Diolch yn fawr, Llywydd. Thank you for the opportunity to update Members on NHS winter pressures. Members will appreciate this winter is proving to be particularly challenging for health and care services across the United Kingdom. This is our third winter of living with COVID. While we knew respiratory viruses would become more prevalent this year, the disruption of seasonal patterns has made the likely impact of these viruses much more difficult to predict. Despite this, we are still delivering around 376,000 consultations and procedures a month in secondary care, in hospitals. In December, we reached about 400,000 contacts in GP and primary care services. So, every single day, every week, there are thousands of people receiving excellent care in the NHS in Wales, but what we do accept is that there are many others who are not receiving the care that they deserve.    

We have asked a lot of our staff over the last two and a half years, and we know pressures have meant staff have often not been able to consistently provide the level of care that they want. We also recognise the strength of feeling amongst our workforce, as reflected in the announcement of further planned strike action amongst ambulance unions, as well as the continuing action by the Royal College of Nursing. It's important to note the impact on capacity as a result of recent industrial action, and that has placed additional pressures on our systems due to reduced staffing and, in some cases, limited or no availability of certain services during these periods.

We are dealing with an increasingly complex case mix of patients. We have more than 500 confirmed patients with COVID in our hospitals and we're seeing rapid increases in other respiratory viruses. In addition, other groups of patients are presenting with increased levels of serious illness, and, while the position has improved since Christmas, there are still over 900 people in hospital beds who are ready to leave but have had their discharge delayed for various reasons. Sickness absence rates among staff have also increased to 6.9 per cent. The result is greater prevalence of long delays for people trying to access care, and the risks of harm we know are associated with such delays. As a consequence, the experiences of people seeking urgent and emergency care across Wales have not always been to the standard that they deserve, and for that I am truly sorry.

We went into the winter having seen record levels of demand on the 111 and ambulance services in October and November, with every expectation that these pressures would increase further throughout the winter. But let me give you an example of the extreme pressure that we saw on our services on 27 December: the 111 telephone service received the highest number of calls ever reported for a single day; the ambulance service received 210 immediately life-threatening calls, amongst the highest daily figures on record. We think 100 is high, and we had 210 on that particular day. As the First Minister said earlier, over 550 people were admitted to hospital in one day. That's the equivalent of around 5 per cent of the available bed capacity in Wales. There were 551 COVID patients in acute hospital beds, which is over 5 per cent of total bed capacity, and around a further 3 per cent of beds were occupied by patients in hospital with influenza. There was also the equivalent of 12 per cent of the total bed capacity in Wales taken up due to delayed discharges.

Now, this level of pressure, at a time when staff illness and absence have had a significant impact, has created massive challenges for the system. Planning for winter started as early as April. We’ve worked hard, every fortnight meeting with local authorities to secure over 500 extra community beds for step-down care, and we’re working towards more over the coming months, which will help improve flow throughout the health system.

We must learn from the recent weeks and months, and we are committed to working with clinical leaders and professional bodies to support meaningful service redesign. We know one of the biggest challenges the health system faces is helping people to leave hospital as soon as it's safe for them to do so. Last month, I launched a new discharge planning guidance report, which sets clear expectations for health boards and regional partnership boards, and that is supported by a national flow programme. In April, we made a five-year commitment of £145 million through the regional integration fund to enable regional partnership boards to build on models of care developed to support rapid discharge and admission avoidance.