Skip to main content

Eluned Morgan MS, Minister for Health and Social Services

First published:
19 May 2022
Last updated:

The ongoing impact of the pandemic on the NHS together with increased demand for emergency care continues to place intense pressure on the NHS, which is most visible in urgent and emergency care services.

This statement updates Members about the latest position and our plans to support and improve urgent and emergency care services across Wales.

Performance is not where we, the NHS or the public want it to be. Throughout the UK – and in many other parts of the world – health services are experiencing similar challenges, as a result of the combination of pandemic and emergency pressures.

However, despite this, every day our NHS continues to successfully treat tens of thousands of people who need emergency and urgent care. NHS staff provide life-saving and life-changing care, sometimes under challenging and stressful circumstances. I want to pay tribute to their hard work, determination and dedication to the service and to patient care.

A number of factors are combining to create the current pressures, which the NHS is experiencing, including increased demand; higher-than-normal levels of staff sickness absence, not just related to Covid-19 and delays in discharging people who are ready to leave hospital. I have discussed these challenges with clinicians, professionals and managers, and have visited emergency departments all over Wales.

High levels of people who are medically fit to leave hospital but are unable to do so because of a lack of capacity in the community prevents flow within the whole health and care system, which is manifested in delays at the front door of the hospital – the emergency department. The lack of capacity in the community has been caused by a number of factors, including closures of care homes and beds in some areas of Wales, due to outbreaks of Covid-19, and a wider shortage of social care staff across the sector.

We are working hard to address the wider issues facing the social care sector – last month we introduced the Real Living Wage for social care, which in turn is part of our work to improve terms and conditions and encourage more people to consider a rewarding career in care.

Ensuring people are able to access the right care, in the right place, at the first time when they need help is at the heart of our plan to support the NHS and improving access to urgent or emergency care.

Almost a month ago, I launched the new Six Goals for Urgent and Emergency Care programme, which is supported by £25m a year.

We have made some early progress:

  • NHS 111 Wales is available all over Wales. People who have urgent care needs can be signposted to the right care, in the right place, first time. NHS data shows more than 146,000 people have used the service since it became available nationally.
  • Eight urgent primary care centres have opened and another will follow this month. These have helped more than 70,000 people access care closer to home without needing to visit an emergency department.
  • A new policy was introduced last month to enable some patients to be referred directly to new same-day emergency care services by ambulance rather than being taken to an emergency department. Same-day emergency care services are being phased in at hospital sites across Wales. These services are based next to emergency departments and are used to treat and observe people with certain conditions throughout the day with the intention that they will be able to be sent home later that day. We are working towards these new same-day emergency care services becoming available 12-hours-a-day, seven-days-a-week.
  • A new, world-leading ambulance triage system is being introduced, which will eventually enable video assessment so people who call 999 can be assessed and some will be successfully helped without the need for an ambulance being dispatched.

The launch of the Six Goals programme is an early marker in our planning for winter 2022-23. I expect objectives to be progressed with pace and purpose over the remainder of the year to put the emergency care system in the best position possible for what will be a difficult winter period for health and social care services.

We will use a range of measures to track progress against the programme and have set service improvement trajectories for key parts of the urgent and emergency care system.

Given the complexity of the urgent and emergency care system, we must be realistic about the pace of improvement. However, we expect to see the following improvements this year and in the lead up to winter:

  • Achievement of a ‘consult and close’ rate of 15% by the Welsh Ambulance Service, with more people safely discharged over the telephone without an ambulance dispatched, where appropriate
  • Health boards will be expected to eradicate ambulance patient handover delays of more than four hours and reduce the average ambulance time lost per arrival by 25% (from the October 2021 level) at each hospital site
  • Continuous improvement in accessibility to same-day emergency care services throughout the year, helping more people to safely return home on the same day of their visit to hospital
  • Continuous improvement  to reduce number of people who spend more than 21 days in a hospital bed following admission, helping them to maintain their independence and reduce the risk of re-admission.

The Six Goals programme board will require health boards to present their plans in summer 2022 and again in October 2022 to understand progress as we approach winter. Delivery of plans will be subject to robust scrutiny.

The Emergency Ambulance Services Committee has allocated £1.8m to the Welsh Ambulance Services NHS Trust as a short term measure to enable immediate continuation of support from St John Ambulance Cymru and provide other additional capacity to meet demand.

I will provide a further update on progress before the summer recess.