4. 3. Statement: The Refreshed Stroke Delivery Plan

Part of the debate – in the Senedd at 3:39 pm on 7 March 2017.

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Photo of Vaughan Gething Vaughan Gething Labour 3:39, 7 March 2017

I’ll deal with the last point first. We haven’t taken an approach of saying there are specific conditions where we’ll think, in particular in ‘Together for Mental Health’, about the mental health needs of that individual, because I think the challenge will be, we could easily parcel up money and activities in a way that would actually dissipate our resource, rather than add to it. The challenge, I think, is for a whole-service approach to seeing the whole person, and understanding—as I said in response to Rhun ap Iorwerth—not just seeing that person with a physical condition, but seeing them as a whole person, and what matters to them.

And that’s why the work on patient reported experience measures really does matter, because that is asking that person about what matters to them, and how we then make sure that we can understand that and measure that in a way that is meaningful for them. So, even if their clinical outcomes are good, actually that may not mean that they are leaving, if you like, the part of the physical care service until they’re actually happy and contented, and that makes a really big difference in terms of their general well-being. So, it is something that we are giving real time and attention to, and that’s why I think, when we come back to 2018 and understanding what those measures are going to look like, we’ll have a lot more information on what could and should make a difference and think about the voice of the citizen in directing some of the care and what outcomes for them are important. So, there is a real and meaningful attempt to have that conversation in all parts of the service, and not just trying to parcel it up. I appreciate that that’s one approach, but I don’t think it would actually deliver the best value for us.

On your first point about whether there are staff unavailable to undertake any scans, I would be really interested in specific examples of what that looks like and how that matches up against our ability to plan the workforce, the investments that we have made in who and where people are, and, indeed, the reconfiguration of the service. I would be very happy if you want to send me correspondence on the examples that you have.

On primary and secondary, there is a constant struggle in understanding who actually has responsibility, but that’s not been brought to me by anyone in the Stroke Association saying that they’re concerned, for example, that there isn’t an understanding of responsibility, either who has the responsibility for rehab or for understanding who will actually undertake the reviews of patients. Their concern has more broadly been about whether we’ve got the right numbers of people working in the right teams as opposed to whether it’s primary or secondary care-led at that point.

On some of your points about advocacy, where people don’t have family members to accompany them when some reviews take place, again, I’m interested if you have specific examples of gaps that you identify rather than the more generalised. There could be. I’d be interested in what does that mean and look like now, and I’d be very happy to deal properly with that. I know that the cross-party group is due to meet in a few weeks’ time. I don’t think I can attend the first meeting, but I expect that there will be a number of points from that group that it might be helpful to collate and send to me, and I can hopefully respond in a helpful and constructive way to the comments that are made. But, broadly, on delayed transfers of care, we have a good record. We have a reducing number of delayed transfers of care, and there is continuing ministerial oversight and expectation for further improvement. In any areas where we see further gaps that still exist, I want to understand why those are there and what we can expect our whole health and care system to do about them. So, I would be very happy to receive that correspondence and then to look at some of the details of what we can do to see further improvement in stroke services across Wales.