Hospital waiting lists

30 March 2022

Dear

Complaint in respect of ATISN 16046 – Waiting Lists

I am responding to your email of 2 March 2022 in which you asked us to review our response to your request for information under the Freedom of Information Act (“FOIA”) 2000. This letter is to inform you of the outcome.

In your original request dated 2 February, you requested:

1. Copies, from January 2019 to 7^th April 2021, of any Ministerial instruction, guidance or request to Dr. Goodall to address the issue of waiting lists.
2. Copies for the same period of any Ministerial instruction, guidance or request to any Board or individual to address the issue of waiting lists.
3. As a result of a Response to a FOI Request I was informed that from the start of the Covid outbreak to the end of September 2021 that 971 persons had died from Covid in The BCUHB Area and that of these 348 had died as a result of probable or definite Hospital Acquired Infection. This amounted to almost 36% of those who died. What are the equivalent figures for the other Welsh Health Boards for the same period?

In respect of questions 1 and 2, our response (dated 24 February) explained that there are no records of Ministerial instructions to Dr Goodall such as you had requested, because waiting times are a Government priority and part of the day-to-day management of the NHS in Wales. We provided a link to a document about NHS recovery following the pandemic, which contained information about waiting times.  We also provided a link to a Welsh Health Circular about the management of people with suspected cancer that set out the expected waiting times.

Furthermore, we explained that the Minister for Health and Social Services meets quarterly with the Chairs of NHS Wales Health Boards. We provided extracts of two letters in which waiting times were specifically mentioned.

With regards to question 3, we provided links to the Office for National Statistics and Public Health Wales dashboards which provide information regarding deaths from all causes within 28 days of a positive Covid test – not deaths specifically due to Covid-19.  We also provided a table which gave a breakdown of deaths following hospital onset of COVID-19 by health board.  Your reply says that BCUHB was able to provide you with information about the number of deaths resulting from hospital acquired infection as well as the overall number of deaths from Covid-19 in the health board area, and that Welsh Government should be able to provide the same information for the other health boards in Wales. But as our response confirmed, the Welsh Government does not hold this information. Instead, it is held by the Office for National Statistics (ONS) and/or Public Health Wales (PHW). In the circumstances, and in accordance with our duty under section 16 of the FOIA (to provide advice and assistance), we provided links to the information on the websites of ONS and PHW. In my view, this was the correct response.

In your email dated 24 February, you indicated that you did not feel that our response was helpful and provided further comments on 2 March in which you stated that you felt that your request was clear and that our responses “avoid and evade” your questions. You provided further comments and observations, requested additional information and also requested that an internal review be undertaken. The request for additional information is being treated as a new request for information and you should have received acknowledgment of this.

Among the comments that you provided in an attachment to your email on 2 March, you have asked a lot of questions about the information that we provided. The FOIA provides a means for you to request copies of recorded information that is held by Welsh Government. What you do with the information that we provide to you is up to you. We cannot always help you to interpret the information– especially when some of the information to which you refer did not come from the Welsh Government.  This is not because we wish to avoid or evade your questions. We try to be as helpful as possible in answering questions about the information when it is both possible and reasonable to do so – in line with section 16 FOIA.

For example, you asked the question: “Are you stating that in BCUHB Hospitals that from the start of the Pandemic to the end of September 2021 402 (over 41%) persons had died from Covid as a result of probable or definite Hospital Acquired Infection?”

The answer is no. The table of information we provided says that in Betsi Cadwaladr UHB, up to September 2021, there were 402 deaths from any cause, following hospital-onset of Covid-19.

I have reviewed our response to your FOI request in accordance with the procedure stated in my previous letter to you (dated 3 March). We interpreted your request as a request for any Ministerial instruction, guidance or request (in the period from January 2019 to 7April 2021) to Andrew Goodall and/or any Board or individual to address the issue of waiting lists. I confirm that the Minister held weekly meetings with Andrew Goodall and it is likely that they discussed waiting times, but we do not hold copies of any Ministerial instruction, guidance or specific requests to address the issue of waiting times. I therefore do not uphold your complaint.

If you remain dissatisfied with this response you also have the right to complain to the Information Commissioner at: 

Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Tel: 01625 545 745
Fax: 01625 524 510
FOI and EIR complaints | ICO

Also, if you think that there has been maladministration in dealing with your request, you have the option to make a complaint to the Public Services Ombudsman for Wales who can be contacted at:

Public Services Ombudsman for Wales 
1 Ffordd yr Hen Gae 
Pencoed 
Bridgend 
CF35 5LJ 

Telephone: 0845 6010987 (local rate) 
Email: ask@ombudsman-wales.org.uk

Yours sincerely

 

Stephen Probert CEng FIET
Deputy Director of Operations

 

 

24 February 2022

Dear 

ATISN 16046 – Waiting Lists

Thank you for your request to the Welsh Government for information under the Freedom of Information Act (2000) received on 2 February 2022. You requested the following: 

1. Copies, from January 2019 to 7 April 2021, of any Ministerial instruction, guidance or request to Dr Goodall to address the issue of waiting lists.
2. Copies for the same period of any Ministerial instruction, guidance or request to any Board or individual to address the issue of waiting lists. 
3. As a result of a Response to a FOI Request I was informed that from the start of the COVID outbreak to the end of September 2021 that 971 persons had died from COVID in The BCUHB Area and that of these 348 had died as a result of probable or definite Hospital Acquired Infection. This amounted to almost 36% of those who died. What are the equivalent figures for the other Welsh Health Boards for the same period?

Our response

Q1. Q2. There are no Ministerial instructions to Dr Goodall asking him to address the issue of waiting times in the form you have requested. This is because addressing waiting times is, and always has been, a Government priority and part of the day-to-day management of the NHS in Wales. The document we published on 22 March 2021 on NHS recovery following the pandemic deals extensively with the issue of waiting times. 

During the period you outline, as well as the letter you have already seen from Dr Goodall dated 7 April 2021, we also published a Welsh Health Circular (WHC) on 14 January 2021 on the management of people with suspected cancer which sets out the expected waiting times. 

The Minister for Health and Social Services also wrote to the NHS Wales Chairs on 20 December 2019 and July 2021 following their quarterly meetings in which a number of issues were covered, including asking the NHS Wales Chairs to place a specific focus around waiting times. An extract from those letters are as follows: 

December 2019 …On performance, we are frustrated and disappointed by the poor performance across a number of areas despite the early allocation of both RTT and unscheduled care funding. Given the significant investment including increasing allocations, I expect to see improvement made and for health boards to meet performance plans. You are reminded that if improvement does not materialise there is a risk that funding will be clawed back. I am disappointed in the increasing number of people waiting over 36 weeks on the RTT pathway, with the figure more than doubled from the end of March. …I also expect action and operational grip.

July 2021 …Tackling waiting times for planned care remains a priority. Organisations are urged to share and implement best practice wherever possible. We will introduce e-prescribing across Wales and an announcement will be made in due course on how we will implement this in secondary and primary care. The system now needs to capitalise and build on new ways of working which were adopted during the pandemic, guided by the principles contained in the National Clinical Framework which we published on 22 March. We highlighted the need for measurable Public Health outcomes, outcomes that can be measured over 3 plus years and the need for a robust mechanism to measure these outcomes and not solely measure waiting lists. Thank you for your offers to help create and test these new measures this will be extremely helpful in ensuring these new measures are a success. 

Q3. The Office for National Statistics (ONS) collect and produce mortality statistics for England and Wales based on information from the death registration process. The ONS publish monthly statistics on deaths due to COVID-19 (i.e. where COVID-19 was identified as the underlying (main) cause on the death certificate) which can be broken down by area.

These reflect deaths by place of residence and therefore may differ to figures provided directly by health boards. The Welsh Government does not hold information on the number of these individuals that have died as a result of probable or definite hospital acquired infection.

Public Health Wales (PHW) publish the number of hospital-onset cases on their dashboard weekly. PHW have previously provided Welsh Government with estimates for the number of people who have died from any cause following probable or definite hospital-onset of COVID-19. These figures are based on the hospital where a person died (rather than where they resided) and represent deaths from all causes within 28 days of a positive COVID sample. They do not represent deaths from COVID-19. For these reasons, the data cannot be compared to the ONS data above or used to calculate a percentage.

The table below provides the breakdown by health board.

Deaths from any cause, following hospital-onset of COVID-19 by health board, up to September 2021.

Health board	Number of deaths
Aneurin Bevan UHB	364
Betsi Cadwaladr UHB	402
Cardiff and Vale UHB	311
Cwm Taf Morgannwg UHB	458
Hywel Dda UHB	241
Powys THB	24
Swansea Bay UHB	337
Velindre NHST	2
Wales Total	2,139

Next steps

If you are dissatisfied with the Welsh Government’s handling of your request, you can ask for an internal review within 40 working days of the date of this response. Requests for an internal review should be addressed to the Welsh Government’s Freedom of Information Officer at: 

Information Rights Unit
Welsh Government
Cathays Park
Cardiff
CF10 3NQ 
or Email:  Freedom.ofinformation@gov.wales

Please remember to quote the ATISN reference number above. You also have the right to complain to the Information Commissioner. The Information Commissioner can be contacted at: 

Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

However, please note that the Commissioner will not normally investigate a complaint until it has been through our own internal review process.

Yours sincerely