6. What assessment has the First Minister made of the effectiveness of community healthcare in North Wales? OAQ53018

Our approach on health and well-being in our communities is set out in our primary care model for Wales. In north Wales, we expect the health board and local authorities to collaborate with a wide range of service providers to plan and deliver effective and seamless health and well-being care.

You will recall that five years ago, a number of community hospitals in north Wales were closed, moving to a new regime of care in the community through the introduction of the home enhanced care system—the HECS—which was sold as a more effective system. And one would expect, therefore, that we could measure any success that has been delivered during that period, but it’s now clear that it isn’t possible to measure the success or failure of this new approach, because there is no consistent record of how many patients receive HECS across the Betsi Cadwaladr health board. The board doesn’t know how many patients are in receipt of HECS at the moment, there is no record of the cost of the service kept and, although the intention is to keep a patient on HECS for just a fortnight, there is no full record of how long patients are in receipt of HECS. Indeed, I’ve seen evidence that some patients have received HECS for over 10 weeks. Now, it appears to me that this is an utter mess. So, why has your Government allowed north Wales to have a new system of healthcare without ensuring that you can measure the success or efficiency of that process? Can you tell us, are you confident that this new system is working?

I'm afraid I don't know the detail that the Member has set out there. I'd be very grateful if he would write to the First Minister, and we'll get a detailed response to him as soon as possible. 

Community and primary care services play a vital role in reducing hospital admissions. As we approach the winter months, it is vital that these services are strengthened to offer a genuine and safe alternative to hospital care, particularly for our older people, and this must include fully co-ordinated, multidisciplinary community care support teams. Now, we know, from last year's evaluation of winter planning, initiatives such as frailty services, which are vital in reducing hospital admissions, did not deliver as effectively as they could or should have done in the Betsi Cadwaladr health board. How are you, as a Government, ensuring that winter pressures funding reaches these services to build capacity and resilience in community services this winter across Wales, and how will you ensure that hospital at home is, in fact, safe treatment and care at home? 

The Cabinet Secretary recently set out his winter preparedness statement, making sure that we are as resilient as it's possible to be as we approach the winter months. Integrated winter delivery plans have been received from each health board, and have been scrutinised carefully by officials, the NHS Wales delivery unit and the national programme for unscheduled care, and feedback has been provided to inform further enhancement of the plans ahead of the winter period. We're as confident, therefore, as we can be, that we are prepared for the winter ahead, but Members will all be aware of the stresses and strains that winter can bring on the NHS, and we could all be well-advised to make sure that our constituents receive the message that they should go to the appropriate healthcare provider, the community pharmacy, where that's appropriate, the GP, where that's appropriate, and not turn up at accident and emergency when they have other issues, so that we can ensure that we have as smooth a winter period as humanly possible.