Part of the debate – in the Senedd at 4:31 pm on 12 October 2022.
I recall about 10 years ago the then chief executive of the Cardiff and Vale health board telling me that in the Heath hospital—our tertiary hospital—the average age of patients was 84 years old, and I very much doubt that that age profile has changed. So, I don't think we should be blaming hospitals for the situation we're in. Everything tips up in the hospital because the other services aren't there. We are never going to arrive unless we are redirecting resources from those hospitals where we have these emergency responses. We have to therefore strengthen community nursing.
Nobody wants to spend more time in a hospital than is medically necessary for them to be there, unless, of course, they haven't got a home to go to that is suitably equipped to meet their needs for convalescence or ongoing needs. I recall one of my constituents, who was a former headteacher, who, aged 93, went into hospital because he had a urinary infection. He played absolute merry hell with me, the MP, the police commissioner, to get him out of there, as well as his family, because he just did not want to be there any longer. Obviously, being a former headteacher, he was somebody who was used to being obeyed, even though he was in his nineties. But you can imagine how somebody else, who didn't have that skill set, would just be left there to die. We cannot go on like this. Nobody wants to die in hospital at all. I certainly don't.
District nursing is not a new idea. It was pioneered in Liverpool in the 1860s and it was an important forerunner of the NHS. It used to consist of a nurse with a bag of kit strapped to the back of a bicycle. But modern district nursing needs to use electronic case load scheduling to optimise safety and cost-effectiveness. I recall visiting the Cwm Taf neighbourhood nursing team in 2020 just before lockdown and heard how the e-scheduling system saved the senior management absolute hours of scheduling to take account of people either going into hospital or people coming out of hospital who needed to be added to the number of people they needed to deal with.
I know that this is something that the Minister is working on, and I'm very glad to hear the progress that is being made, because it really is one of the keys to changing the dial on this system. Because what it does is enable us to understand the demand for district nursing services where there is capacity or need to support the system to prevent admissions and to facilitate discharges. The team leader has got to be able to understand what demand the neighbourhood requires and what skill and volume of staff they're going to need to meet it. This has also enabled teams to safely incorporate the skills of healthcare support workers into their teams and release more highly qualified registered nurses to deliver more complex care. Understanding capacity and demand on an hour-by-hour basis can enable district nursing services to flex the workforce to meet the demand and to respond to any short-term financing issues. So, I'm really pleased to understand—[Interruption.] Altaf, did you want to make an intervention?