The Welsh NHS

Part of 3. Topical Questions – in the Senedd at 2:42 pm on 10 January 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 2:42, 10 January 2018

Thank you for the series of questions. To think about where we are and about the pressure that exists right across the system, much of our commentary ends up inevitably being about the front door of a hospital and the emergency department, but, actually, the pressure is right across the system, including in primary care, where on peak days they've had 100,000 contacts in primary care across the country. Part of my idea was not just the £10 million to go into the system, it was also throughout QOF and the admin duties of GPs to give them more time to spend with patients who need to have their care and assistance. 

There's also that pressure across the social care system. I think perhaps suggesting that social services were virtually absent for two weeks was a little unkind and not exactly accurate, because, actually, part of the reason that services continue to work is because of the commitment of social care staff, in addition to their colleagues within the health service. But, part of our challenge in moving through this—and I understand that we'll need to do better in the future—as always, is not just what happens at the front door either in primary care, or in general practice, or an emergency department, but as you get to the other end and needing to return people to their own homes, whether that's their own home in a private residence or residential care as well. So, the money we have announced we think will help at the nexus between health and social care in particular, because we recognised at one point last week when I did an interview that there are about 350 medically fit people in beds within our hospital system. That's a challenge not of bed capacity, but of flow within our whole health and care system. So, there is a challenge that goes across health and social care in resolving this.

The £50 million was about maintaining performance, not just unscheduled care, but scheduled care as well. We expect to be in an improved position at the end of this financial year on our scheduled referral-to-treatment figures as well. So, we've made different choices. We haven't had a nationwide cancellation of elective care. We've seen some of that continuing, but there have been some cancellations to make sure that emergency admissions are dealt with. We will, of course, report back to the National Assembly, and I expect to face scrutiny in this Chamber and in committee about what the £50 million has delivered. It's to deliver to the end of the year, so I won't undertake a mid-point inquiry, as opposed to understanding through the whole system what it's done in preparing for and delivering across winter. 

The same for the learning we will obviously take from this winter, both at the point of extreme pressure, as it almost always is in the first week of January, but then to see the whole winter period in the round. Because, at the time when you initially asked this question, that was at one of the peak points in pressure. Fortunately, it has reduced across the country. We see a different level of escalation now. But the winter is certainly not over and I suspect there will be many more difficult days.

So, we need to understand not just what happened this time around with winter planning, and the voices you say there that were not taken account of actually went into some of the winter planning, because there were colleagues representing every part of the service, not just health care, but actually social care colleagues in the room, as well. There's always a challenge in terms of how we gather together the voices of staff and understand how they plan together to deliver our service. We will, of course, learn from this winter. We want to be better prepared again for next winter, and I expect to be completely transparent about what we have learnt and what we expect to do better in the year to come. In addition, I want to improve our response for the remainder of the current winter.