5. How is the Welsh Government working with Cwm Taf Morgannwg University Health Board to increase the capacity of step-down beds for patients across Bridgend? OQ59109

Working with the Welsh Government, Cwm Taf Morgannwg University Health Board and Bridgend County Borough Council have 48 step-down beds and community packages across Bridgend. This contributes towards the all-Wales total of 595 beds that have been created to support the discharge of people from hospital this winter.

Diolch. Thank you, Minister. Last month, the Royal College of Emergency Medicine hosted an event here in the Senedd on the future of emergency care in Wales. The event heard from clinicians on the ground who spoke about the need for a long-term sustainable strategy. Data shows that whilst attendance to A&E is similar year on year, capacity continues to be stretched. We know that there are a range of issues causing this, from patients having high complex needs to a reduction in community beds across Wales and the need to increase staffing levels of consultants. At the event, Bridgend was represented by our clinical director of emergency care for the Princess of Wales Hospital, and it was good, actually, to hear that the No. 1 issue, as it is in many other places, is not actually staff recruitment. However, it is the lack of community beds that is creating a slow hospital flow and thus impacting waiting times, because Princess of Wales has about 300 beds, and 160 of those are filled with medically fit patients, and 80 of those are simply waiting for a community or step-down bed. Bridgend is facing an exit block.

I appreciate the Welsh Government is working hard to combat these issues across Wales. The 595 community beds for Wales are welcome, but it is disappointing that just 15 of these beds reached Princess of Wales. How, then, Minister, is the access to more community beds determined, and what more can be done to ensure that those 80 patients in Bridgend, waiting in our hospital, can be discharged, improving the flow of patients through Princess of Wales as well as their care? Diolch.

Diolch. As the Member knows, the focus for health and social care in Wales is on strengthening our community-based services. We want people to live at home, as independently as possible and for as long as possible. Although it is extremely challenging, I think there is an emerging picture of improved patient flow and reduced length of stay for some of our oldest and frailest patients, and that's partially contributed to a stable performance position in the NHS, despite the significant challenges that have been faced this winter. 

Regarding the additional step-down beds and the community care packages created over the winter, as I described in my initial response, the total number now does stand at 595. And I know, in Bridgend, between 450 and 500 hours of extra reablement care have been commissioned and are being delivered locally.

Minister, the provision of step-down care is vital if we are to tackle the ever-growing waiting times experienced by patients in my region and across Wales. Of course, if a previous Welsh Government had not closed community hospitals and overseen the removal of over 10,000 beds from our NHS, we might not be in this predicament today. However, what is important now is that step-down care is provided in as safe a manner as possible. Minister, I have received a number of reports that patients have been transferred to step-down beds whilst not medically stable. In such cases, the step-down ward has to depend on the ambulance service for emergency medical care. What steps are your Government taking to ensure that there are no unsafe transfers to step-down care and that any step-down bed has adequate medical as well as domiciliary care?

Well, you used the very important word, and that was 'safe', and that is absolutely the priority. On 5 January, the Minister for Health and Social Services' officials held a national discharge summit with all regional partnership boards across Wales, to reiterate her expectations for every effort to be made to keep people at home and not admit them into hospital in the first place unless absolutely necessary, and, of course, the reverse, to enable those in hospital to leave hospital as soon as it was safe for them to do so, to help preserve our hospital capacity and prevent the risks associated with a prolonged hospital stay.