Thank you, Deputy Presiding Officer. I am pleased to update Members on how NHS Wales, local authorities and other partners are planning to deliver resilient services for the winter. Last winter was one of the most difficult that our health and care services have faced in several years and saw increased challenges for our front-line staff. This was not, however, unique to Wales as health services across the UK were put under immense strain. Significant snowfall, freezing conditions, increased demand for GP and emergency care services, increased admissions to hospitals for older people with complex conditions, and the largest number of flu cases since the pandemic of 2009 meant that our NHS and social care system was under unprecedented pressure. Despite these pressures, the majority of people accessing health and social care services during last winter received timely and safe care. This is testament to the thousands of committed staff working in often difficult circumstances, often going above and beyond what could reasonably be expected of them to deliver professional and compassionate care. 

Members will be aware that an evaluation of health and social care resilience over the last winter was published recently. Reflecting on learning from this evaluation, it was recognised that a co-ordinated and collaborative whole-system approach is essential. It also suggested that prioritising delivery of a small number of areas in a targeted way ahead of this winter would support better management of surges in demand and changes in patterns of demand.

As I stated in my written statement on 25 October, my officials have worked with national clinical leaders, leaders from the NHS Wales organisations and local authorities to develop five winter delivery priorities for this winter. These will increase focus on the management of patients in the community, make sure there is clinically focused hospital management to manage risk and peaks in demand, and to ensure that people are able to return home from hospital when they are ready.

While we recognise that pressures on the health and care system are a year-round reality, planning for winter remains a significant priority for our health and care system and national agencies. Preparations for this winter have been taking place throughout Wales and across organisational boundaries since last winter. Local health boards, the Welsh ambulance service, local authorities and other partners have been working over recent months to develop and finalise integrated winter delivery plans for their health and care communities, aligned to those five priorities. 

Integrated winter delivery plans have been received from every health board and they have been scrutinised by my officials, the NHS Wales delivery unit and the national programme for unscheduled care. Feedback has been provided to help improve their plans ahead of the winter. The Welsh Ambulance Services NHS Trust has developed a national plan that has been considered and agreed by the Emergency Ambulance Services Committee as well.

The local plans include an additional focus on providing telephone advice to people with urgent care needs, increasing access to services in the community over evenings and weekends, and collaborative working with the third sector to support people to leave hospital when they are ready.

To support the delivery plans, I announced a £20 million package for the NHS and social care partners in Wales ahead of this winter. Learning from previous years, I made the decision to allocate this funding earlier this year to ensure local health and care teams are as prepared as they can be for the winter to come. This funding is, of course, on top of the £5 million I announced on 17 October to help relieve pressure on critical care units and the £10 million I announced on 22 October to support sustainable social services through this winter. It will help people to access care closer to home, ensure there is sufficient available hospital capacity and help people to leave hospital for home when they are ready. Sixteen million pounds of that £20 million package will be allocated directly to local health boards to support delivery of actions featured in their plans, alongside their partners in the ambulance service, local authorities and the third sector.

I expect that funding to be used to support health boards’ delivery against milestones identified for this winter, as part of the adoption and adaptation of the primary care model for Wales. Delivery against these milestones will be monitored through monthly meetings with directors of primary and community care. We've made clear our expectations to health boards that this funding must be used to support delivery of actions outlined in their integrated winter plans, and that, again, will be evaluated as part of another review of winter resilience after this winter finishes.

The remaining £4 million of the £20 million package will fund nationally agreed priorities for the winter period, and these include increasing capacity in emergency departments to support patient flow, four high-impact Welsh ambulance service projects to manage patient demand in the community, and two pilots to extend primary care out-of-hours access.

The winter will also see NHS Wales work more closely with the third sector. For example, local health boards will work with the British Red Cross to support patients and staff in emergency departments, and transport relevant patients home, helping them to resettle and reconnect with community services. The Welsh ambulance service will also be working with St John Cymru Wales to scale up a project, trialled in south Wales last winter, to introduce a dedicated falls service, and I outlines this in my statement last week about the amber review. This will help avoid sending essential emergency ambulance resources to people who can safely be resettled without a clinical intervention.

Health boards have been asked to formulate operational plans for the crucial 18-day period between 21 December and 6 January. That's in recognition of the particular challenges that this period presents due to the number of bank holidays. This year’s Choose Well winter campaign that I launched recently places more of a focus on the role of community pharmacy and the wide range of other services that are available within the community. They're often closer to people’s homes and available at more convenient times for a range of people in the evenings and weekends.

I was pleased to launch the annual Beat Flu campaign on 3 October, and I had my flu jab in a community pharmacy in Cwmbran. The Beat Flu campaign encourages all those who are eligible for the free flu vaccination to get protected. This year, the vaccine will be more widely available than ever before, including for staff within the social care sector, paid for by the national health service.

But there is no reason to think that this winter will be any less challenging than previous years and, yet again, we will rely on the dedication of our staff at the most extreme times of pressure. However, the plans that we have across health and social care come from a partnership between our NHS, local authorities, the third sector and the Government. The combination of local and national plans should provide increased resilience against the inevitable pressures that will come over the winter months. As ever, it is our aim, and that of our dedicated staff, to make sure that patients continue to access the care they require, when they need it and where they need it.