The Chief Executive of the NHS in Wales believes that steady and sustained improvement is being made in the nation, according to a new report.
Dr Andrew Goodall launched the Annual Quality Statement for NHS Wales with a positive message on progress in the healthcare system.
This latest tome is intended to outline some of the improvements and innovations made in the health service over the last 12 months, but also outline potential areas for improvement.
A new form of plastic surgery for lymphoedema patients was particularly documented by the report as a major and valuable new innovation.
This new form of surgery means that patients do not require compression garments, not only providing convenience for NHS consumers, but also saving the health service money.
The procedure has been provided by the Health Technologies Fund of the Welsh government, and thus is only available within Wales, not England, Scotland or Northern Ireland.
In other areas, more than 150 new staff members have been recruited and new services have been created for Children and Adolescent Mental Health services in Wales.
And new crisis intervention teams are caring for 15 to 24-year-olds experiencing severe mental illness.
Commenting on the achievements in the Welsh healthcare system, Goodall reflected on what he deemed to be a positive year.
“We have seen several years of sustained improvement in diabetes outcomes for children and young people. Cancer survival rates continue to improve despite increasing numbers of people requiring treatment.”
While NHS trusts have floundered against waiting times throughout the United Kingdom, Goodall believes that Wales has performed more than adequately in some areas.
“Waiting times to access diagnostic services continue to fall and we have seen a steady decline in people experiencing delays in their hospital discharge thanks to improved links between hospitals and social care. Our new clinical response model has vastly improved ambulance response times and has attracted interest from across the UK and the world.”
The author of the report was also keen to acknowledge the contribution made by healthcare professionals in Wales.
“Passionate and committed NHS staff are leading improvements in the healthcare services across Wales, services used by thousands of people every week; the Annual Quantity Statement takes a look at just some of these improvements, but also looks at what we need to do next.”
But Goodall also believes that there is still room for improvement, and encouraged Welsh NHS staff to build on the progress made over the last 12 months.
“I want to challenge the NHS to keep on improving; to work to provide care that is truly centred on the individual patients, and to ensure health and care are delivered to the same high standards consistently across Wales.”
In the course of compiling the report, it became apparent that the Welsh healthcare system deals with one-million accident and emergency attendees, 750,000 hospital admissions and 450,000 ambulance calls annually.
One of the most significant hospitals in Wales will upgrade some of the most important facilities at its major location.
A £6.6 million extension to a Swansea Morriston Hospital’s cardiac intensive care unit has been unveiled.
Work has been conducted at the hospital since September, while there has been the overarching aim of ensuring that surgery can continue unimpeded in the meantime.
It is hoped that the new facility will enable Morriston Hospital to reduce waiting times for patients.
Abertawe Bro Morgannwg University Health Board said one of the factors behind longer waiting times in the past had been a lack of beds for people after surgery.
And this opinion comes hot on the back of the new official statistics which indicates that bed blocking in the NHS is now worse than at any other time in the history of the health service.
The extension will add four more critical care beds, and it is hoped that this will be particularly beneficial for Accident and Emergency operations at the institution.
Health Secretary Vaughan Gething visited the hospital recently in order to see the final stages of the redevelopment.
It is believed that the unit will be completed later this month, and shortly afterwards go into operation.
Gething indicated that the Welsh government had followed recommendations and feedback from clinical staff already working in the hospital when putting the programme into practice.
The minister also look forward to the quality of care at the Swansea hospital improving.
“I’m pleased that more people will be able to benefit from high quality care closer to home. We have made progress in reducing cardiac waiting times and are now investing to increase capacity in Wales.”
Figures released by the Society for Cardiothoracic Surgery in 2015 ranked Morriston’s unit sixth out of 39 for survival rates between April 2011 and March 2014.
Reports back in January indicated that NHS patients in Wales wait longer for treatment and diagnosis than patients in England for most of the main categories.
And waiting times for hip surgery have deteriorated significantly in Wales over the past four years.
Since 2011/12, the average wait has risen by a fifth for the nearly 6,000 people who had hip operations in 2014/15.
The health minister of Wales has suggested that the views of Jeremy Hunt in suggesting that the Welsh health service is significantly worse than that of England is completely lacking in credibility.
And Mark Drakeford went as far as suggesting that the Health Secretary is a “victim of his own propaganda”.
Drakeford was speaking at Welsh Labour’s spring conference in Llandudno, where the health service was a persistent source of debate and discussion.
The Welsh health secretary also suggested that he was angry about patients being made fearful by continual attacks on the health service in the nation by the Tories.
And Drakeford has been backed up in his opinion by a credible official documents.
A major report published earlier this month by the Organisation for Economic Co-operation and Development (OECD) found the NHS was no worse in any one part of the UK than another.
The OECD found there were “no consistent picture emerges of one of the United Kingdom’s four health systems performing better than another”.
This authoritative report certainly supports the view that Conservative attacks on the NHS in Wales were entirely unfounded.
Commenting on the situation, Drakeford suggested that the minister had become carried away with rhetoric and that the facts simply did not back up his exaggerated opinion.
“[Hunt] was a victim of his own propaganda in that he believed, somehow, that the [OECD] report would vindicate the allegations that he was making against the Welsh NHS. It didn’t.”
Drakeford went on to indicate his belief that the policies of the Conservative party towards the NHS in Wales represented an assault, and that it needed to be rectified in the coming years.
“We can’t avoid the fact that the Tory assault on the Welsh NHS has done harm. It’s done harm to the morale of staff from time to time. Worst of all, when I look back at over the time I’ve been health minister, some of the things I will feel most bitterly about will be letters that I’ve had from vulnerable people who’ve read that sort of stuff and who are then anxious about the service that they will get in the Welsh NHS.”
The eminent professor also accused the Conservative party of fearmongering over the future of the NHS, in a damning attack on British government policy.
“They were made fearful for absolutely no legitimate reason and they were made fearful because there were people who, in a political battle, were prepared to sacrifice them in pursuit of their own political ambitions.”
As the political wrangle continues, it is certain that there will be more claims and counter-claims from the major political parties in the UK.
Data acquired via Freedom of Information requests indicates that NHS patients in Wales wait longer for many forms of treatment and diagnosis than patients in England.
In some categories, the difference between waiting times in England and Wales is quite dramatic.
For example, hip operations showed the biggest difference of four months, with an average wait in England of 75 days compared to 197 in Wales in 2014/15.
And waiting times in Wales for the treatment of cataracts, hernias and some heart operations are around two months longer than in England.
The political opposition to the Welsh government suggested that the results should incite a strong reaction, both politically and within the health service itself.
With waiting times throughout the NHS considered to be a hot potato issue, the particularly poor performance of the NHS in Wales will clearly be of concern.
The figures are drawn from the headline figures measured in the Hospital Episode Statistics from the English NHS and the Patient Episode Database for Wales.
Commenting on the figures, Vaughan Gething, a Welsh Labour Co-operative politician and the Deputy Minister for Health, accepted that there had been fundamental failings in the NHS in Wales.
Gething also expressed his determination to play a part in improving the situation as quickly as possible.
“We want to have a system that properly runs on waiting for treatment that is acceptable, but importantly the focus has to be on outcomes. How do we run a service in a different way because we know we have lots more demand coming into the system with an older population? What we need to do in Wales is to have a real focus on outcomes and not just on treatment times.”
With attention being directed at the Welsh NHS Confederation, the organisation attempted to explain the problem in an official response.
A spokesman for the confederation suggested that the waiting time statistics could be considered somewhat misleading, and do not represent the full scope of NHS activities in Wales.
“Much of the work carried out by the NHS is helping people to manage long-term conditions, often in primary care and the community, and avoid the need for hospital admission. While waiting times will always be a priority, our members will continue to work hard to improve the quality of care, and people’s health and well-being in the future.”
Nonetheless, despite the defence of the NHS operation in Wales, the Conservative opposition was predictably fast in proffering a scathing view on the subject.
The parties suggested that the statistics compiled in relation to the NHS in Wales provide “further evidence of the damaging legacy of Labour’s cuts, closures and downgrades”.
Shadow Health Minister Darren Millar was strongly critical of the role of the Labour Party in the situation.
“It is utterly disgusting that people are waiting almost twice as long in Wales to have a heart bypass operation, placing vulnerable patients at risk of serious harm and potentially premature death. Meanwhile, waiting times for the treatment of cataracts, hernias and hip operations are also much longer here than over the border; impacting on them and their loved ones, and ruining their quality of life.”
A leading Welsh doctor has suggested that the accident and emergency departments in Wales are experiencing massive difficulties.
Dr Robin Roop, head of the Royal College of Emergency Medicine in Wales, described the plight of A&E in Wales as being “on the edge”.
Roop suggested that the current waiting times are simply far too long, with some patients being forced to queue for over 24 hours in the accident and emergency department.
He also warned no A&E department in Wales had enough consultants to meet minimum RCEM staffing levels.
Responding to these criticisms, the Welsh government suggested that the pressures being exerted on the Welsh accident and emergency system where nothing out of the ordinary, and shared by other nations.
Yet recent statistics indicate that around 80% of patients spend less than four hours in A&E; a Figure which shows no improvement from 2014.
By way of comparison, the government has set the target for these figure at 95%; a number that NHS departments all over the United Kingdom have greatly struggled to meet.
Roop suggested that the major reason behind these figures is a chronic shortage of senior doctors and emergency unit nurses.
Indeed, recent evidence has documented that the NHS is struggling to recruit both doctors and nurses, with financial issues proving particularly influential.
“In Wales staff turnover in emergency medicine is getting worse. We have not been able to recruit new consultants at the same level here as in other countries,” Roop commented.
Roop also indicated his belief that trusts across Wales have failed to respond to the situation appropriately, and this is merely exacerbating the problem.
“The health boards have learnt from previous years about winter pressures and what needs to be done – things like expanding bed capacity and changing elective operations – they’ve worked to a small degree. But we still see a reduction in the number of patients being able to be passed on (from emergency units) in a timely fashion. And we still see ‘exit-blocks’. It means staff aren’t doing what they’ve been trained to do in emergency medicine. They are now doing the additional things of looking after for longer because of the delays.”
In response to the criticisms made by the Wrexham-based doctor, a spokesman on behalf of the Welsh government suggesting that the figures related to accident and emergency in Wales have improved significantly.
“There was a 23% reduction in the number of people who spent more than 12 hours in emergency departments in December compared to November but we know there is more work to do. We expect all health boards to ensure they have the right mix of staff to ensure services are safe, sustainable, and to ensure patient experience and outcomes are optimised.”
Aside from the four hour target, another aim of Welsh health policy is to eradicate waits of 12 hours or more within all hospital emergency care facilities.
Evidently, this is not being achieved, and the usual story of underfunding and understaffing appears to be at the centre of this story.
The National Health Service will receive an investment worth nearly £300 million according to new draft spending plans drawn up by the Welsh administration.
Finance Minister Jane Hutt told members of the Welsh parliaments that the 2016/17 draft budget backed Labour’s “priorities for Wales and its future”.
As a result of the new spending plans, the amount of being spent on healthcare overall will rise by in excess of 4 per cent.
It is hoped that the extra funds will provide a significant boost to healthcare in Wales.
Nonetheless, despite the promise of extra funding for the Welsh NHS, the Conservative Opposition suggested that the spending plans were inadequate.
Tories stated that the spending plan was “too little, far too late for our hardworking NHS staff”.
Of the overall amount pledged, the Welsh government has already confirmed that in the region of £260 million will be set aside for day-to-day expenditure on NHS services.
Meanwhile, over £30 million has been earmarked for expenditure on infrastructure, maintaining the existing NHS estate and purchasing additional equipment.
In order to balance the books, the Welsh assembly has also announced efficiency savings of £50 million within the health service.
Finance Minister Jane Hutt commented on her responsibility to protect the services that mattered most to people, within the financial constraints of the Welsh government.
“It has been another challenging settlement which has been set against the backdrop of successive real terms cuts to our Budget over the last five years. We have continued our record investment in health with more than a quarter of a billion pounds going to the Welsh NHS in 2016-17 – demonstrating our wider approach to the health and social care and the value of preventative spend.”
Despite the apparent improvement in health funding in Wales, the Conservative Opposition was unsurprisingly scathing about the government policy.
Conservative Shadow Finance Minister Nick Ramsay suggested that the plans represented a piecemeal response to years of neglect for the NHS in Wales.
“Hospital downgrading, huge delays in waiting times, a failure to recruit staff; this chaos is a direct result of Labour’s record-breaking NHS budget cuts. By failing to protect the budget, our health service has been starved of £1bn since 2010/11,” Ramsay remarked.
But Ramsay represented pretty much a lone voice of dissent in the Welsh assembly.
By contrast, Plaid Cymru AM Alun Ffred Jones was appreciative of the extra cash to being promised to the NHS in Wales.
James particularly hopes that the extra cash could be pledged towards the process of reducing waiting times within the Welsh health service.
“I do very much hope that this will enable waiting lists to be substantially reduced, in light of the harsh criticism of the Royal College of Surgeons in their statement yesterday.”
The Welsh National Health Service has concocted a plan in order to cope with high demand over the winter.
It has already been reported that the NHS faces a crisis over the winter period due to occupancy issues.
So the Welsh NHS has sought emergency measures in order to cope with the situation.
Among these are cutting hospital admissions and discharging patients more quickly.
And NHS Wales chief executive Dr Andrew Goodall urged people to use emergency care only for life-threatening conditions needing immediate attention.
Pressures on accident and emergency departments last year resulted in one senior nurse comparing hospitals in Wales to warzones.
In an attempt to address this situation, Dr Goodall has stated that health bodies and councils have collaborated closely on joint resolutions.
And extra staff have been recruited by some health boards in Wales in order to deal with the extra demand.
The Welsh NHS has also placed an emphasis on identifying how traditional hospital beds can be utilised in order to respond rapidly to surges in demand.
Hospitals in Wales will also be utilising minor injury units to deal with capacity issues, and working closely with GPs at out-of-hours services in order to reduce hospital admissions.
The Welsh NHS has also pledged better support for people at home in order to help them to be discharged from hospital at the first available opportunity.
Commenting on the plans of the health service in Wales, Dr Goodall suggested that workers from every area of the NHS can play their part in dealing with winter pressures.
“The health service maintains and reviews plans constantly throughout the year but we all know winter can bring additional pressures. Our health boards, councils and the ambulance service have developed integrated winter plans to prepare for winter, particularly during peaks in pressure.”
Additionally, he emphasised that the general public can in fact treat illnesses themselves by utilising “over-the-counter medicines and plenty of rest”.
“When your injury or illness can’t be managed at home, your GP practice, NHS Direct Wales, local pharmacy, optician or dentist can help. A&E is for serious, life-threatening conditions that need immediate medical attention,” Goodall added.
In response to the apparent crisis, Conservative Shadow Health Minister Darren Millar suggested that superior NHS performance would only be possible when ministers from the Labour Party addressed the crippling problems of the health service.
“The reality is that GP out-of-hours services are in crisis in some parts of Wales, waiting times are too long and the four hour A and E target hasn’t been met in six years,” Millar stated.