3. Statement by the Cabinet Secretary for Health and Social Services: Findings of the Independent Accelerated Programme for Amber Review

Part of the debate – in the Senedd at 2:52 pm on 6 November 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 2:52, 6 November 2018

Thank you for the comments and the range of questions. I'll try and deal with them as well as I can in the time available. You, of course, referred to a range of figures at the start, particularly on the focus on handovers and others, and, of course, you have 475,000 calls to the service. But there's a recognition that there's more improvement needed on a more consistent basis across the country, because there is some variation in the country about not just handover rates, but that's one part of the whole system. What the review tries to do is to place all of that within the whole-system context. So, lots of improvement in getting the right response to the right people. They need that to discharge at the scene where possible, and, if they need to go to hospital, properly discharged, and also for them to be able to leave a hospital setting promptly as well. So, it is part of a wider system.

I recognise your points about sickness. There are certainly measures to take, and I'm pleased to say they will be taken forward by employers, together with trade unions as well. And I don't know if you've seen the constructive response to the recognised trade unions within the service, but it's positive; there's a recognition of the need to improve sickness rates in particular in the service, and, of course, that's also partly recognised in the pay and conditions conversations and negotiations that are taking place in the recent months.

On your point about recruiting appropriate clinical staff to contact centres, it might help to reflect that there are three clinical contact centres in the country, so, three centres to recruit staff to. There'll be a challenge there about making sure we have the right staff to recruit. We're confident we'll be able to do that, as well as staff within the wider system. And, actually, in the wider system and the points you make there, actually we're looking at being able to get on with the winter plans, drawn up by health and social care together, including the ambulance service. So, that money is based on funding those plans in addition to the £10 million that I announced previously, together with Huw Irranca-Davies, the Minister, to actually put into the social care system. We're looking at the whole system as part of that, and those plans are consistent with findings in the amber review.

You also talked about clinical leadership and accountability to be able to take this forward. And in this, we're in a positive place because you have leadership within the paramedic workforce that is positive about our direction of travel, including the need to invest in the numbers of people we have. So, that's about training, about retaining the bursary as well as recruitment of experienced staff. It's also about investing in the skills of the workforce in social care and in the health service. I hope you've had time to look at some of the investment in the future of advanced paramedics as well, what they can do, both within a contact centre, but also in their job on the ground, of being able to see and treat, and hear and treat, as well. I'm really pleased that Jo Mower, the national unscheduled care lead, is having an impact with her colleagues in the wider unscheduled care system. She comes with real credibility because she is still a serving clinician. She's a consultant in emergency medicine, and she's working part-time in that role and part-time as the unscheduled care lead. So, she has real credibility with colleagues across the system.

I'll deal with your point about sepsis as well, because, if you look at the national early warning scores that are used, that's part of the early warning system for sepsis. Now, I'll happily have a look at the specifics you mentioned, but I do just want to get over that this is a challenge for the whole system. And actually, in my time in the job and previously as the Deputy Minister, I have definitely seen over that time a much higher profile of sepsis within ambulance centres, where staff are based, with much more visible material, and, actually, we know that we are getting better.

Now, the challenge is what else we could and should do to continue that improvement. So, it's not about complacency; it's a marker of improvement that's been made and what more we could do. Actually, I think the NEW scores and the fact that they're in here as a measure that we use is really helpful, because that should help us to identify people at risk of sepsis and to make sure that that is a risk that is properly and appropriately resolved. On this, I know that we share the same objective about wanting to do more, to see more lives saved and to see more avoidable disability not taking place within our health and care system.