Ein cyf/Our ref: MA/P/VG/2175/17


Dr Dai Lloyd AM

Chair, Health, Social Care and Sport Committee

Cardiff Bay

Cardiff

CF99 1NA


4 July 2017



Dear Chair,

 

Thank you for your letter of 7 June 2017 that seeks an update on a number of recommendations from the Health, Social Care and Sport Committee’s report into Winter Preparedness for 2016/17.  Please find my response to each of the points you raise below.

 

Recommendation 3. The Cabinet Secretary should ensure that arrangements are in place to evaluate the effectiveness of all Welsh Government campaigns relating to winter health, and to publish the lessons learned quickly. He should also ensure that arrangements are in place for effective whole-system learning from these evaluations.

 

The Choose Well campaign is the Welsh Government’s principle method of communicating messages to citizens on how to best prepare for the winter period and which service to access for their health needs over winter. Evidence gathered this year suggests messages are getting through to the public about self care actions and appropriate use of Emergency Department (ED) with a 13% increase in attendances at Minor Injuries Units and an approximate 17% reduction in attendances at ED among the 17-24 age cohort since the campaign was launched in 2011-12.

 

We will continuously evaluate all communications campaigns against the objectives set at the start of the campaign and, alongside this, new research was commissioned at the end of the Choose Well annual campaign in March 2017 as part of the Wales Omnibus Survey.

 

A report highlighting detailed findings is due to be published in summer 2017 on the Welsh Government Social Research (GSR) web page. In line with the GSR protocol, figures can only be used internally until publication. However, initial findings were positive and we will use the same questions at the end of the next campaign to measure progress. The findings will also be used to shape the campaign for next year. Planning is underway and will engage and involve stakeholders with complimentary winter campaigns including Age Cymru (Spread the Warmth) and Public Health Wales (Beat Flu).

 

The findings and emerging plans for next winter for Choose Well will also be presented at a forthcoming National Programme for Unscheduled Care (NPUC) steering group meeting for consideration on how messaging can be developed further for next winter.

 

Recommendation 4. The Cabinet Secretary should report back to us at the end of the next quarter with details of progress against targets for the additional £50 million investment by the Welsh Government in winter pressures for this year.

 

The £50 million was distributed to health boards in Wales as detailed in the table below, to help maintain an improved performance trajectory over the winter period.  However, to ensure that the funding was only used to deliver performance improvements, £5.1 million was clawed back from Abertawe Bro Morgannwg University Health Board at the year end as they did not deliver against their agreed plans.

 

Local Health Board

Fairshare split

(£m)

ABM UHB

9.33

Aneurin Bevan UHB

9.97

Betsi Cadwaladr UHB

11.09

Cardiff and Vale UHB

7.50

Cwm Taf UHB

5.80

Hywel Dda UHB

6.31

All Wales

50.00

 

Over the winter period, RTT performance was generally better than it was when compared to the previous year:

 

-       end of March 2017 26 week performance was 88% which is 1.2 percentage points higher than March 2016;

-       36 week numbers were 28% fewer than March 2016 and the best they had been since March 2014; and

-       diagnostic eight week waits were the fewest they have been for six years; and

-       cancer 62 day performance was the best it had been since November 2014.

 

On postponed procedures, there were 564 (4%) fewer postponements on the day or day before a planned procedure over winter 2016-17 than the previous winter, with the proportion of patients who had their procedure postponed due to a lack of a bed, either on the day or day before, 965 (38%) lower than winter 2015-16.

 

Ambulance responsiveness, patient handover and performance against four and twelve hour standards was generally better than during winter 2015-16 despite, at times, record levels of demand.  For example, the ambulance service responded to 77.9% of Red calls within 8 minutes (12.2% better than March 2016), performance against the 4 hour target improved by 4.4%, 12 hours reduced by 27% and ambulance handover delays reduced by 45%.   I continue to expect more resilience and an improvement in performance on outcomes.

 

 

 

 

 

Feedback to the Committee from the Royal College of Physicians (RCP) and Royal College of Emergency Medicine (RCEM).

 

In February 2017, the NPUC commissioned a review of the resilience of health and social care services over winter 2016-17 which has now concluded and a report will be published shortly to inform planning for next winter.

 

Both the RCP and RCEM helpfully contributed to the review with the RCP response suggesting many members felt lessons had been learnt while being clear there was work to be done to support improved resilience for next winter. The College was also clear that clinicians should be involved at an early stage in the planning process.  As you will recall, the RCEM is a member of the Unscheduled Care Programme Board.

 

Similarly, the RCEM felt that concerted efforts had been made to improve winter resilience in recent years, although services remained under pressure, identifying a number of areas for improvement. The review considered this evidence alongside feedback from other professional bodies, staff, patients and system leaders in developing the report and recommendations to support whole system improvement. The Deputy Chief Executive for NHS Wales wrote to Local Health Boards in April with emerging findings to ensure time is not lost in preparing for next winter.

 

The intention is for the report to be published in July 2017 and I will share a copy with the Committee upon publication.

 

I would expect this important work to support organisations in their planning arrangements, ensuring lessons are learnt and that appropriate action is taken to ensure we continue to build on the progress made in recent years and further increase resilience on a sustainable basis.

 

 

Yours sincerely

 

 

Vaughan Gething AC/AM

Ysgrifennydd y Cabinet dros Iechyd, Llesiant a Chwaraeon

Cabinet Secretary for Health, Well-being and Sport

 

Cc:  Rebecca Evans AM, Minister for Social Services and Public Health