Statement by the Welsh Health Minister

Today’s Plenary session has received an update from Health Minister Vaughan Gething.

TITLE Coronavirus – COVID-19 – NHS WALES OPERATING FRAMEWORK QUARTER 1 PLANS
DATE 3 June 2020
BY Vaughan Gething, Minister for Health and Social Services

 

Today’s statement will focus on providing members with an update on restarting more NHS activity in Wales.

I am pleased to report that, while we are still supporting those that have coronavirus, the number of confirmed cases is falling, as are the numbers of people that have lost their lives from this pandemic.

There were still 67 new confirmed cases reported by Public Health Wales yesterday, with death figures in single figures. However each number was a person and a tragic reminder of the need for care and caution from all of us, now and in the foreseeable future if we are to reduce the spread of the virus.

No-one should underestimate the importance of continuing to maintain our state of readiness if we are to see and cope with any future peaks of the virus. We still need to support people in our communities that need our health service for other reasons that are not Covid related.

I approved the NHS Operating Framework that was issued on 6th May. It describes four types of harm:

  1. Harm from COVID itself;
  2. Harm from overwhelmed NHS and social care system
  3. Harm from reduction in non-COVID activity
  4. Harm from wider societal actions/lockdown

I recognise that we need to move slowly and cautiously.  Shorter term planning, on quarterly cycles, is important for organisations to demonstrate that they can be agile and flexible. Being able to divert resources easily and quickly to adjust to the demand, between both COVID-19 and non–COVID-19 essential service areas is crucial.

While recognising all four potential harms, the Quarter 1 plans are particularly aimed at progressively scaling essential NHS activity back up, whilst also addressing the current demands of COVID-19. We all recognise it is important to get essential services operating efficiently for those that need them, but in a safe and effective manner. The fact is that the threat of COVID-19 will be with us for some time to come.

The Quarter 1 plans were all received as required on 18 May. They set out how the health boards and trusts are planning to deliver the range of essential services including cancer, cardiac, ophthalmology and other services, often in new and innovative ways.

Many organisations are working to re-zone their estate, to provide areas where staff and patients feel safe to undertake diagnostic tests and receive treatment. The use of additional independent sector hospitals has been helpful for some treatments.

Health boards are currently reviewing the use of the available facilities to see how they might be used going forward. Our aim is for our healthcare system to rebalance within a more usual hospital environment. This work with the independent sector has been helpful but we will of course need to review its use, which is explored in the plans.

The majority of health boards have made arrangements to create additional field hospital capacity. It is a real positive that we have not had to make significant use of field hospitals during the first peak. The plans reflect the need to review and re-assess as we move forward. A national review of field hospitals facilities during June will support this work.

There are still issues to be overcome as we move to upscale our essential services: ensuring sufficient PPE, medicines, testing, staff and training will be required. This is what the plans have outlined. In addition, I have asked the NHS to continue to look at where it can make greater use of regional solutions – pooling resources and expertise to ensure patients receive the best care.

However out of this crisis we have also been able to embrace innovation. Much greater use of technology has been deployed over the past 10 weeks. In a two week period 19-26 May there were 977 more remote consultations across the NHS using the new NHS Wales Video Consultation Service. Using these new ways of working we can still do so much more, with a growing proportion of consultations being able to be conducted virtually.   Equally importantly, 97% of patients and 85% of clinicians (TEC Cymru), rated this new way or working as ‘excellent’, ‘really good’ or ‘good’.

We have also seen a rise in the number of outpatient follow-ups that have been able to be conducted by telephone. This shows how in our response to the pandemic we have explored existing tools and services to deliver care in more efficient ways. We are changing the way in which we are delivering services and using our resources differently.

Swansea Bay UHB has established a Health Board wide centre to coordinate the flow of patients including Rapid Discharge, community “step up” and any additional surge or super surge capacity within Field Hospitals. They also have an Outpatient Modernisation Group planning the re-activation of services.  These are developing new models of care and ways of working which have been taken in response to COVID.

My officials will be meeting with each of the organisations over the next few weeks, to review their plans and support them to ensure implementation. The Operating Framework contained a number of commitments for the Welsh Government which are enablers to support implementation.

Examples of action being taken forward include:

 

  • The Digital Priorities Investment Fund, that I announced last September, has been used to accelerate new Digital Programmes and initiatives. This includes the acceleration of video consultation across the whole of Wales, infrastructure and devices to enable remote working, and a new digital system for contact tracing, all of which have been rolled out in weeks.  A programme to make  Microsoft Teams and Office 365 available to all NHS staff, which started last autumn, has been compressed from three years to one.  I will also bring forward a new digital system for use in Intensive Care Units, a new digital platform for Eye Care, and accelerating an upgrade to our digital pathology services.  The pace at which organisations have worked together to deploy new digital technologies has been impressive.

 

  • The Wales Critical Care and Trauma Network has developed draft advice on critical care during the next phase of the pandemic and restarting NHS services, alongside newly published guidance.

 

  • an ongoing communications campaign is being developed encourage patients to access essential services and

 

  • funding has been provided for the establishment of the field hospitals; private sector capacity; and student workforce.

Using the feedback and review of Quarter 1 we will move toward a continuing framework approach for Quarter 2. This will include understanding the next steps in planning over the summer months and then for winter contingency for Quarter 3.  I will keep members updated on progress. I have also provided members with more detail on the Quarter 1 plans in a written statement issued earlier today.

Monday this week saw the launch of our national NHS Test Trace and Protect service in Wales. Contact tracing is an essential next step in our fight against Covid-19. It will help us to prevent transmission of the virus, protect the public, quickly identify and take action to control clusters and outbreaks.  Our new national service began, as planned, on Monday 1 June. Anyone who has tested positive for coronavirus in Wales will now be contacted and asked for the details of all the people they have had contact with while they have had symptoms.

As I have previously said, our approach is to build and grow our local contact tracing capacity. The reality is that a national plan will only work if we make full use of the existing local knowledge, skills and expertise that has been built up over many years within the health protection teams of our local authorities and health boards.  This partnership approach has enabled us to quickly bring together a Wales-wide workforce of over 600 contact tracers to start the new national service. Regional plans, jointly agreed by local government and health board partners will enable us to rapidly scale up the workforce, if and when necessary. This follows a successful two week pilot exercise across four health board regions. A key focus of the pilots was to ensure that staff received the high quality training, guidance and support they need to be able to do this highly important and challenging role effectively.

Since Sunday, PHW have reported 208 positive cases all of which have been transferred to our contact tracing teams.  Where appropriate people have been interviewed and, on average, this is identifying a further 3 to 4 follow-up contacts per positive case. The early feedback also indicates that individuals contacted by our tracing teams are engaging positively. So far the signs are encouraging but we must never take the public’s support for granted.

So for now the focus is on the next few weeks, within which we can make a difference and it to strike the right balance between all four areas of harm and keep Wales safe.

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