Thank you for the questions and the comments, and in particular your opening and the recognition of the contribution of our staff in what is still the most testing time of the year.

I'll start with your final points on the flu season. On the vaccine, we always work with partners across the UK in trying to order and agree on the most appropriate form of vaccine for the most likely strain. With the different strains that exist in the flu season each year, there is always an element of trying to understand what that should be, but we make those choices sensibly and carefully as healthcare systems—there isn’t a particular difference, as it were, between different nations. And it’s still the case that the flu vaccine is the most effective protection people have against flu before the flu season, and, actually, part of my concern is that, every year, somebody says that the flu vaccine isn’t at all effective.

So, we do need to encourage greater take-up, which goes back to your point about encouraging greater take-up amongst health and care staff on the front line, as well as at-risk members of the public. Because I have had a previous kidney condition, I am in an at-risk group myself, so I have the flu vaccine every year. So, I don’t just have someone stick a needle in my arm in a community pharmacy for the sake of a photo op; I actually do need the jab myself as well. And it’s something we can do in a small role, demonstrating some leadership. But, this year, actually, we started with a campaign fronted by the then Minister for public health. We’ve actually seen an increase in take-up across health and care staff, so I look forward to seeing what the final figures are, and then to see what further improvement we need to make, because there is absolutely no pretence that where we are in terms of staff take-up in particular is adequate or we’d like to say that the situation is resolved, because it certainly is not. I’ve seen for myself at first hand the closures and reduction in capacity that the flu outbreak has meant. When I was in Wrexham Maelor A&E recently, they were closing off an area because they had three confirmed flu cases in there. So, it does affect real capacity within the service, and there’s a knock-on impact from that through the front door and the back as well.

I guess that takes me to your point about transfers of care, then, as well. Because part of what we need to do is to think about how we actually get people out of the hospital part of the system when they no longer need to be there. That’s why the anticipatory part of those models of care matters. The Ynys Môn model really matters, because a lot of that is about keeping people in their own homes, as well as about getting them out. That’s why it’s a good thing that, in the last year, we’ve had a good record on delayed transfers of care, but there's much more still to do. But the £10 million that I have announced today to go into the social care system should help us to get people out of the hospital system and into a more appropriate point for their care to take place, because we recognise that, at any point, we’ve had 300 to 400 medically fit people across the system. And, actually, if you could release those people to go back into their own homes, where they’ll need support, then actually we'd have a much greater amount of capacity for people who do need a hospital bed. That would reduce waits, be a more appropriate way to deliver care, and deliver dignity and appropriateness, and we’re likely to see better outcomes as well. So, we need to be looking at investing in different parts of our system at points in time, and it’s also why the teams that I talk about—if you like, the community rehab and community resource teams—are a really important part of that as well.

On out of hours, there is a mixed picture. It’s been fragile in different parts of the country at different points of time, and, again, there’s no point in pretending that that is a fixed issue. I think 111 still gives us the best model moving forward to help fix some of that out-of-hours challenge across the country, and there’s something there about that helping to manage and underpin the out-of-hours service rather than wholly replacing it. And if you look at what’s happened in Swansea, Neath Port Talbot and, indeed, Carmarthenshire, we’ve seen a real improvement there as well. So, there’ll be more to come, and I’ll be utterly transparent with the Chamber again as we have that evaluation and the step forward in 111 and its further roll-out.

Just on your point about the evaluation of winter and, in particular, I think, about bed capacity, well, we’ve introduced about 400 extra beds across our system—so, if you like, the size of a normal-sized district general hospital. And yet, still we recognise real challenges in capacity across the whole system. So, in the evaluation of winter that we’ll undertake with the Royal College of Emergency Medicine and others, we’ll need to look again at what’s happened this winter, how successful that has and hasn’t been at various points in time and, I think, at where we need extra capacity across our system, whether that’s extra capacity in the hospital part of the system with the staff that we need to have to do that, or whether, actually, if we had extra beds, we'd simply fill them up with more people and not improve flow across our system as well. That’s where we need to think about smart investment choices, either to keep people in their own homes or to get them out of a hospital, and I think that’s the first point to go to. Actually, that was the first point of action in the letter from the consultants at the Royal College of Emergency Medicine, about investing more in social care. To help us to do that, to lead some of that clinical consensus, we have appointed Jo Mower as a national clinical director for unscheduled care. Jo is an emergency department consultant based in Cardiff, and part of her role will be some of that leadership and looking at national systems leadership and local practice across the country. I think she'll be well received by her peers in emergency departments across the country as one part of our response to this whole-system challenge.