4. Statement by the Minister for Health and Social Services: Update on the Transformation Fund

Part of the debate – in the Senedd at 4:15 pm on 19 February 2019.

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Photo of Vaughan Gething Vaughan Gething Labour 4:15, 19 February 2019

Across health and social care within the UK, there is real interest in what we're doing, and I want there to be a genuinely open and two-way process, where we're interested in not just selling and telling the rest of the UK what we're doing, but actually looking at what the rest of the UK is doing as well. It has to be a genuinely rounded approach. That was actually at the centre of the speech that I gave to the NHS England confederation conference in Liverpool about 18 months ago.

In terms of where we are with the bids, well, we've confirmed each of those seven areas and it's now for partnership boards to deliver against the bids that they have submitted. In terms of where they are, Cardiff and Vale, Gwent regional partnership board—north Wales regional partnership board had two bids approved. Western Bay, which is soon to become Swansea bay university health board area, they've had two bids approved, and west Wales has had one. I'm expecting to have bids from other areas for me to consider—some this week and more in the pipeline. Now, overall, they make up £41.2 million. When we've made each announcement, we've highlighted what those sums of money are. For example, west Wales is over £11 million in the bid that I've recently approved; Gwent, the headline was £13 million—they're looking to reprofile that, but not to remove the scale or shape of the ambition—and others of varying amounts.

Now, the point is that I don't want people to get lost in money, as if this is only being allocated on a fair-share basis for each area, because the money for each of those bids is predicated on what they contain and what's required for each of them. So, your point about staff numbers—well, the bids are not predicated on staff numbers to be supported by the bids; it's how we transform the model of what we're delivering rather than talking about staff numbers. So, the spend depends on the agreed bids, and the staff numbers depend on agreed bids as well. But, crucially, this is about how you transform what comes. So, it's about what comes at the end of each bid, because this is a limited programme in the sense that there is a time frame to it, and what we're looking for is a clear strategy to understand, to evaluate, does it work, and then, if it does work, how is it scaled up and then how do actually those partners spend their core resource, rather than looking for additional money from the Welsh Government. So, that's important about how it adds value. 

The one part of your series of questions that made me wince a bit was when you talked about making sure this isn't supporting health boards that may be a bit lazy about transformation. I don't think that's a fair or a helpful description of any particular health board, or indeed the regional partners, and we've deliberately set this out as bids that have to be supported by the whole regional partnership board. So, it isn't just a health-led transformation programme, it is genuinely about health and social care together. So, health, local government and their partners in the third sector sit around those regional partnership board tables, and, within the period of a few weeks, housing will be there on a regular basis as well. And the point is that they have to follow the design principles that we have set out in guidance, and so that does look at how you add value. It must be about being genuinely transformative and having a real potential to be scaleable, rather than a micro project that everyone who lives around there will talk about but has no prospect of working across the whole system. I previously made it clear that the primary level and the partnership between health and social care is the area where I see this fund making the biggest difference. So, I'm not looking for projects to transform within hospital-based services. It doesn't rule out or say that no hospital-based service may apply, but the biggest aim and value and gain to be made is in that partnership with primary care and the partnership with social care. 

In terms of the review, it's an independently commissioned review. It's been shared with the transformation panel. It was a range of external actors outside Government as well. It's got points about what we can do to improve where we are, as well as the areas where we're working well. I'm happy to share key messages on that. It may be helpful if I write to Members, as we get through having made the next round of announcements, to give some of the headlines about that independent review—and I recognise that the Chair of the health committee and others are in the room—and to share those key messages with members of the committee and some of the points about where we are currently in the transformation fund and more broadly on delivering 'A Healthier Wales' as well. I'm fully expecting to be invited to the committee at some point to explain where we are and where we're not. 

On third sector involvement, that is for regional partners to determine. I'm not going through each bid and saying that I expect a certain sum to be allocated to a third sector partner. I am well aware that, on a range of the bids delivered, it will involve the third sector not just in agreeing what happens, not just the third sector partner around a regional partnership board table, but more broadly than that, actually, the delivery of it will require the third sector and that will vary from each partnership board, depending on the bid that it is and the area of transformation they're looking to deliver.