Category: Wales

  • Vaughan Gething – 2020 Statement on Scientific Advice in Wales

    Vaughan Gething – 2020 Statement on Scientific Advice in Wales

    Below is the text of the statement made by Vaughan Gething, the Minister for Health and Social Services in Wales, on 4 May 2020.

    The Welsh Government’s Chief Scientific Advisor for Health Dr Rob Orford joined the UK Government’s Scientific Advisory Group for Emergencies (SAGE) COVID-19 meetings on 11 February 2020.

    SAGE is responsible for ensuring timely and co-ordinated scientific advice is available to decision makers to support UK cross-government decisions in the Cabinet Office Briefing Room (COBR).

    Wales’ Chief Medical Officer Dr Frank Atherton and Dr Orford agreed a formal technical and scientific advisory structure within Welsh Government was also needed to provide official sensitive advice to Ministers. The terms of reference for a Technical Advisory Cell (TAC) were agreed on 3 March, in accordance with SAGE guidance. TAC meets three times a week.

    The TAC is designed to:

    Interpret SAGE outputs into a Welsh context

    Relay relevant information and questions from Welsh Government to SAGE

    Ensure indirect harm is not caused by the proposed interventions

    Help inform NHS and social care planning guidance

    Ensure Welsh Government and Public Health Wales have timely access to the most up-to-date scientific and technical information

    Brief Local Resilience Forum and Strategic Coordinating Group chairs about scientific and technical outputs, via the

    Strategic Health Coordinating Support Group, which is chaired by Public Health Wales.

    TAC does not replace statutory functions of Public Health Wales or use the technical or scientific information, which has not been agreed or discussed by SAGE, unless this has a specific Welsh context.

    The priorities of TAC are aligned to SAGE and include:

    The detection and monitoring of coronavirus

    Understanding effective actions to help contain a cluster

    Understand, measure and alter the shape of the UK epidemic

    Ensure indirect harm is not caused by the proposed interventions

    Model the UK epidemic and identify key numbers for NHS planning

    Understand risk factors around demographics, geographies and vulnerable groups

    Generate behavioural science insights for policy makers

    Ensure NHS tests and trials key interventions

    Consider emerging therapeutic, diagnostic and other opportunities.

    TAC is co-chaired by Dr Orford and the Deputy Director for Technology and Digital. Membership is drawn from Welsh Government, Public Health Wales, Cardiff University and Swansea University. A range of experts from different disciplines are included covering public health, health protection, medicine, epidemiology, modelling, technology, data science, statistics, microbiology, molecular biology, immunology, genomics, physical sciences and research.

    Membership of TAC is kept under constant review.

  • Vaughan Gething – 2020 Statement on the NHS and Covid-19 in Wales

    Vaughan Gething – 2020 Statement on the NHS and Covid-19 in Wales

    Below is the text of the statement made by Vaughan Gething, the Minister for Health and Social Services in Wales, on 6 May 2020.

    We are moving out of a period of COVID-19 critical planning and response and into a longer period where our health and care system must remain both prepared for any future peaks and effectively providing essential services and other high quality care and treatment for the people of Wales.

    In March I made a number of decisions to ensure early and decisive action to continue to provide care and support to the most vulnerable people in our communities, whilst also making sure organisations and professionals were supported to prepare local responses to the public health emergency. The NHS in Wales has already delivered a remarkable response to the COVID-19 health emergency since receiving the first coronavirus patients and now we must take the next steps.

    To maintain momentum and to ensure the system continues to focus its attention on the provision of a wider range of services, I have issued an NHS Wales COVID-19 operating framework for quarter 1 (2020/21).

    The document highlights four types of harm that could emanate from Covid-19 which we must remain focused on and guard against. These are;

    Harm from COVID-19 itself

    Harm from an overwhelmed NHS and social care system

    Harm from a reduction in non COVID-19 activity

    Harm from a wider societal actions / lockdown

    This framework will drive, even further, our systems focus on the two components of ensuring both a continued effective response to COVID-19 whilst providing other essential services in a careful and balanced manner.

    I have taken advice from professional colleagues, including NHS Chief Executives and Medical Directors. This advice demonstrates consensus across the health and care system that we must ensure delivery of essential services for our population and where possible recommence more routine care. The advice I have received also says that this must be done progressively, with caution and in a flexible and agile manner to ensure confidence for the public and staff.

    This framework is set under a number of themes;

    New ways of working and workforce wellbeing – Staff have created and quickly embraced new ways of working to respond to the COVID19 challenge- offering benefits in terms of safety and quality to both staff and patients whilst also contributing to reduced congestion in primary care and hospital settings. We must continue to build on this work and harness the opportunities it has provided.

    Examples of the scale of transformation include the rollout of video consultations safely to primary care. Locally and nationally these new ways of working must be sustainably embedded.

    This framework recognises the importance of the wellbeing of our workforce, and in particular those staff who have been under significant pressure in responding to COVID 19 and they must be at the forefront of our minds. Pressures may increase again in the next few months. I am clear that appropriate testing systems must be in place and be informed by the impending Testing Strategy being developed to support and help sustain staff.

    Managing COVID 19 – It will always be difficult to guarantee that health and social settings will be COVID free, however patients using the NHS must be confident that hospital environments are as safe as possible. The key criterion I will looking to organisations to be assured on include:

    Ongoing and consistent application of Infection Prevention and Control guidance.

    Identification of COVID “zones” and dedicated isolation facilities. I will be anticipating that regional solutions are explored along with the targeted use of independent sector hospitals and field hospitals to support the separation of covid and non-covid activity in the immediate term.

    New service or specialty based triage and streaming processes in both unscheduled and planned care to support the separation of patient services.

    Continued implementation of Acute Pathways for COVID 19 and the related rehabilitation
    Assurance on the availability of sufficient physical and workforce capacity that reflect the need to maintain social distancing and infection prevention and control measures.

    The framework reflects my determination that we retain our ability to quickly activate additional critical care capacity, if we enter into another peak.

    “Essential” services – I am clear that Essential Services should be maintained at all times throughout the pandemic. An Essential Services technical document has been developed in line with The World Health Organization (WHO) guidance. If, in any areas of essential services, the response to COVID 19 has led to backlogs they must be urgently addressed. Ultimately I recognise that some decisions on treatment will rest between patients and their clinicians, taking account of their specific risks during the COVID outbreak.

    “Routine” services – We know that capacity exists in some parts of our system to support the re-introduction of routine services. The reintroduction of these services is a local operational decision for Health Boards and Trusts in conjunction with relevant partners. These decisions must be taken with care, and organisations need to assure themselves that it is safe and appropriate to do so. I outline how they need to assure themselves in the framework.

    Primary care – For General Medical Services we have seen a shift to telephone first triage; this must remain in place during Quarter 1 and I encourage it longer term. Equally our community pharmacy services have been under significant pressure and have introduced new ways of working to manage patient care safely and efficiently, these too must continue where the benefits are clear.

    All routine primary care dental treatments and check-ups continue to be cancelled. Dental practices with NHS contracts remain ‘open’ for remote triage, the provision of advice and the issuing of prescription. Further guidance will be issued separately to this framework about the future status and restoration of dental services. In optometry services, a number of practices remain open for emergency and essential eye care services. Health boards must continue to ensure urgent patients are seen.

    Social Care Interface – Finally the framework makes clear that NHS organisations must continue to work with partners to ensure an effective interface with social care. This is in line with the approach set out in “A Healthier Wales” and the framework makes clear how this must happen.

    There has been clear and consistent messages for the public that the NHS is still available at times of need despite COVID-19. We must continue to ensure that key services are available and patients can access them, now and in the future.

    To help patients access these services over the last eight to ten weeks there has been a seismic level of transformation across our system. We must reflect on these changes but not dwell on them. They must be adopted, adapted and applied. This framework supports the health and care system in moving to the next phase of providing services.

  • Lee Waters – 2020 Statement on Sustainable Transport after Covid-19

    Lee Waters – 2020 Statement on Sustainable Transport after Covid-19

    Below is the text of the statement made by Lee Waters, the Deputy Minister for Economy and Transport in Wales, on 7 May 2020.

    Today I am writing to all local authorities in Wales to invite them to put forward expressions of interest to introduce temporary measures to improve the safety and conditions for sustainable and active travel modes in their area.

    We will make grant funding available to respond quickly to the transport opportunities and challenges that the Covid 19 crisis brings.

    We are currently experiencing unprecedented changes that affect all aspects of our lives, and transport, across all modes, is particularly affected. With the restrictions imposed, we have seen large reductions in motorised traffic on all parts of the road network, much reduced patronage of buses and trains and higher rates of walking and cycling, both for essential journeys and for daily exercise. We have seen a vast increase in digital remote working which has shown that we do not all need to travel long distances for work, and we wish to see this maintained as we find a new normal. For the sake of the air we all breathe, the world’s climate and public health, we need to try and lock in this shift and avoid returning to pre-Covid travel patterns.

    With our support, we want local authorities in Wales to follow the example set by towns and cities across the globe, and to take action to achieve this. These measures should not be limited to large urban areas, as the same principles apply for smaller towns in rural areas. We are seeking expressions of interest from local authorities across Wales to introduce measures to ensure the safety and reliability of sustainable transport modes during and following the Covid 19 crisis. We are looking for low cost – high impact imaginative measures that can be quickly developed and rapidly introduced as well as other measures that reduce the impact and reliance on car journeys.

    There are two main reasons for this call to action:

    Firstly, we want to protect public health and safety. The expectation is that social distancing will need to be observed for many months to come. The space available on footways and shared use paths is often wholly insufficient to allow safe passing distances. There is also additional pressure on the available space from queues outside shops and at bus stops. As a result, pedestrians and cyclists are frequently forced to step or ride into the carriageway to avoid close passing. Whilst this is largely possible with current traffic volumes, it is already problematic for many, for example those with reduced mobility or young children, and it will become extremely unsafe when traffic volumes increase.

    Secondly, we want to address potential increases in car use. There is a high degree of uncertainty regarding the public’s willingness to use public transport modes once restrictions are eased. There is already evidence from China which showed much reduced public transport use and significant increases in car use. There is therefore a high risk that, if no action is taken, we will see even greater percentages of journeys being undertaken by car in Wales in the future. This would clearly go against the policy direction we want to achieve across Government and lead to negative impacts for people, society and the environment. We therefore need to use the current reduction in volumes proactively to create conditions that make non-car modes safer, healthy and convenient.

    We therefore invite initial expressions of interest for funding for ‘pop-up’ measures that enable social distancing. These can include schemes such as footway widening, temporary cycle lanes, speed restrictions, and bus infrastructure improvements enabling social distancing.

    Measures aimed at improving walking and cycling should prioritise routes that are part of existing or planned active travel route networks, in particular routes to schools. A package approach combining different measures is likely to be most effective. Most measures are expected to be introduced on a temporary or experimental basis. However, where they are effective, should be introduced on a permanent basis.

    We are asking for initial expressions of interest by 21 May to allow us to gauge the overall funding requirement. We will then seek additional information as required before considering the proposals further. We envisage measures to be introduced from early summer.

  • Mark Drakeford – 2020 Statement on Wales and Ending Lockdown

    Mark Drakeford – 2020 Statement on Wales and Ending Lockdown

    Below is the text of the statement made by Mark Drakeford, the Welsh First Minister, on 8 May 2020.

    The Health Protection (Coronavirus Restrictions) (Wales) Regulations 2020 (‘the Regulations’), impose restrictions on gatherings, the movement of people, and the operation of businesses, including closures, in Wales. They impose requirements on businesses that are open to take reasonable measures to ensure physical distancing between people. This has been done to help protect everyone from the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

    Under regulation 3(2) Welsh Ministers are required to review the need for the requirements and restrictions in the Regulations every 21 days. The second review was due by 7 May.

    We carried out this second review using the latest evidence from the UK Scientific Advisory Group for Emergencies (SAGE) and the advice of the Chief Medical Officer for Wales. While we have passed the first peak of infection and rates continue to fall, it is still too early for significant lifting of requirements or restrictions.

    This means that schools will not be opening up over the next three weeks beyond what is already permissible under the Regulations.

    The reproduction rate of the virus continues to fall. It is below the rate of 1 above which we would see exponential growth. Our NHS has coped well and is continuing to build capacity. Plans are in place to build-up our test, track and trace capability, and to ensure the continued availability of PPE. These conditions, taken together, will allow us to continue to take incremental steps over the coming weeks and months to ease restrictions when it is safe to do so.

    The improving situation and latest evidence on transmission of the virus has meant we have been able to consider some minor adjustments to the Regulations to come into force on Monday. SAGE advises that the risk of infection is diminished outdoors, but physical distancing of 2m must be maintained and groups must not congregate. Given the significant health and wellbeing benefits of exercise, we are bringing forward amendments to the Regulations to allow for exercise more than once a day.

    We will work with our partners across Wales to plan for additional activity that can take place outdoors if conditions continue to improve. Garden centres can open provided they adhere to the physical distancing duty.

    People who can work from home should continue to do so. We will continue to work closely with our partners in the public sector, trade unions, businesses, the third sector and others, to support businesses and employees who cannot work from home to carry out their work safely.

    Amendments will be brought forward to the Regulations to allow people to leave their home to access some specified public services; starting with Household Waste and Recycling Centres and libraries. The timing of these changes will need to be agreed with local authorities and service operators, so that there is time to put in place guidance and protocols.

    To increase democratic oversight, we will amend the Regulations to remove the Welsh Ministers’ power to terminate requirements or restrictions by direction. This means that all changes to the principal Regulations must be brought before the Senedd.

    We keep the Regulations under continuous review so that we can respond to the latest evidence on transmission of the virus, effectiveness of the requirements and restrictions, and levels of compliance, as soon as needed.

    Our preference remains a four-nation response to coming out of lock-down, and we remain in consultation with all parts of the UK. Our duty is to the people of Wales, and our decisions will be based on the evidence and specific circumstances of Wales.

  • Jeremy Miles – 2020 Statement on Wales and the Exit from the EU

    Jeremy Miles – 2020 Statement on Wales and the Exit from the EU

    Below is the text of the statement made by Jeremy Miles, the Counsel General for Wales, on 7 May 2020.

    This statement provides members with an update on issues related to the UK’s exit from the EU, focusing on the latest position in the negotiations on the UK / EU future relationship and the implications of this for the huge and complex programme of work required by the end of the transition period given that governments in the UK and EU are rightly focused on responding to Covid-19.

    Responding to the Covid-19 pandemic continues to be the immediate priority of the Welsh Government, and we maintain that the negotiations on the future UK / EU relationship should be paused and an extension to the transition period sought. Despite the realities of the current crisis, the UK Government continues to argue that successful negotiations, and the necessary work to implement an agreement, can be concluded alongside dealing with the current national emergency. We have seen no evidence to support that position.

    EU / UK Negotiations

    Following an understandable pause in formal talks between the UK and EU as all parties rightly focused their efforts on responding to Covid-19 and keeping all of our citizens safe, the negotiations resumed in the week commencing 20 April, albeit with reduced numbers and via videoconference.

    At the end of the second full round of talks, there were clearly major differences remaining between the two sides as outlined by Michel Barnier in recent comments. The largest areas of difference include: the UK Government’s unwillingness to sign up to a ‘level playing field’ of economic, social and environmental standards which the EU insists should underpin the envisaged zero-tariff, zero-quota trade deal; the UK Government’s rejections of any role for the Court of Justice of the European Union in relation to aspects of the future relationship; the UK Government’s position that there should be multiple separate agreements as opposed to the EU’s preference for one overarching agreement; and fishing rights. There seems to have been little, if any, progress in resolving these fundamental differences despite the fact we are now half way between the publication of negotiating mandates and the critical end of June date (which under the terms of the Withdrawal Agreement is the last point at which an extension to the transition period can be agreed).

    The negotiations have to date focused on the presentation and clarification of negotiating positions. If the UK Government persists in seeking to work to the original timetable, then the negotiations need to reach agreement swiftly, which will require compromise and pragmatism. Despite best efforts there will inevitably be limitations about what can be achieved by video conference rather than face to face negotiations, especially when there are clear fundamental differences between the two sides.

    The UK Government continues to refuse to contemplate extending the end date of the transition period. This is despite requests from us and many others to pause the negotiations and extend the transition period, recognising the fundamentally changed circumstances facing the economy and society due to the Covid-19 pandemic. It is of great concern in the current circumstances that we will exit transition on 31 December 2020. The focus must be for us to work together to combat Covid-19 and the economic consequences thereafter, rather than unnecessarily compounding these issues by adding the economic shock a change in our economic relationship with the EU will inevitably entail. The UK Government must also recognise that conducting complex negotiations under these constrained circumstances is unlikely to lead to an outcome which protects our interests.

    UK Government engagement with the Devolved Governments on the negotiations remains deficient: despite the promises of improved engagement as the future relationship negotiations got underway, Ministerial engagement became even more inadequate. The UK Government has failed despite their formal commitment in the terms of reference of the Joint Ministerial Committee (EU Negotiations) to seek agreement with the Devolved Governments on the negotiations to provide us with meaningful opportunities to influence. Whilst we have made clear that the UK Government position is not one we can support since it does not represent Wales’ interests, as a responsible government, we continue to take any opportunities that we can to press our case on specific points. We will, of course, continue to speak up for what we believe is in Wales’ interests in these negotiations, both in our dealings with the UK Government and in public.

    A meeting of the Joint Ministerial Committee (EU Negotiations) is being arranged for the middle of May. This is the first meeting since January. I have also spoken bilaterally this week and last week with the UK Government’s Paymaster General, Penny Mordaunt MP. These short calls are welcome but necessarily limited in their effectiveness and therefore I continue to press for structured, collective and detailed discussions involving all three Devolved Governments and the UK Government on the negotiations, and in particular on changes to the UK Government’s negotiating position.

    EU Exit Implementation

    The uncertain and deeply concerning situation on the negotiations exacerbates the pressures and risks we face in preparing for the end of the transition period – in particular on preparedness, legislation, frameworks, policy and finance.

    In relation to preparedness overall, at the end of transition we need to be able to implement any deal reached on the future UK / EU relationship, or manage the implications if no such deal is agreed. We may not know until well into the autumn, or even later, which scenario we face.

    Covid-19 has already affected the current capacity of both the UK Government and the Welsh Government to prepare for the end of transition. More fundamentally, the scale of the immediate crisis has hugely reduced the capacity of people, businesses and other organisations to consider, let alone take action to prepare for, the end of transition. The risks of this will multiply if significant changes to trade and supply chains hit already fragile businesses which are not prepared and still suffering from the impact of the pandemic – with potentially serious implications across Wales.

    We have repeatedly pressed the UK Government to work with the Devolved Governments on the preparations for the end of the transition period, as happened – eventually – in respect of preparations for a ‘no deal’ scenario in 2019. However, at a central level the UK Government is choosing not to share information or work with the Devolved Governments on the wide range of preparedness work which we know it is seeking to carry out, including on the functioning of the Northern Ireland Protocol. As we made clear during the work on a ‘no deal’ scenario previously, it is not possible for the Welsh Government to prepare Wales for whatever situation we face at the end of transition period in isolation from the UK Government’s work in England or at a UK level. Moreover, the UK as a whole cannot be properly prepared if the UK Government does not work effectively with the Devolved Governments. As such, the UK Government’s continued reluctance to share information and to work with the Devolved Governments – and the months of time lost for joint preparedness work as a result is profoundly concerning.

    In relation to legislation, there remains a high degree of uncertainty with relatively limited information available from the UK Government on the scope and nature of the legislation needed, in particular on the implementation of the Withdrawal Agreement and related agreements, and with even less certainty regarding a possible treaty on the future relationship with the EU. We have asked the UK Government to share a credible plan for how all the necessary legislation can be passed by the end of December, but no such plan has been shared. The successful implementation of the Withdrawal Agreement requires a cross-UK approach, or at least understanding, and this cannot be achieved without input from the UK Government. We are very aware that there is likely to be a significant programme of SIs required and we will continue to press the UK Government to work with us on such legislation and to ensure that the devolution settlement is properly respected.

    Moreover, there is extensive work required in relation to ‘common frameworks’ by the end of 2020. Officials from all four administrations have been working together to consider how to deliver the most important framework areas. However, even achieving this by the end of this year will be difficult. More broadly, work in relation to common frameworks and the internal market serves to illustrate powerfully how inter-governmental relations and devolution / constitutional issues could well grow significantly in breadth and complexity in the future. There is much work to do in a short period of time to resolve potential challenges and maintain a positive economic and constitutional landscape within the UK.

    In addition to frameworks, there is a wide-ranging policy agenda which relates to EU exit, encompassing policy making in Wales (for example, in respect of future agriculture policy) and our need to seek to influence policy making at a UK level (for example, on how the UK internal market will function, and on migration policy) to ensure they meet the needs of Wales. All this will also need to be calibrated according to the progress of recovery from the Covid-19 crisis.

    Furthermore, there is an important set of issues relating to finance. Around £700m a year comes to Wales now from the EU and whereas there are short-term reassurances from the UK Government on aspects of this, we need to protect our interests in longer-term funding decisions, particularly in respect of the possible Shared Prosperity Fund (SPF) and future agricultural and rural development funding. We will hold the UK Government to promises made that Wales will not be a penny worse off as a result of leaving the EU, and that the Welsh Government will continue to be responsible for deploying these funds in Wales.

    This statement demonstrates the scale and the complexity of the work on EU exit issues facing us in the remainder of 2020 and illustrates how it links to the new realities and work arising from the Covid-19 pandemic. The Welsh Government will continue to do all we can to seek to influence the negotiations and to work on the necessary preparations for the end of the transition period. This is constrained however, by the current approach of the UK Government. I will continue to keep members up to date on developments, in particular following the anticipated JMC(EN) meeting later this month.