3. Will the Minister make a statement on the availability of emergency stroke services in Cardiff? OQ56928

Emergency stroke services in Cardiff are the responsibility of Cardiff and Vale University Health Board. Patients attending the University Hospital of Wales emergency department are prioritised for assessment and imaging to diagnose stroke, and are placed on the fully integrated stroke pathway.

Thank you, Minister. One of my constituents was correctly diagnosed as having a stroke by a 999 call handler and obviously confirmed that he needed to be seen as an emergency in the Heath hospital. Because it was unclear how long it would take for an ambulance to arrive, the family informed 999 they would take him to hospital themselves, but, on arrival, they got stuck in the emergency department for 27 hours before he was admitted to the acute stroke ward. Now, I fully appreciate the unprecedented pressures that the emergency services are dealing with, and screening people for COVID who arrive unannounced is an important part of ensuring we keep COVID out of hospitals. But, as Cardiff and Vale pioneered a new phone triage system to stop people backing up in the emergency department during the pandemic, how can we improve the interface between 999 and Cardiff and Vale's 24/7 so that, once diagnosed, they're actually being directed to the specialist clinicians they need to see?

Thanks very much, Jenny. I'm really sorry to hear about the situation that your constituent found themselves in. I think that is obviously wholly unacceptable and very difficult, and certainly nobody should be waiting 27 hours after a stroke. But, obviously, it's difficult for me to go into detail about individual matters. As you say, the pressures on our emergency services continue to remain extremely high at the moment. There is a complex range of national and local challenges across the system that are impacting on that patient flow, and that includes incredible demands that are coming from the public, as well as asking the workforce who have been at it for such a tremendous amount of time now. But, as you say, I think that the triaging system in Cardiff is something that is pioneering, trying to avoid people coming in, getting them to phone first and then trying to get them to the right place. So, it is rather surprising that they weren't directed to a more appropriate place. But it may be that the system is just trying to keep people away from hospital, rather than specific places in the hospital, and it may be worth a chat about seeing if that system can be tweaked somewhat. But I know, in terms of Cardiff, that there are some very innovative programmes when it comes to stroke, that 72 per cent of stroke patients in Cardiff have also access to supported discharge and there has been an award-winning programme in Cardiff and Vale, the Stop a Stroke campaign, and 90 per cent of practices have taken part in that programme.

The Sentinel Stroke National Audit Programme—the SSNAP—published a UK-wide audit of stroke services in our hospitals, and Wales plays its part in contributing data on a regular basis to this important work. Their acute organisational audit report in December 2019 showed that only 30 per cent of hospital sites across the UK had the recommended level of registered nurses working at the weekend. Can the Minister confirm if any of these hospitals were in Wales, and, if so, what is being done to ensure the right number of nurses are in our stroke units? Thank you, Minister. 

Thanks very much, Altaf, for that question. Obviously, I'm always very aware, when I respond to you, that I'm speaking to an expert, so I always have to be, probably, more careful with you than anybody else in this Chamber. [Laughter.]

I think it's absolutely right that we have to keep an eye on the numbers of nurses. And, of course, we do in Wales have legislation around that, and that is a unique piece of legislation that has not been enacted across the rest of the United Kingdom, where nursing staff levels are a legal requirement. And I was pleased to be able to speak to the Royal College of Nursing this morning about that situation and the implementation of that. So, we are in a different place from other parts of the UK in terms of nursing. I think there are other things that we can do in relation to stroke in Wales—promoting atrial fibrillation within primary care is something else that I'm very keen to see if we can pursue.