[R] signifies the Member has declared an interest. [W] signifies that the question was tabled in Welsh.

I have accepted an urgent question under Standing Order 12.66. I call on Mohammad Asghar to ask the urgent question.

Will the Minister make a statement on the Welsh Government’s review into acutely sick patients’ care following the highly critical investigation by the Public Service Ombudsman into the care of a 93-year-old patient at the Royal Gwent Hospital? EAQ(5)0096(HWS)

Thank you for the question. In response to issues raised in the ombudsman’s ‘Out of hours’ thematic report, and some subsequent cases, arrangements for a peer review programme focusing on the management of acutely sick patients in acute hospitals will be finalised shortly. The work of the peer review will commence early in the new year.

Thank you, Cabinet Secretary. Last week, the announcement of a review came after the publication of a highly critical ombudsman investigation into the care of a 93-year-old man who died three days after being admitted to Newport’s Royal Gwent Hospital. The report found that the man was not seen by a doctor for more than six hours on Sunday, the day before his death, and that was despite concerns about his deteriorating health and the guidelines indicating that he should have been medically reviewed within 30 minutes. This appalling lack of care also involved the failure of nurses to escalate concern about the delay, meaning antibiotics were not given in a timely manner. The undignified end to this patient’s life is disgraceful and, sadly, a case we have seen too often in our hospitals in Wales. Cabinet Secretary, we have heard warm words before, but, sadly, very little improvement in outcomes. What confidence can we have in your Government to ensure that high levels of care are delivered on weekends for patients across South Wales East and the rest of Wales, and not to have these sorts of things happening in this country again?

The Member’s question comes on the same day that the Care Quality Commission in England have indicated that no NHS trust in England is properly investigating deaths. There are challenges right across the NHS family here. What we are looking to do here in Wales is to have a proper approach to a peer review for those patients we should rightly be concerned about. One instance of this sort of care is one instance too many. The challenge for us is: how do we ensure we have a proper approach to that peer review to ensure there’s proper scrutiny, learning and, importantly, improvements within our national health service? I think it’s a sign of honesty and maturity in our system that we’ve agreed a proper peer review process. I will ensure that Members are kept up to date. The initial stage will focus on Aneurin Bevan, it will then roll out across the country, and, over the next year, I expect to be able to report back to Members on what’s been found within that peer review or what improvement actions will be taken within the national health service here in Wales.

I want to declare an interest, that my wife is employed by the NHS. The Cabinet Secretary mentioned in his previous answer the review by the Care Quality Commission in England that found that there is a failure there to learn from patient deaths and other serious errors in the system. That prevents and inhibits processes being put in place in the future, because there isn’t the culture of sharing, not just best practice, but worst practice, actually, because much more can be learnt, sometimes, from when things go wrong. I’m concerned that the public service ombudsman’s report on the failings at the Gwent has some parallels with the report from the quality care commission in England—that similar issues and similar mistakes are being repeated, often repeated in silos, with patient care suffering. Even the health board’s own investigations are identified as failing to highlight the root problems when they arise. So, what assurances can the Cabinet Secretary give patients in the Aneurin Bevan area in particular that there are efforts in place to standardise and improve the investigatory process into patient deaths and other significant mistakes in the NHS system, to make sure that those mistakes are not repeated over and over again?

I thank the Member for his question. As I indicated earlier, one instance of this sort of care and challenges in care that lead to undignified endings for individuals in Wales is one instance too many. We already have a range of actions in place. There’s been a mortality review of different case notes. We’re the first nation within the UK to undertake that approach. That is all about learning from what happened. That’s the whole point—how we learn from what happens and how we try to improve. Now, I regularly get asked questions in this place and others about what the NHS does, and I think it’s really important not to either try to claim that everything is wrong where something does go wrong. We know that when things go wrong in the health service it has a significant impact on individuals and their families. I don’t try to hide from that or that reality, but the great majority of the time, it does not go wrong. I don’t want to see these really tragic cases used to try and attack the whole health service, to try to give the impression that everything is wrong. What we need to do is understand the nature of our challenge and properly address it.

In fact, what we did was we got together the 1000 Lives Improvement programme—representatives from the medical world, nursing, ambulance and the chair of the rapid response for acute illness group to come together to design this specific peer review process to make sure that we are addressing the concerns set out by the ombudsman in his thematic report. We then can have some proper learning with real scrutiny in public—the report will be published and made available—and the improvement actions, importantly, to come from that. Always, we need to look at what we can do to improve our whole system to make sure that if you or I or one of our loved ones were in this position, we could have some reassurances it would not be the case, and we’d certainly minimise and level down the opportunity for it. We’re constantly looking for opportunities to learn and to improve.

I thank the Cabinet Secretary.