Part of the debate – in the Senedd at 3:21 pm on 7 February 2017.
Thank you for that series of questions. I know you like asking lots of questions, and I don’t have any issue with that; I just want to try and get through them in the time allotted.
I do welcome your recognition upfront about the role of staff in delivering very real improvements by NHS Wales. I know, every now and again, the tenor of the debate around health is about the challenges that we have, and I acknowledge we do have them, but this is an area of real and significant improvement, with more lives being saved as a direct result of what the NHS is doing.
I’ll deal first with the point about life-saving skills, because actually I’d indicated that, in the—. We’ll have a plan that’s going to be published in April. That plan is being developed with a range of different people about how we roll out further and build on the success, already, of life-saving skills, as well as understanding where those defibrillators are and people that are trained to use them. So, there is more work that’s ongoing and I’ll be launching that plan. I look forward to delivering it through the rest of this term with partners and to assess its impact again on delivering further improvement.
On your challenge about how the £1 million will be used, it’s not going to be allocated on a formula basis across health boards. The £1 million, as with every delivery plan, is actually allocated by the implementation group against their priorities. You should see those in the plan, but I’ve indicated some of them. So, that’s how the money will be used.
I think that part of what they’re going to do will answer some of your other questions about measures, because they’re looking at piloting component points to try and understand, at various different points, as you’re being treated, how long people are waiting along that whole pathway, to identify where there are potential blockages or inequality. I think that’s really useful. That should provide a very interesting overview for clinicians, as well as the public, and in the way in which we then engineer and deliver our services.
That may make some difficult reading at the outset about where we are waiting and things we aren’t happy with. But we have to be able to understand how we deliver that improvement, and that’s being driven by clinicians to understand where those component waits exist, and what they’re then able to do about them to reduce them, in the way that almost all of the elements we’re talking about have come from the conversation between clinicians, the third sector, and patients.
That’s the same in the community cardiology developments that are being rolled out. And, in particular, I think, your broad point about socio-economic inequalities, and the messages we have there about public health challenges, not just in heart disease, but a whole range of conditions that we’re all familiar with: the ability to do something about smoking rates, to continue to see that driven down, to do something about our alcohol use, but also diet and exercise as well, because we do know that obesity is a huge issue. So, if we can’t do something about diet and exercise then we’ll see a floor beneath which we won’t be able to make any further progress on reducing instances of heart disease within the population.
That’s also why the cardiovascular risk assessment programme started in Aneurin Bevan and Cwm Taf, in our most deprived communities—deliberately targeted in that way because we recognised the socio-economic inequalities that exist. That’s also why the rollout is now taking place in ABM and the more deprived areas first. It is because we’re getting to those people who don’t often attend, are in those high-risk groups, and if they’re not seen and treated and encouraged to actually undertake a different way of making choices about their own health then either their underlying medical conditions that already exist, or the additional risk they’re building up, we’re unlikely to see that challenged.
That’s why it’s deliberately being targeted in a way that tries to take away the medicalisation of that, to try and encourage people in their own communities to undertake different forms of activity, and it underscores the important things like social prescribing and the way we can make activity and healthier choices easier, without being judgmental. It’s about how you actually get into having a conversation within someone’s community that they’re comfortable with and they recognise the real benefit for them of making a change. So, there’s much to do, but lots to be optimistic about as well, I think.