2. What discussions is the Minister having with health boards and associated partners to improve the transfer of patients from hospitals back into community settings? OAQ54912

I thank David Rees for that question. I am having regular discussions about these issues with health and social care partners, as is the Minister, including meetings in Swansea Bay last week. It is vital to prevent unnecessary admissions and transfer people from hospital to their homes or community settings as soon as they are ready.

Thank you for that answer, Deputy Minister. As the Minister found out for himself last week, when he visited the minor injury unit in Neath Port Talbot Hospital, there were, on that particular day, 125 patients in Morriston awaiting discharge who were physically fit to go out of hospital, but who were sitting there because they weren't able to get out. There's clearly a relationship with partners to make sure that care packages are in place, that care home places are available, or nursing home places are available, and that the adaptations are done. This is causing a problem, because we are always highlighting the fact that there are ambulances parked up outside hospitals and that accident and emergency departments are facing difficulties, but there's the flow through the hospitals and the discharges that are actually blocking everything up.

What are you actually doing to ensure that those departments and those social services, those partners, are actually doing the best they can? I know they're under pressure—I fully appreciate the pressures they're under—but they need to be able to ensure that those patients can get out as soon as possible so that the beds that they're occupying can be released to make sure that the flow through hospitals gets better.

Thank you, David Rees, for making those very important points. We do expect health boards to work together with local authorities and with the third sector to ensure that people do return home from hospital as soon as they are fit to do so, because I think we all know about the damage of people staying in hospital longer, as well as affecting the flow through the hospital. I know from recent visits, particularly to Swansea Bay, that there is a real commitment to do this.

So, we are putting effort and money in. We're supporting improvements through the national Every Day Counts programme and the discharge to recovery and assess pathways. We've invested in new initiatives through the integrated care fund and the transformation fund, where, of course, local authorities, health boards and the third sector all work together to come up with solutions.

The Swansea Bay region is putting in a number of measures, including through investing over £1 million in its hospital-to-home service, which they told me about in detail last week. That is supporting early discharge. These actions have led to improvements, so, certainly, in November and December the delayed transfers of care were reduced.

You mentioned the transformation fund, Minister, and the delayed discharges into community settings. One of the barriers is still around the whole area of funding, particularly if a person requires funding from both the health service and from the social services because of the mixed care package that they require. Quite often, there are—a kind way, perhaps, to describe it—marginal turf wars. People have got their own budgets, they've got to protect their budgets and they have to account for their budgets. I wondered what work is being done, through the transformation fund, particularly in 'A Healthier West Wales', where all of the organisations are supposedly coming together to deliver better outcomes for patients and getting them out of hospitals and back into community settings. I wonder if we're able to start learning some lessons about how we can resolve these funding issues, so that, whatever else happens, getting somebody out of a hospital and back into their home or into residential care—the block is not because of funding and who pays what element of the care that person requires. 

Angela Burns is right, there is sometimes difficulty over those different elements of funding. But it's absolutely essential that the patient, the individual, is at the absolute centre of the way that decisions are made. And I know that there have been projects, under the transformation funding, looking at how that can develop, and I hope that we'll be able to learn through that. Continuing care is one issue that has to be addressed, and I think we've had a statement on that fairly recently, and I know that we are looking at certain elements of community care and reviewing them.