6. Debate on the Health and Social Care Committee Report: Hospital discharge and its impact on patient flow through hospitals

Part of the debate – in the Senedd at 4:55 pm on 12 October 2022.

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Photo of Russell George Russell George Conservative 4:55, 12 October 2022

Thank you, Deputy Presiding Officer. Can I thank all Members for taking part in this debate this afternoon, and I particularly thank—I think Gareth Davies made a point in his contribution of thanking the clerking team and the wider research team that support our committee’s work, so I’d like to put that on the record from myself as well.

I think that it was Rhun and Sarah who talked about the need for step-down beds, and the need to allocate funds for step-down beds fairly across health boards was a point that I think Sarah made. The Minister, in her contribution, referred to that, and I welcome some of the contribution that the Minister made in terms of building more community capacity. Also, I think that Rhun, in his opening remarks, talked about the importance of considering patient flow. I think that we do need to look in the round, and examine where the barriers lie, and of course remove and address some of those barriers.

Joyce mentioned, in her contribution perhaps why the committee has focused on hospital discharge. We had quite a discussion about this in committee: long-standing issues, social care capacity, health and social care integration, the workforce crisis that we are in. And Joyce highlighted, of course, the plight of unpaid carers as well, and some of the challenges that they have now. Joyce also put the question as well that we need to know more about why people are leaving the social care profession. I think that we know that to a certain extent, but I think that there is more that we can do to understand why that is.

Many Members mentioned those beds that—. I mentioned in my opening comments the ambulances queuing outside hospitals. I think that it was Huw who mentioned—and it was a good phrase—the queuing of ambulances as a symptom of patient flow. So, while I mentioned that, and we are all aware of those ambulances waiting outside hospitals, so patients and people who need those beds can’t get in there, there is the other side to this as well, which Joyce and Jenny referred to, about people’s health deteriorating when they are in hospital beds, and when they themselves need to go home for their own health as well, but in terms of the frustrations of people in those beds who can’t get home. Jenny gave an example of one of her constituents, but perhaps not all of those have got the skills to advocate for themselves to get home, which I think was the point that Jenny was making.

Many made the point as well about the need for people to get home as quickly as possible, but again, of course, we know that this then links to some of the issues that we have within care staffing levels. Gareth, importantly, mentioned the issues around data. This is part of the report, and some of the issues that we made some recommendations around. But he was also mentioning around the pay and working conditions as well. But, importantly, we need to make the profession more attractive, don’t we? And pointing out as well the exacerbated pressures that we will have this winter.

I thank Sarah for, quite rightly, pointing out the praise for organisations such as the Red Cross and Age Concern. I think that both the Minister in her response and Huw talked about the complex issues, and also rising demands and rising expectations as well, and that a whole-system approach is needed, which Huw and the Minister both referred to. 

In terms of the Minister’s response, the Minister talked about the need for people to get home quickly as well, but of course, people can’t get home if those services aren’t available to support them. I very much welcome, particularly as a rural constituency Member, some of the discussion from the Minister around having services as close to home as possible. I very much welcome that from a very rural perspective.

There is a huge need there for recruitment, and the drive for recruitment, and the Minister mentioned that in her closing remarks, and the huge campaign that is behind that. But what I would have liked to have known a little bit more about is how successful that campaign has been, and has that campaign been effective. I think it would have been good to know a little bit more about that. But I’m pleased with the Minister in terms of some of those integration problems I mentioned at the beginning, with GDPR and other systems working together. In my opening comments, I talked about fax machines still being not only used but bought in the NHS. It’s good to see the improvements in terms of the integration of systems are making good progress, and obviously as a committee we’ll keep a particularly close eye on that. Diolch yn fawr.