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Mark Drakeford, Minister for Health and Social Services

First published:
10 December 2013
Last updated:

This was published under the 2011 to 2016 administration of the Welsh Government

This time last year we were already experiencing a difficult winter. It went on to become particularly long and brought with it many service delivery challenges. By 23 April, when I made my statement to the Assembly, it was clear that a concerted effort was needed to plan and improve unscheduled care services. I therefore announced a wide range of actions, all of which would be taken forward through a National Unscheduled Care Programme.

The work of this Programme has included the appointment of a National Clinical Lead and lead Chief Executive to ensure the improvement programme is embedded in the service. It has focused on patient flows, capacity issues, collaborative working between health and social services and enhanced monitoring and intervention.

The programme has had a positive impact. Performance levels have improved with reductions in 12 hour waits, reduced ambulance handover delays, improved category A response times and A&E 4 hour performance. Our planning for this Winter has been necessarily rigorous. Whilst there will undoubtedly be difficult days during the remainder of this winter, we are now better prepared to meet these and deliver further improvements.

Our planned care system is also facing challenges. Some of these are a consequence of the pressure in our unscheduled care system. However, others relate to working practices and delivery arrangements. Whilst there are many areas of strength, there are others which now need to be modernised. There is a need for significant and urgent change.  

I have therefore decided to replicate the model introduced last year for Unscheduled Care through a National Planned Care Programme. The Programme will be led by a Chief Executive and will have a National Clinical Lead for Planned Care who will draw on expertise from other areas as necessary. They will work closely with relevant Royal Colleges to develop sustainable improvement in planned care performance. A National Oversight Board, with an external chair, and significant external representation will be established. I want to ensure our plans are fully tested against national and international benchmarks.

The Programme will include a number of work streams: Better managing capacity and demand; ensuring appropriate thresholds for treatment; optimising workforce contributions; and ensuring sustainable delivery arrangements. The impact of the age of austerity in our services is real, as are the effects of demography and new advances in medicine. This Programme will focus on the continued provision of high quality, dependable planned care services for the future, in this context.  

Just as our planning for the winter of 2013-14 began in March of this year, so I want the planning for the post winter period to begin now. In this way we will be able to make necessary changes and introduce agreed new practice during the first half of 2014.