The next item, therefore, is a statement by the Cabinet Secretary for Health and Social Services on how digital technology is improving primary care. I call on the Cabinet Secretary to make the statement—Vaughan Gething.

Thank you, Presiding Officer. The way that we deliver primary care services is, of course, changing. Digital technology is transforming the way that citizens access their local healthcare. Greater use of digital technology is a key aspect of our vision to deliver the right care, at the right time, and in the right place, as close to home as possible.

One of the ways that we are achieving this is through the introduction of the Welsh patient referral service system. This service has been in place since 2015, so GPs can now send referrals to secondary care electronically, enabling the referral to be processed in under an hour. This is in contrast to the days or weeks that it takes for paper-based processed referrals, meaning that patients receive faster specialist care. GPs are using this digital technology to ensure that nearly 20,000 referrals are prioritised every month. The service also enables the consultant to request additional information from the GP referrer. In the future,  this will be further developed to allow dialogue to take place, empowering GPs to manage their cases locally and, of course, to avoid unnecessary referrals.

Of course, the local healthcare team is more than our hardworking GPs. For example, community pharmacists play a vital role in meeting people’s needs locally. The Welsh Government has, of course, invested substantially in the Choose Pharmacy IT platform to support community pharmacists to deliver services that would traditionally be accessed through GPs. This avoids the need for patients to wait for a GP appointment, and it includes the common ailment service, the seasonal flu vaccination and the discharge medicines review service. Working digitally allows community pharmacists to access a patient’s GP summary record, including information on allergies, and ensuring that medications are prescribed safely and appropriately. Since this service started in September 2013, our community pharmacists have undertaken over 22,000 common ailments consultations and have delivered 30,000 flu vaccinations in this season alone.

The Choose Pharmacy platform also supports the electronic transfer of hospital discharge information to ensure that relevant information about an individual’s medication is shared appropriately between primary and secondary care, and I expect us to do more on making the very best use of the Choose Pharmacy platform. This, combined with access to the patient’s summary record, ensures that community pharmacists can provide their service with the full knowledge of an individual’s medication regime, to ensure that that patient receives the correct medication and to help them to understand their medication regime—not simply using a pharmacy to dispense a volume of medication, but to actually improve the quality of the care and that ease of access.

And digital technology is also improving how we deliver community care. The Welsh community care information system that you may have heard referred to as WCCIS in visits around the country or locality has been live since April 2016. And that’s driving joint working between NHS Wales organisations and our local authorities. It’s an excellent example of that joint working. It supports the safe sharing of information between health and social care with a system that is helping to deliver improved care and support for people across Wales. This is being achieved by allowing health and care staff, including community nurses, mental health teams, social workers and therapists to use a single system, to have access to a shared electronic record of care for the patient. And, for the patient, that should ensure that the health and care system is more joined up. It will avoid them having to repeat information, and it will give them confidence that the professionals they meet will understand their treatment and care needs.

Nine local authorities in Wales are currently live with the Welsh community care information system, along with Powys Teaching Local Health Board. A number of our early implementer local authorities include front-line health professionals who work within locally integrated care teams To support this, the provision of mobile devices for community nurses across Wales is being funded through the integrated care fund.

While there is clear evidence of the growing use of digital technology to provide care locally, it is still not yet at the scale that I would expect. So, it’s important that people are able to find up-to-date, trusted information and advice and assistance on the right care at the right place, and at the right time, and a proposed online platform for health and well-being, and the development of the integrated directory of services for health, social services and the third sector, will enable individual citizens to easily find this information online in a single place. And that directory of services has already been developed and used to support the 111 service where it’s already been rolled out in Wales.

The use of point-of-care testing, where diagnostic testing is undertaken outside a laboratory, will increase, and that will mean that more testing will be carried out close to, or within, a patient’s home. We're funding two studies that include provision of specialist devices to 100 GP practices and recruitment of patients to undertake self-testing and management at home. 

I've already explained some of the benefits that digital technology is bringing to the GP referral process. In this next year, from April onwards, the Welsh Government aims to introduce a similar electronic referral system within both dentistry and optometry. Ultimately, this should enable more people to be treated and cared for locally. That should reduce demand in secondary care and provide a better experience for the person themselves.

But we shouldn’t underestimate the challenges that we face in achieving our digital vision for local healthcare. We need to ensure the workforce has the skills and capability to use digital technology successfully. The way in which local healthcare and support is delivered is changing, and communication with the public is critical to this. The NHS and social care across Wales already gather a wide range of data and information. The more digitally we work, the more essential it becomes to use that data to improve the public’s participation in, and experience of, health and care services. This is why, last October, I set out plans to develop a clear policy framework to support effective, efficient and safe sharing and use of health and care data. Alongside this, we need to have a national conversation with the public to ensure that they better understand the way we use and share data, and explain how we protect and use that data responsibly to enhance and improve their own experience of care and treatment.

Effective engagement, of course, with our health and care professionals is essential to this. We need to create an environment where they're given time to inform and champion future developments. Our plans to exploit the potential of digital technology to improve care with local health and care professionals routinely communicating with specialists to diagnose, treat and care for people at or close to home are wide-ranging and ambitious. But, as the parliamentary review recognised, we have more to do, and more gain to be made. Greater and better use of digital technology is an essential part of the future of our health and care system, and I look forward to reporting on further progress to be made.

The Deputy Presiding Officer took the Chair.

Can I thank the Cabinet Secretary for bringing the statement forward today? I think that repeating information is the bane of a patient's life and a common cause for complaint, and I do believe that digital technology, used in the right way, will certainly help to take our health service into the twenty-first century. I believe that more and more people want to take ownership of their own healthcare data, and I was very pleased, Cabinet Secretary, to read in your statement of the success of the Welsh patient referral system to help GPs. However, you also refer in your statement—you make the comment that,

'there is clear evidence of the growing use of digital to provide care locally, it is not yet at the scale I expect'.

Could you please go into more detail as to what you expect, what the hold-ups are, what hasn't happened and what the lessons are that have been learnt so far in the progression of that?

I note with interest the desire to roll a similar referral scheme out to dentistry and optometry, and I look forward to seeing how that works. I would like to understand what controls might be in place to ensure that health boards across Wales are training their staff appropriately and well, because the weakest link in a data trail is actually, indeed, literally the weakest link, and can cause that data to be corrupted, to be inadvertently misused, and we need to make sure people understand the responsibility that they have towards ensuring patient data is absolutely correct. Could you please perhaps give us an overview about how you're going to protect all of this data that we are collecting, and ensure that there is adequate data protection?

I do note that the parliamentary review flagged this up as being incredibly important, and I do think it will make healthcare provision far more efficient, and we will no longer, perhaps, as Assembly Members, have to listen to patients who have written to us with stories of turning up to see a consultant after waiting for x months only to find that their notes haven't followed through, or the x-rays haven't followed through, or the blood test results haven't followed through, because it's such a colossal waste of their time and the NHS's time.

I would like to understand how radical you intend to be, Cabinet Secretary. I have floated before the idea of patients being in control of their data. I would like to see every patient in Wales have a credit card with all their NHS data on it. As somebody who inadvertently, for a gruesome 18 months, became an NHS frequent flyer, I can tell you that it would absolutely have helped me to have been able to access my data, understand what the issues were, understand what had happened, understand what hadn't happened, and, more importantly, be able to take that data to all the other people who were involved in the care that I so excellently received from the NHS. How are you going to make sure that people are empowered so they no longer have to write in and ask for their NHS information and that we understand that it's their information and they have that absolute right to it?

Finally, I'd like to just touch on how bold you intend to be in terms of the true digitisation of the NHS. If you look to Europe, many European countries—Germany and France, for example—do not have a paper trail in their hospitals. Everything just goes straight onto laptops, into tablets, and, of course, the great advantage of that is that, when somebody picks it up to put somebody's observations in, they can immediately see if that patient's supposed to have a particular medicine at a certain time, or needs key information.

I will just end, if I may, Deputy Presiding Officer, with a rather vaguely amusing, although perhaps not quite so amusing at the time, story of when I was lying there in hospital, and this rather important doctor came bustling in on a Sunday to do the ward round, and he picked up my admittedly not inconsiderable file that was sitting at the end of my bed and rattled through it, and then he said, 'Oh, Mrs Burns, so how did the operation go?', to which I replied, 'I haven't had an operation; I'm in here recovering from sepsis.' You know, it was just a game: 'Let's look at it', no real use of it. Let's make this data really useful and make sure that mistakes aren't made, that information gets to the right place at the right time, and I would support you, Cabinet Secretary, in being as ambitious as you possibly can be to make sure that we use this as a way of making our NHS and our social care system as effective as it possibly can be. 

Thank you. I broadly agree with where you want to be, in that I don't think  there's going to be much party difference on where we want to get to in terms of a vision of having a genuinely electronic patient record and having proper access between different parts of healthcare, because within primary care, which this statement is largely focused on, you have GPs, you have a range of community staff, you have the community pharmacy sector, you have optometry and dentistry, you have a range of areas where we all recognise that services are provided, and wanting to make sure that we reduce the room for error, which is one of the points you made, which a patient-based record always has and for loss, but also that should be seen as an opportunity to improve treatment and care as well. 

So, I'm interested in the Wales Audit Office report, which I'm sure we'll hear more of later—I'm looking at my colleague the Member for Llanelli. They recognise that there's a vision that they think is clear about having access to that record and having it available and having access to it consistently, but we haven't moved as quickly as we want to. Some of it has been about some of our challenges in actually getting different partners to point in the same direction at the same place in time, so it's about some of our staff groups and it's also about some of our organisational barriers as well. That's when I talk about not having moved at the pace that I want to see. I would have wanted us to have been in a position where the sharing of the record has made greater pace and progress than it has done to date. I'd want it to be where people are already able to access their own information more readily—one of the points you made several times in your comments. 

There is something about that there are some people who want to take greater ownership of their own health information, and that would help them to make further improvements in managing and sustaining their own healthcare. That's also why the investment, we're not just making it in the IT platform in pharmacies, but actually it's about the advice that should be given. Actually, we're paying for the quality of care that is provided in the pharmacy, and it's not simply about dispensing. It should also mean, actually, that we're able to process people more quickly through our system. So, part of the challenge we have in a hospital discharge service is whether people are waiting in a pharmacy there, when they could actually be seen, with electronic transfer, to actually go to their own pharmacy or to have that medication delivered to someone's home as well. So, there is lots of gain to be made, and a number of examples of why I'd want us to move more quickly than we have done. 

And, interestingly, when you think about your challenge about, 'What do you want to do more quickly?', optometry is a really good example. We need to have agreement on a system to use and to make sure that we have a once-for-Wales system, so that we don't have different health boards, as has happened in the past, having different products that clinicians are used to using, and then when you try to have a consistent system across our national health service, let alone to a join-on with social care, you have different systems that aren't necessarily compatible with each other, and you've got to transfer people to move onto a different system. That's taken time, energy and effort, and I wish it had not done. 

Interestingly my colleague Julie James is now in the room, because we do have a national informatics board that meets, and thinking about the way we have a more consistent approach across Government. So, Julie James will now be spending some of her time with that informatics board to try and make sure there's a consistent digital vision, and that health and care are very much part of that.

And, you know, your point about record provision across our system, it isn't just about the GP record; it's actually things like images as well. We've actually done quite a lot in eye care where you can actually transfer records from high street optometrists to the hospital sector as well, and that's a good example of where you can improve care as well. So, really good examples, but the consistency, the pace and the scale are not where we need them to be, but we have made real progress. The next stage is to do much more, because otherwise we won't meet the challenge the parliamentary review sets us on really realising the potential of digital for all the health gain that has yet to be made, and the way that, frankly, citizens are already used to living their lives.

I think you're entirely right, Cabinet Secretary—there should be very little difference between anyone in this Chamber in terms of our aspiration to move towards a position where our health service is entirely digital, where systems work together for the benefit of patients. And yet, in the context of Brexit, people’s willingness to turn the clock back does make one think that some people might prefer to go back to doctors keeping their records on slate, but I hope that it would be a minority who would be of that view.

You’ve taken us through a number of elements of the technology that is being and has been introduced into our health service—the Welsh patient referral service system. It’s very important that we get this right, and the telecommunications platform for Choose Pharmacy is also extremely important. You say that digital technology is transforming the way in which people access healthcare, and certainly it should be. My concern is that we are still failing to make ground in some of the most crucial areas.

We’ve recently had an informal discussion on a digital system that should assist nurses in carrying out their duties on wards, and some delays in the system and in ensuring that that is being rolled out across Wales. In the context of pharmacy, I very often discuss the frustration of pharmacists that there isn’t a read-write system in place that allows real communication between pharmacists and GPs, so that the primary care system truly can work in a united way. There are still too many patients leaving hospital with a piece of paper scrunched up in their pocket that they’re supposed to pass on to their GP once they’ve left hospital, and they lose that paper and the systems break down. One would hope that we could move to far more stable streamlined systems within our health service.

I’d like to focus my questions, however, on one change that’s been announced by the Government within the past few days. This gives us a clear warning on the importance of getting things right in introducing systems that have a strong element of futureproofing, so that we avoid problems further on down the line. I’m talking about the decision, following a procurement process, to change the clinical system that is used by GP surgeries across Wales. A number of surgeries have contacted me, not so much expressing disappointment, but almost in a panic at the decision to take the EMIS Web contract, or rather not to allow EMIS Web to be the system that is used in primary care in future. This system has only been in place for three or four years. There has been substantial investment in introducing this system in surgeries across Wales, and now those surgeries are hearing that the system is to be scrapped, and that a new system will have to be put in place. Eighty-nine of the 118 surgeries that are affected in this case are in north Wales, so there’s a particularly acute issue in the part of Wales where I live. Surgeries have had to invest in hardware and software to work with EMIS Web. They’ve had to have new ECG machines, new blood monitoring machines for patients on warfarin, and other equipment so that they have equipment that interacts with the EMIS system. I will read to you what another surgery told me:

'Half of practices in Wales will be forced into changing their clinical system. Practices have not been consulted. Practices have not been given a reason. We're told that EMIS have failed to reach standards. What is apparent is that whoever made this decision has absolutely no idea of the upheaval this will cause practices who are already under pressure.'

Now, I am very concerned about the effect of this change. Can I ask, in the context of your statement today on the need to get digital right in primary care, what support Welsh Government will give to surgeries to get them through this change, including financial support? Because investment has been made in hardware to go along with a system that has only been introduced in the past three or four years. What does that tell you, Cabinet Secretary, about the need, as we roll out new digital right across the NHS, for getting it right and futureproofing because we can't operate in a way that is not strategic? It is costly and it means that we cannot get a system that works both for NHS staff and for patients.

Thank you for the comments and the substantial question at the end about the IT system in general practice. I recognise what you said about the nurse rostering and organisation system in Wrexham. I still maintain an interest in that and want to see that properly developed in the hospital service. I guess for the hospital discharge part, that's about the discharge between secondary care back into primary care. There is certainly more that we could and should do, and I will have more to say as we're looking for more pilot work to be done in that area.

But as the substantial questions were about what's happened with the IT system in general practice, and in particular with EMIS, who have not been successful in the recent tendering exercise, I am, as I said last week, still limited in what I can say. Today is the last day of a potential 10-day legal challenge period, so if that challenge is not made, then there's more that we can say, but I am restricted in what I can say. But I recognise the very practical nature of the challenge for those practices who have taken up EMIS as a system.

It was raised with me on my recent visit to north Wales when I met doctors at the Bethesda practice. They are an EMIS practice and they were talking about—they were concerned about the practical reality of having to migrate to a new system, even if, to be fair, they did recognise that we'd indicated there would be support provided through the NHS Wales Informatics Service for them. In meeting that group of doctors, I think they see that there's a long enough future in the profession for them that they would go through that. They don't particularly welcome the change, but part of my real concern and recognition is that, if you are within a few years of retiring in any event, then this is the sort of change where some people may seriously consider actually not coming back, or actually accelerating their plans to retire. I recognise there is a real risk of that, and that's something that has been raised both by the Royal College of General Practitioners and by the British Medical Association as well. They're practical things they want people to talk through to try and make the transition as easy as possible for their members, and I expect to be meeting—if I'm not meeting them directly, an official will be meeting with them in the near future to talk through where we are as we get through the period of challenge. It is worth highlighting again, though, that I expect there to be a robust process to try and deliver proper value for the public purse and the actual service that that then procures and provides, and the general practice committee of the BMA were engaged as part of the decision-making architecture around this and they supported the choice, even though they recognised it would cause real difficulty for their members. They still think it was the right choice to make.

In the coming days, as I said, once we get past today, I may well be in a position where I can say more and provide a fuller explanation, not just to yourself but to general practitioners themselves. I'm keen that we can do that so that people can see the context in which that choice has been made, and then to actually deal with the practical challenge that we are nevertheless left with, regardless of the propriety of the choice that has been made.

Cabinet Secretary, I've seen the future, and it works. Last night, I had my first online GP consultation. I downloaded an app. I subscribed for a service at £5 a month. I was able to get an appointment within an hour. I sent the GP my notes and some pictures. I had a very good consultation, and within minutes a prescription had been e-mailed to a chemist of my choice.

The pace of change outside the NHS is extraordinary, and as a Labour and Co-operative Assembly Member, I don't want to be using the private sector. But given the frustrations people have in accessing a GP, and given the ponderous pace of digital change within the NHS, there are revolutionary changes happening around us, and the NHS simply isn't keeping pace. The debate this afternoon has primarily been about back-of-office functions, record access, not about patient care, not about diagnostics, not about the potential in digital and artificial intelligence that revolutionised the way that people access healthcare services. And I really worry that the approach we have, the approach to procurement in particular—the rather bureaucratic, longwinded culture we have in the NHS in Wales, in particular—is really holding us back. The Public Accounts Committee has been hearing of the 10 years it's going to take for an IT system on hospital catering to appear after it was first recommended; seven years is a typical time lag. Given what we know of the changes in digital and AI, seven years is more than a lifetime. It simply isn't good enough.

So, I could ask you, Cabinet Secretary, you've had now very critical reports from the Wales Audit Office on the NHS Wales Informatics Service, and bear in mind Wales Audit Office reports are agreed reports, they're negotiated reports with the host bodies, they generally are fairly calm in their criticism—this report was very firm and damning. We've also had the parliamentary review, which gives chapter and verse on how change needs to happen, and I simply fear that our cultural approach up to now is no longer fit for purpose and we need some radical change rather than continuing in the rather ponderous way we have to date. 

And I recognise that we have real challenges in moving the health service we have today that people are used to into a different way of communicating, because there are lots of people that will expect to be able to communicate in the remote way that you have done in having an online consultation. So, a number of GPs are already able to and are investing in Skype for Business, which will allow that contact to be delivered in a different way. And I think more and more people will want to do that; there are others who will still want the rather more traditional face-to-face. So, we're asking GPs to be agile with their local healthcare team in the way in which they interact with patients and provide that care advice, treatment and support. So, investing in the architecture matters, and within that we have to make priorities and choices. So, is the investment in a hospital catering system the first priority we'd choose? I don't think it would be; I think there are other points where there is a larger impact on patient care and patient experience we would choose to invest in first. 

It comes back to the comments that I made honestly in this place and outside before about understanding our capacity to deliver some of that change, understanding the need to catch up with the way the public make choices about how they live their life already, and choosing to invest that time, energy and effort in areas that will make the biggest difference and the biggest return for the service and for the citizen as well, because the experience of people's care very much reflects on how people feel and their confidence about the quality of care they then receive as well. 

So, I recognise the challenges that you set out, and I recognise what the future could well look like in making greater use of digital. So, I don't apologise for, myself, having some restlessness over where we are, because I think it's really important to drive into our system to make clear that we can't say, actually, we can take lots and lots of time thinking and reconsidering what we're doing. But the statement today is to point out that we've made some real progress in the last three to four years. Actually, we need to make even faster progress in the next three to four years if we're going to catch up and deliver the sorts of services that people will, I think, more and more demand.

And you'll see some of that in the response to the Wales Audit Office report. The response will be provided—a full response—by the start of March I think is the timescale, but there will always be more for us to do. But today is a genuine attempt to set out progress made and to give people an assurance that we recognise there's much, much more that we need to do at a faster pace.  

Finally, Caroline Jones. 

Finally, thank you. Diolch, Dirprwy Llywydd. 

Thank you for your statement, Cabinet Secretary. Digital technology is transforming our health service. The use of information technology is vital to a modern NHS. We can’t go back to the days of paper records or a time when test results took weeks to arrive with our Royal Mail service.

I welcome the introduction of the Welsh patient referral system, which is speeding up the referral process and making it much more reliable. Cabinet Secretary how do you plan to expand upon this system? Aneurin Bevan Local Health Board has partnered with DrDoctor, which has digitised communications between patients and appointments management. The local health board have said that this system has already saved them £1 million from better clinic utilisation. Do you have any plans to encourage other local health boards to adopt similar systems?

I also welcome the investment in the Choose Pharmacy platform, and the benefits this is delivering to patient care. Cabinet Secretary, how will you be building upon the Choose Pharmacy IT system to ensure that everyone in Wales has access to online prescription ordering, regardless of where they live?

Digital technology is transforming healthcare for the better, but we have to ensure that it is properly implemented. We learnt yesterday that the majority of trusts in England who fell foul of last year’s cyber attack have still not secured their systems. Can you outline the steps we are taking in Wales to prevent such attacks on our primary care IT infrastructure?

Data scientists, information security specialists and software engineers are as vital to our NHS as the clinicians, pharmacists and allied health professionals who staff hospitals and GP surgeries. Can you outline how the Welsh Government plans to increase the IT workforce within the NHS?

And, finally, Cabinet Secretary, I would like to return to the issue of the GP IT systems. Many GP practices have undertaken significant investment in systems that integrate with EMIS. Can you outline what assistance the Welsh Government will be giving to those practices to ensure that their systems will work with replacement systems and how you will help to train staff on the EMIS replacement?

Thank you once again for your statement. I look forward to the further improvements digital technologies will bring to our NHS. Diolch yn fawr.

Thank you for those questions. On your final point, I think I've answered most of those points in response to Rhun ap Iorwerth, but, as I say, I expect all my officials—if not me, then my officials will be meeting with both the Royal College of General Practitioners and the BMA general practice committee to understand the practical steps that we'll need to take in rolling out a new system, in addition to providing a fuller explanation when we're able to about the reasons for the choice that has been made following the procurement.

On your point about workforce—how we develop and maintain a workforce—there's something here about exactly that: what will the workforce do? How much of our workforce will be needed to maintain our current systems and to sustain them and how much will we have to do to develop new products as well and then how will we then assess the product development that takes place outside the health service? We have lots of examples of different Welsh companies that are able to develop products that could and should help the service. There's a challenge about how quickly we assess that. So, Health Technology Wales should be able to help us assess the efficacy of some of this. We then need to get, at a much faster pace, into how we then adopt that technology and make choices across the country as well.

We invested about £10.5 million recently, in this financial year. I've approved that to accelerate some of our national systems. That should provide us with greater robustness in dealing with cyber attacks. The recent outage wasn't actually an issue about cyber attacks, but it does actually highlight the need to continue to improve our systems as well rather than simply assuming that if it hasn't fallen over it will all be okay. There's something there about the more general message for our healthcare systems as well about not waiting for something to go wrong before we look to improve it. Again, that's part of what this statement is supposed to set out.

In terms of people's ability to order prescriptions online, I don't think that's really about Choose Pharmacy. That's really about a proper use of myhealthonline or a successor product, and thinking about how easy it is to use for the individual citizen and also for the practice as well. We had about 220,000-odd people sign up to use myhealthonline but, actually, in a country of 3.1 million people, that's not enough. It's not a great enough proportion who are able to use it and access it and equally then to make sure that our general practices are able then and willing to properly use the whole system. There's also something about, for example, the greater use of texts and other things, about simple things that have actually improved people's awareness of what's going on and actually are just making sure that we don't lose time in the way that our appointments and infrastructure work as well. There's great waste and inefficiency in that, and digital technology will help to be part of the answer to try and reduce that. That should mean a better use of the healthcare professionals' time.

We talked previously about the use of telemedicine and telecare, and it's an issue both for hospital-based care but also in local healthcare as well—not just the comments that Lee Waters has made, but thinking about the opportunity to provide advice, guidance, care and treatment with a healthcare professional as well as to make sure we move information around our system to make sure it's getting to the right healthcare professionals to help make a choice, to have an informed conversation with the individual citizen. I think this goes back to Angela Burns's points at the start as well about the safe sharing of data and the effective use of data. The encouragement is that we have actually set ourselves on a path where we are looking to make that easier to do, to make it easier to share that data across our health and care system, and the other encouragement in that is I think we've turned the corner. A few years ago—well, certainly when I first became an Assembly Member, there was much greater reticence between health and care professional groups about sharing of data and information. I think we're in a different place now. Not only that but the public are ahead of where we are and ahead of where I think professionals are. They want and they expect us to be able to share that information, to help them to make choices, to make sure they don't have to repeat information to more than one person, and because they want us to be more joined up. That's where they want us to be. So, this isn't just an enabler, it's essential to delivering the vision for the future. Some of it happens now and we should celebrate and recognise that. The challenge as ever is how much more we could and should do to deliver better care, better outcomes and, actually, better value for all of us through our health and care system.

Thank you very much, Cabinet Secretary, and that brings today's proceedings to a close. Thank you.

The meeting ended at 18:40.