your say on three proposals to improve the way we provide care for our population. Each proposal has been designed and tested by our clinicians to ensure that our services are safe, sustainable, accessible and kind for our generation and those to come,” a health board spokesman said. Mr Williams  has worked in emergency care for over 20 years. He said: “Glangwili and the other Emergency Units in Hywel Dda are under similar pressures to the rest of the UK.  Large numbers of patients are coming in, many of whom could be dealt with more appropriately in the community.  Nursing and medical staff in the departments are extremely stressed.  One of our main problems is that when we’ve initially managed these patients and realised that they require admission to hospital there is often no appropriate bed for them to be placed, so patients are spending too long in the Emergency Units. “Generally speaking the job I do now is really very dissimilar to the job that I started doing 21 years ago.   We are looking after patients for longer, in effect acting as a Clinical Decision Unit – patients should actually be discharged, transferred or admitted from the Emergency Unit within four hours, however too many are spending significantly longer than this which often interferes with their care and places additional pressures on our staff. “In my opinion the most important component of any organisation is its staff and there are certainly many dedicated nursing and medical staff in the emergency units across Hywel Dda, and this is extremely important because in an imperfect system – which is what we currently have – individuals can make a difference. “We don’t currently have enough senior medical staff at the front door and we’re splitting the ones that we do have between three sites – three Emergency Units and one Minor Injuries Unit.  In my view there would certainly be benefits to be gained from amalgamating these staff; it would improve the quality of care, it would improve recruitment and allow us to place more senior decision makers at the front door for more hours of the day, which would significantly improve patient care.” You can find out more about the consultation and the health board’s proposals, at