Welsh Government
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Minister sets out action to tackle pressure on A&E departments

Health Minister Mark Drakeford has set out a number of immediate actions to tackle pressures on emergency health services in Wales, along with longer-term plans to ensure future problems are prevented.

Short term measures focus on tackling lengthy patient handover delays at A&E departments and improving discharge arrangements to enable medically fit patients to leave hospital beds in a timely manner.

These issues are a major cause of pressure felt across Wales’ A&E departments and all Local Health Boards have submitted plans detailing how they will achieve improvements in these areas, in conjunction with NHS Wales and Local Authority partners.

The Health Minister has stated clearly that these plans must encompass health services in the community, including GP Out of Hours services.

As well as freeing up hospital beds by speeding up health and social care assessments and discharges from hospital, current guidance will be enforced so patients will be transferred to appropriate interim accommodation, pending the availability of a placement.

The Minister also announced action to change the policy which applies when the NHS and social services cannot agree financial responsibilities between them. In such circumstances the patient should be transferred to a suitable out of hospital setting rather than remain in hospital until the financial issue is resolved.

A new Lead Chair for Unscheduled Care, who will act to ensure uniform implementation of the actions announced recently across Wales, has also been named. The Minister announced Dr Chris Jones, Chair of Cwm Taf LHB, will take on this role.

In the medium term, the Minister promised a rapid response to the review of the ambulance service, due to be debated in the National Assembly on 7 May.

Mark Drakeford said:

"Over the past six months, the demand for emergency care services has risen steeply, due mainly to the number of acutely ill elderly patients being admitted to A&E departments.

"All parts of the UK are experiencing these pressures but Wales has the highest proportion of people over 85 and this number is increasing at the fastest rate.

"Older people with complex conditions often need to stay in hospital longer but pressures are made much more difficult when beds are occupied by patients who remain there after they are ready for discharge.

"More work needs to be undertaken to free up beds by ensuring when patients no longer require hospital treatment, they are discharged in a timely manner.

"Action will be taken to apply Welsh Government policy on choice consistently and uniformly across Wales. Too many acute hospital beds are still occupied by people who are fit to be discharged but who then wait for space at their preferred residential or nursing home. It cannot be right that the exercise of choice by one person can lead to the denial of another’s right to necessary treatment.

"I am also keen to address the consistent finding that too many people are attending our A&E departments unnecessarily. The way in which we introduce a non-emergency helpline system in Wales will be vital and I have asked for plans for an NHS 111 number to be accelerated where possible.

"In the longer term, we need a new national conversation about the way we care for an ageing population. Currently, when an older person is drawn into the NHS, they are treated according to a medical model of care, when their needs are likely to be far wider. In order to help start such a debate in Wales, I have asked Baroness Ilora Finlay to bring together a small group of people to advise me on the best way in which to take this conversation forward."

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