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 3:18 pm on 6 November 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 3:18, 6 November 2018

Thank you for the comments and questions, and I welcome the praise and acknowledgment for the model and the move to implement that. That was not a straightforward or necessarily popular decision at the time.

I'll try and deal in turn with, I think, the four areas that you covered on bed cuts and the ambulance service. I don't believe that the numbers of beds are actually the challenge for ambulances as to why they're spending too long outside hospitals when they need to discharge patients. Actually, it's about flow through our whole system. It's a system-wide problem. And, actually, we do know that unlocking flow in a better relationship with other parts of the health service and a better relationship with social care will actually deliver results throughout the system. That's, actually, why myself and the Minister are putting money into partnership between health and social care, to try and make sure that health recognise it's in their interest as well to work with local government to do that and not simply to pass responsibility between the two, as well, of course, as the health service taking control and ownership of what it could and should do to see flow throughout the system.

On your point about frequent callers, there are two points there. One is about individuals. There's quite a lot of work that's been done on a range of NHS Wales awards over the last two years on frequent callers. Often, they don't need an emergency ambulance response, they have a different healthcare need. So, the Welsh ambulance service, together with both other parts of the health service and, sometimes, local government and partners and the third sector too, have gone to those individuals and discussed what their need is, even if it's clear that it isn't an emergency ambulance service.

We've actually seen a reduction in frequent callers over the last two years. That hasn't come from a ministerial directive, that's come because we've had greater scrutiny on our figures, greater information, and our staff have chosen to address that because they recognise it's good for them and the job they do, but also good for those individuals and the healthcare need they have. 

The second part of frequent callers are some care homes. There is a challenge here, for some care homes are much more likely to call out than others. Often. it's a fall response, people who aren't injured but staff won't undertake lifting. So, that's partly why we're investing in a lifting pilot. There's an unfinished piece of work to be done between myself and the local government Secretary about the role of the fire and rescue service as well, as a potential answer for a lifting service. That's also why, in my statement, I made reference to lifting cushions, because we do have to reduce the level of unnecessary call outs to care homes. They are part of the frequent callers challenge we face. 

On 111, the roll-out is being successful. I'm pleased with how those proceedings have gone through in Powys as well as the next port of call. We're seeing, around the country, a roll-out of a successful service, and that's actually run and administered through the Welsh ambulance service trust. They're actually running the call centre for it, but it's in partnership generally with each of the health boards. So, I'm content that it's a good news story for Wales. We're rolling out a successful service at the right pace in different parts of the country. 

Finally, on dental services, I won't deal with the question properly today because I will have the opportunity in the coming weeks to deliver a different statement on dental services and reform in Wales.