7. Statement by the Cabinet Secretary for Health and Social Services: Winter Delivery Planning

Part of the debate – in the Senedd at 5:37 pm on 13 November 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 5:37, 13 November 2018

I tried to cover the final point in the series of questions in the statement. I tried to refer to the range of bank holidays that take place between 21 December and 6 January. We know that's partly about bank holidays and also about the additional surge that we tend to see both after Christmas and after new year when people have put off going to seek help and advice, and after each of those particular milestones we see a surge in demand coming into the whole health and care system, not just our hospital sector, but general practitioners certainly see that surge in demand as well.

On your—I'm trying to address the number and the range of questions that you asked—I think the plans will help to make sure that we have the best prospect of delivering the best possible service through winter, and I recognise there is always pressure and stress on staff. We're talking about the busiest end of the service, both in emergency departments, but even more so in primary care. The busiest part of our system is actually primary care. And I can't take away all of the stresses of the job. And there's something about honesty when you meet staff—being honest with them about what you can do and an understanding of the pressures that they're going through and recognising that the system really is busy all year. But what should give people some confidence isn't a group of politicians who sit down with a variety of officials in a room and decide to concoct plans that have no bearing on practice. The advice we get and the plans are drawn up by people leading and working in our system. For example, the clinical lead that we have for unscheduled care is actually an emergency department consultant who works in the Heath in a busy department, has been part of leading an improvement in that unit and has, frankly, buy-in from her colleagues around the country in a way that a politician or an official who has never done that job doesn't have. So, there's real confidence that it is possible to deliver improvement as well as understanding the specific nature of some of the workspaces and demand coming into different parts of the country.

On your particular point about occupational therapy, there's a challenge about the shorter term and the money may help with some of that shorter term capacity through winter, but there is, of course, a longer term challenge as well, and that's where we'll look at our training places and the numbers we invest. We've had a significant increase in occupational therapy training places over the last four to five years. The same goes for some of the points made by the Royal College of General Practitioners today. We're actually looking again at how we recruit and where we recruit GPs to and from. In the last two years—we overfilled our GP training place numbers the year before last; this year, we had a 98 per cent fill rate in GP training and Health Education and Improvement Wales will be looking again at both how we recruit, but also the numbers of training places again in this year.

On your point about out of hours, it's something that I recognise as a challenge. The 111 programme that I talked about is not just about a different way to deliver part of an out-of-hours service; it's actually reshaping the model of how we deliver out-of-hours services, and a broader range of healthcare professionals—GPs, pharmacists, nurses and therapists in particular—to make sure that a range of advice is available and to make sure that there is resilience across the whole system.

On your point about money, the £20 million that I announced weeks ago for the national health service, with partners—that's one-off money to make sure that we get through winter this year. The £10 million that you will have heard us put into the social care system—that's one-off money, but, of course, that will be followed by £13 million of recurrent investment into the social services system from the health budget for the next financial year. 

Finally, your point on the third sector. We have national partnerships in some areas. The examples I've given are St John Cymru and the Red Cross, but, equally, you will understand that there are more local third sector partners that deliver services, and that is absolutely part of the learning for this winter. And I expect we'll learn again at the end of this winter what has worked successfully and what we could do even more successfully in other parts of our system.