Statement by the Minister for Health and Social Services

TITLE Coronavirus Covid 19 Update
DATE 29 April 2020
BY Vaughan Gething AM, Minister for Health and Social Services

 Members will know that I have committed to keep them informed about Covid-19 developments.

The challenge from Coronavirus is far from over. We have been successful in ensuring that the NHS has not been overwhelmed but we continue to operate in an uncertain environment.  This will continue for some time. It is clear that the NHS and social care systems must operate with Covid-19 as an ever present challenge for the foreseeable future.  So we must remain vigilant and continue to use the best scientific evidence and advice to inform how we plan services going forward. Today I want to update Members about some important developments.

Essential Services and Urgent Care

 We have had to take unprecedented steps to increase all aspects of NHS capacity – staff, beds, medicines, equipment and more to plan for the worst possible scenario to provide services to meet the needs of those who are affected by COVID-19.

We have also had to give careful consideration to how essential services can be provided during this time, without which there is a significant risk that indirect mortality and serious harm could increase dramatically.  Difficult decisions have to be made to balance these demands and this will continue for some time. Our ethical framework will help guide such decision making.

At the end of March, the World Health Organisation issued interim operational guidance for maintaining essential health services during an outbreak. This guidance is informing our own approach to maintaining services now and in considering any changes will make as we move forward. The WHO suggest that in selecting such priorities, they should initially focus on:

 

  • the prevention for communicable diseases, particularly vaccination;
  • services related to care during pregnancy and childbirth, reproductive health and care of vulnerable populations, such as young infants and older adults;
  • the provision of medicines and supplies for the ongoing management of chronic diseases, including mental health conditions;
  • the continuity of critical inpatient therapies and the management of emergency and acute presentations that require time-sensitive intervention; and
  • as importantly, services such as diagnostic imaging, laboratory services, and blood bank services.

This is complex, but minimising harm and determining where care is time sensitive are the priorities. Innovative solutions are and will continue to be found, including the use of digital and IT, as well as considering regional solutions for example for cancer treatment.

There remains a need to balance the risk and benefits of having treatment at this time, including for example for people with cancer. This is something that needs to largely be determined on an individual level between patients and their clinician.

We are acutely aware, and concerned about a fall in the use of urgent and emergency care services; and the risk of harm to people who may have serious illness but are not dialling 999 or presenting at Emergency Departments as they should.

 

  • To date in April 2020, we have seen a 29% reduction in ambulances transporting patients to hospital compared to the same period in April 2019.

 

  • Daily average attendances at Emergency Departments have also reduced by 50% and emergency admissions to hospital by 35% in April compared to February, prior to the outbreak of COVID-19.

 

  • Clinicians in Emergency Departments reported an increase in people with anxiety or emotional distress, and people who have presented later than they should manifesting in additional health complications.

I am urging people who are seriously ill and need urgent advice or treatment to use NHS Wales’ services because our clinicians and health professionals are still there for you.

People who are concerned about attending Emergency Departments should be reassured that they will be screened on arrival; they will also be segregated from any patients with symptoms of the virus.  There are now well established protocols and pathways across the urgent and emergency care system to optimise safety and limit the spread of the virus.

The WHO identifies the need to develop a roadmap for progressive, phased re-introduction of services and this will be a further important consideration in due course to inform local and national recovery plans.

Any such plans will need to ensure that we can re- introduce surge capacity flexibly and quickly as well as maintain essential services if faced with a further peak of virus transmission. These are difficult scenarios to plan for and I would like to thank again the NHS staff and those working in partner organisations who are rising to this challenge.

PPE

 PPE remains my number one priority to keep staff across health and care safe. I can confirm that from the 9th March up to the 26th April, we have issued over 60 million items of PPE for the use of frontline health and social care staff with over 12 million items delivered to the frontline for use specifically in social care settings.

Last weekend, we received masks from China into our Shared Services stores.  PPE equipment for use in care homes and social care environments are being managed by local social services who know their own geographical area and can co-ordinate priority deliveries

Yesterday vital supplies of personal protective equipment for frontline health and care workers in Wales arrived at Cardiff Airport. The flight into Wales carried 200,000 fluid resistant gowns from Cambodia.  In total, 660,000 gowns will be flown in to Cardiff Airport from Phnom Penh, in Cambodia and Hangzhou, in China

As well as taking the initiative in procuring PPE for Wales, we continue to work closely with the other UK countries through mutual aid arrangements and to ensure an equitable share of UK PPE procurements.

Testing

Members will be aware that testing is now also available to critical workers and members of their families if they have suspected covid 19. The current daily capacity (as of 22 April 2020) is more than 2,000 tests a day, but we are working hard to increase that number and to make sure all available tests are being taken up.

In order to ramp up our testing programme, we are opening up more mass drive-through testing centres in addition to the Cardiff and Newport mass-drive through centres, and the community testing centres already in place.  This week we are opening up more testing centres in Llandudno and Carmarthen.  A further centre will follow soon and is likely to be in Merthyr and we are looking at strengthening capacity in Ceredigion, Pembrokeshire and Powys. Our approach involves a hub and spoke model with mobiles operating to give greater reach and flexibility

As I’ve made clear, care home staff and residents are a priority for us and we have expanded testing there already. I want to be sure that we doing everything we need to keep staff and residents safe and to this end,  last week we announced that we will be testing those being discharged from hospital into care homes, whether they a symptomatic or not, further protecting our most vulnerable people.  I will want to see testing made available to everyone in a care home as testing capacity increases.

I’m aware of UK plans announced last night.  We will continue to extend to key groups as part of our testing strategy and as I’ve set out that is under constant review to make sure we are doing all testing we need when we need it. I’ve committed to providing further updates on a regular basis.

Deaths

Sadly we continue to see deaths on a daily basis. Everyone is a tragic loss for the families, friends and communities affected. Understanding and acknowledging the number of people who have died is important to us all.

Yesterday we published a report following the identification on 23 April of a significant number of deaths that had not been reported to Public Health Wales. The actions identified within the report have already been put in place.

Death in service

Yesterday, many of us stood silent for a minute to remember workers who have lost their life to coronavirus or work related accident or illness.

On Monday I announced that families of Welsh NHS and social care workers who die in service, as a result of Covid-19 will be entitled to financial support with a payment of £60,000. I know our front line workers are going above and beyond to care for vulnerable patients every day and this scheme gives equal recognition to staff across health and social care. It provides a safety net for eligible staff who have delivered frontline services who may have been ineligible to join the Pension Scheme or decided not to because of affordability. I hope this will be of some help during a difficult time.

I will be making an Oral Statement on a fortnightly basis so that Members are assured about the Covid-19 measures being taken across the health and care system. I continue to urge people everywhere to stay at home and stay safe.

 

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