Tag: Eluned Morgan

The statement made by Eluned Morgan, the Welsh Minister for Health and Social Services, on 7 February 2023.

The increased emergency pressures on the NHS, which have been so evident over the winter months, have been compounded by a number of factors, including concurrent surges in a range of respiratory viruses, including Covid-19, flu and scarlet fever.

But external factors, such as the ongoing consequences of Brexit, the cost-of-living crisis and the war in Ukraine, are all also impacting our health and care services.

I have recently spoken about the need for clear priorities – this statement highlights the priorities I have set for the health service in Wales. They will help address the immediate pressures and help to build a sustainable health and care service over the next year.

It is important people play their part in helping the NHS by looking after their own health and wellbeing and taking steps to stay well. I want to continue this conversation with the public so together we can create a healthier population, reduce pressure on acute NHS services and improve outcomes in the longer term.

The current environment means the priorities need to be targeted to the challenges we face. The NHS Planning Framework 2023-26 sets out the broad requirements that will underpin NHS plans going forward – this includes the importance of quality, safety, prevention and good health outcomes at the heart of the NHS in Wales.

We must continue to focus on population health and prevention as the route to better health and wellbeing and to sustainability in the longer term. Reducing inequity and improving the quality, safety and experience of those in need of health services must always be a driving force in service planning and delivery. Delivering efficiently, effectively, and optimising service delivery is how the improvements must be embedded in the DNA of the NHS in Wales.

It is crucial the NHS focuses on these priorities so resources and capacity can be used to make a real difference to people throughout Wales.

Members will be very well aware that frailty is driving demand for healthcare, particularly urgent emergency care, and social care.  Once clinical interventions are complete, people should be able to return to the community, and services must be available in an integrated way to facilitate that.  That’s why in this calendar year I am prioritising work to increase the number of healthy days at home for people experiencing frailty.

This must be an equal partnership between the NHS and social care organisations, and be really focussed on people receiving a consistent standard of community care across Wales.  The approach, backed up by improved data collection will provide a better basis for focused support.  In developing a plan for this work with organisations and other key partners, the aim is to have regions and localities working towards the national service specification and workforce model well ahead of next Winter, and for there to be means in place for identifying relative impact.

Priorities

• A closer relationship between the NHS and local government to tackle delayed transfers of care, and an effort to move further and to deliver an integrated community care service for Wales is essential. Work is ongoing across health and social care to introduce the Pathways of Care Reporting framework for delayed transfers of care in 2023. Health boards will be expected to use this to monitor the progress of safe and timely discharges of patients.  All organisations must deliver care closer to home. The focus should be on doing the right things to support people, to ensure they receive the care they need at home.

• Improving access to general practice, dentistry, optometry and pharmacy This will include independent prescribing and increasing self-referral to a wider range of community-based allied health professionals, including rehabilitation, mental health and audiology.

• Urgent and emergency care must focus on the effective management of people with urgent care needs in the community 24/7, and help more people to safely access alternatives to hospital-based care, for example through robust, seven-day same-day emergency care services and integrated health and social care community response models. Health boards must work with partners to significantly reduce the time patients spend waiting in ambulances outside emergency departments.

• Planned care and recovery is being led by the National Recovery Programme, which will set specific requirements for health boards. Meeting these requirements must be a priority. Regional diagnostic centres and treatment centres should be at the forefront of organisations’ plans. This must include actions to move services, workforce and funding from hospitals into the community so people need to go to hospital when it is right for them. Organisations must demonstrate how they will deliver a significant increase in the numbers of patients who undertake pre-habilitation. Diagnostics services improvements must result in a reduction in numbers of people waiting for diagnostic tests to pre-pandemic levels as a minimum, including for mental health diagnosis.

• Cancer services must enact the quality statement on cancer and ensure there is a reduction in the backlog of patients waiting too long on the cancer pathway. Achieving the required standards must be a priority for health boards.

• Mental health and child and adolescent mental health services there must be improvements across all age services and equity and parity between physical and mental health services. Health boards must plan to expand tier 0/1 support to provide easy access to population level support for lower-level mental health issues, improve services across CAMHS, adults and older adult services and implement 111 press 2 for urgent mental health support. Reconfiguring eating disorder services to target earlier intervention and ensure a maximum of a four-week wait for routine access to eating disorder services is required. Improving memory assessment services to obtain a timely diagnosis and treatment should also be included. Improved access to full range of all age mental health and wellbeing services, particularly for children and young people, boosting prevention support for adults and children and de-medicalise the approach to mental health services where appropriate.

Core Supporting Functions

Digital, innovation, technology and transformation must underpin the delivery of optimum care and services for patients, alongside workforce, wellbeing and robust financial management.

It is important the NHS focuses on ways to deploy the existing and future workforce to best effect. This includes enhanced use of multidisciplinary teamworking, role redesign, developing new roles, and advanced practice models, enabling people to develop their careers and work at the top of their license.

The economic and financial outlook is extremely challenging. The value of the overall Welsh Government budget has fallen in real terms by £3bn over the current spending review period. A renewed focus on cost reduction and value improvement in the NHS is therefore critical to ensure the ongoing sustainability of services.

Robust financial planning, fully integrated with service and workforce planning, is essential, as is tight financial governance and financial management. Capital plans must be prioritised and aligned to decarbonisation targets.

The role of NHS organisations as anchor institutions provides a driver to implement care and services in a way that supports individuals and communities as part of normal business. This will include the approach to the foundational economy and how the NHS can respond to the cost-of-living crisis for both patients and staff.

The net zero target for the public sector in 2030, decarbonisation action plans and social value, as part of contributing to achieving the aims of the Well-being of Future Generations (Wales) Act 2015, remain as commitments and opportunities to build in actions and benefits as part of service planning and should be taken.

All NHS organisations must submit board-approved plans providing firm commitments about how these priorities will be delivered by 31 March 2023.

This is a challenging period in which to plan and deliver health services but I am confident the NHS will continue build on the progress and learning from the pandemic and the ongoing pressures to deliver the sustainable services we all want.

The statement made by Eluned Morgan, the Welsh Minister for Health and Social Services, on 3 February 2023.

Following continued discussions over the last week, we are pleased to announce that an enhanced pay offer has been made to our health trade unions. On this basis, we are hopeful that the planned industrial action over Monday 6th and Tuesday 7th February will be postponed, allowing trade unions to discuss the proposals further with their members. Individual trade unions will confirm their intentions regarding next week’s action, prior to further talks with their members.

This revised pay offer comprises an additional 3%, of which 1.5% is consolidated so will be in pay packets year-on-year, on top of the Pay Review Body recommendations, which have already been implemented in full. This offer will be backdated to April 2022. Included in this revised package are a number of non-pay commitments to enhance staff well-being, on which negotiations will continue next week.

Whilst there is currently no improved pay offer on the table for NHS staff in England, it was also agreed that any resulting Barnett consequential following any improved offer to staff in England would result in a further pay offer to staff in Wales.

We would like to thank those that have participated in the negotiations for their positive engagement and goodwill. We are awaiting a formal response from each of the individual trade unions.

The statement made by Eluned Morgan, the Welsh Minister for Health and Social Services, on 26 January 2023.

I am pleased to announce the Welsh Government will be funding up to 140 medical student places a year at the new North Wales Medical School. Direct intake will start in 2024.

We expect student numbers to increase steadily and to reach their optimum number from 2029 onwards. This gradual trajectory will provide time to assess and evaluate both the quality tuition and student experience at the new medical school.

Establishing a new medical school in North Wales is a key commitment, which will help Wales to train more medical students and ensure that training opportunities and the provision of qualified doctors are spread across Wales.

This is a real boost for North Wales, for Betsi Cadwaladr University Health Board and for Bangor University.

I have written to the General Medical Council to confirm our support and endorsement of these plans. This letter of assurance enables the GMC to progress the accreditation process.

The statement made by Eluned Morgan, the Welsh Minister for Health and Social Services, on 18 January 2023.

Despite the challenges we face today, we continue to invest in the education and training of healthcare professionals in Wales. There is great demand on our NHS in Wales and the continued necessity to increase the training numbers and funding for essential health professionals in 2023/24. This is why, for the ninth consecutive year, funding to support health professional education and training in Wales will increase.

£281.98m will be invested in 2023/24; this equates to a 8% increase from 2022/23 which is an extra £1.7m for education and training programmes for healthcare professionals in Wales;  £7.14m extra for medical training places, an extra £1.68m to support core GP training numbers and a net increase of £3.41m for pharmacy training across Wales.  This will continue to be a record level of funding to support the highest ever number of training opportunities in Wales.

A well-trained NHS workforce with the right skills is essential to providing a sustainable high-quality care to people across Wales and improving standards in our health service.

I am proud of this government’s record on investing in education and training to support and sustain the health workforce across Wales. The NHS has more people working in it than at any time in its history, all aimed at prevention and care for members of society, across every community in Wales.

The Welsh Government remains committed to providing the NHS with the workforce it needs and these additional training places will increase the capacity of the workforce to help the NHS respond to the challenges facing it in the future.

Over the past five years nurse training places have increased by 41.3% and midwives have increased by 41.8%. Tables showing the increase in health professional and medical training places for 2023/24 can be found at Annex A.

Annex A

NHS Wales Education Commissioning and Training Plan for 2023/24

The following tables show the increase in health professional and medical training places for 2023/24.

Speciality	From	To	% Increase
Adult Nursing	1651	1892	14.6%
Mental Health Nursing	410	530	29.2%
Child	175	192	9.7%
Midwifery	185	190	2.7%
Dietetics	66	82	24.2%
Occupational Therapy	179	197	10%
Physiotherapy	174	180	3.4%
PhD Clinical Psychology	36	40	11.1%
Paramedics	116	120	3.4%
Operating Department practitioners	49	62	26.5%
Scientist Training Programme	39	53	36%
Higher Specialist Training	8	10	25%
Cardiac Physiology	23	24	4.3%
Audiology	11	12	9%
Respiratory & Sleep Science	8	14	75%
Neurophysiology	3	4	33%
Life Sciences (Bio Medical Sciences)	24	26	8.3%
Clinical Engineering	6	8	33%
Pre-registration Pharmacy Technicians	83	100	20.5%
Pharmacy Technicians	30	50	66.7%
Secondary Care/Speciality Training	89	92	3.4%
Foundation training	60	69	15%
Physician Associates	52	57	9.6%

Urgent and Emergency Care
Intensive Care Medicine	Increase of 3 higher Training Programme posts (fifth successive year of increases).
Higher Emergency Medicine	To increase by 4 higher posts for 2023, 4 posts for 2024 and 2 posts for 2025.  The increases for 2024 and 2025 are required to ensure the pipeline via ACCS EM established in previous workforce plans is aligned to the higher programme.
ACCS Emergency Medicine	To increase by 4 posts for 2023 (2 in North Wales and 2 in South Wales) and by 2 posts for 2024 (South Wales).
Geriatric Medicine	To increase by 5 posts each year for 3 years commencing in 2023.  These recommendations will be reviewed on an annual basis and increased if high recruitment levels into the programme are sustained.
Internal Medicine	To increase by 12 posts for 2023 to maintain the pipeline created following expansion in 2021 and 2022.
Foundation	To increase the number of Foundation Year 1 posts by 39 and Foundation Year 2 posts by 30 for August 2023 as detailed in the Foundation Expansion Business Case.
Cancer Care
Clinical Oncology	Increase by 4 additional Higher Training posts implementing year 3 of the proposal to expand by 4 posts per year for 5 years.
Medical Oncology	Increase by 3 additional Higher Training posts implementing year 3 of the proposal to expand by 3 posts per year for 5 years.
Palliative Medicine	To increase Palliative Medicine training by a further 2 posts for August 2023 as recommended in the 22/23 plan.
Planned Care
General Surgery	Increase by 7 higher posts for 2023.
Trauma & Orthopaedics	To increase by 5 posts in 2023 and then by a further 5 in 2024 and in 2025 (to be reviewed and dependent upon training capacity).
Higher Anaesthetics	Increase of 6 Higher Anaesthetics posts.
Dermatology	To increase by 3 posts in 2023 and by 3 posts in 2024.
Rheumatology	To increase by 2 posts for 2023 as recommended in the 22/23 plan.
Neurology	To increase by 3 posts for 2023.
Diabetes & Endocrinology	To increase by 1 post in 2023 and a further post in 2024.
Diagnostic specialties & Health promotion/prevention
Medical Microbiology/ Infectious Diseases	Increase of 3 Medical Microbiology/Infectious Diseases posts implementing year 4 of a plan to increase posts every year for 5 years.
Clinical Radiology	To support the recommended expansion as required to appoint 20 trainees for the 2023 intake into the South Wales programme.
Clinical Neurophysiology	To increase by 1 post in 2023 and then by a further post in 2024.
Public Health Medicine	To increase by 3 posts as recommended in the 22/23 plan.
Clinical Pharmacology and Therapeutics (CPT)	To increase by 1 post in 2023.
Mental Health
Child and Adolescent Psychiatry	No increase to the higher programme for 2023 but to monitor demand and act accordingly. To pilot 2 new innovative ST1 run through posts for 2023.
Old age psychiatry	To increase by 2 posts for 2023 and a further 2 for 2024 as recommended in the 22/23 plan.
General Adult Psychiatry	To increase by 2 posts in North Wales in 2023.  Increases will be recommended for South Wales in the 24/25 plan if current vacancies are filled.
Forensic Psychiatry	To increase by 1 post for 2023 to enable the creation of a North Wales programme.
Core psychiatry	To increase by 8 posts in 2023 and a further 8 posts in 2024 to maintain the pipeline created through the initial expansion in the 22/23 plan.

The statement made by Eluned Morgan, the Minister for Health and Social Services, on 14 October 2022.

On 16 October, we mark Restart a Heart Day. Save a Life Cymru and its partners will be encouraging us to learn more about life-saving cardio-pulmonary resuscitation (CPR), using defibrillators and knowing how to help when someone has a cardiac arrest.

I want to use this opportunity to provide Members with a further update about progress to implement the Out of Hospital Cardiac Arrest Plan and Save a Life Cymru’s work.

The Out of Hospital Cardiac Arrest Plan was launched in 2017 and we established the Save a Life Cymru partnership that brings together organisations across Wales to help develop the Welsh public’s CPR and defibrillation skills so people feel confident to help if they witness someone experiencing an out-of-hospital cardiac arrest. Last year we increased the funding for this life saving programme.

Earlier this month a new save a Life Cymru campaign was launched. ‘Help is closer than you think’ (Cofia, mae help wrth law) which focuses on increasing people’s confidence to intervene in a cardiac arrest emergency by highlighting the importance of calling 999 immediately, as well as the support provided by the call handler to do CPR and locate a registered defibrillator until an ambulance arrives. A TV, radio and social media advertisement went live from Monday 10 October.

Save a Life Cymru has recruited a clinical out-of-hospital cardiac arrest programme manager who is developing an all Wales CPR and defibrillator framework to help communities become rescue ready and have the right resources in the right place to help someone having a cardiac arrest. It has also recruited four Save a Life Cymru community support coordinators, one of whom is already in post, and it is hoped the remainder will be in post before the end of November. They are also currently advertising for two Save a Life Cymru community support team leader posts.

Save a Life Cymru is working with a range of organisations to support people of all ages and backgrounds to learn CPR and defibrillation skills, including:

• Continuing to develop their partnership with the Football Association of Wales to broaden the reach of teaching CPR in Wales.
• Following a successful pilot, Cardiff University has rolled out its model for all medical students who are trained in CPR to train all first year students.
• Supporting One Voice Wales, which represents community and town councils, employing a person to co-ordinate CPR and defibrillator activity in communities across Wales, including ensuring defibrillators are registered and in good working order.
• Appointing, in conjunction with Cardiff Metropolitan University, a post-doctoral research fellow who will develop research projects to initiate improvements in Out of Hospital Cardiac arrest outcomes in Wales
• Partnering with Ospreys Rugby medical team to help raise awareness of CPR and defibrillation among its audiences.
•  Producing a bilingual educational leaflet to support community CPR
• Providing CPR training at the Welsh Government stand in some national events such as the Urdd Eisteddfod and Royal Welsh Show
• Supporting Betsi Cadwaladr University Health Board (BCUHB) to produce a bilingual Primary School resource, supported by BSL, which teaches children the sequence of CPR through song and dance.

During 2021/22 I announced a further £1m to purchase 1,000 additional defibrillators which community groups and public organisation across Wales were able to apply for.  638 groups and organisations successfully applied for a defibrillator and so far about 238 have been installed in communities across Wales. There have been some delays in groups being able to purchase and install the cabinets so defibrillators are still being distributed.

Communities and organisations which already have defibrillators are being encouraged to register them on The Circuit – more than 7164 are registered and now 72% have a guardian. We have seen a significant increase in the number registered and in the percentage with a guardian but there is still more work to be done.

Additionally, the Welsh Ambulance Service partnered with GoodSAM app to improve mobilisation of clinically trained staff and volunteers to life-threatening emergency calls. So when an emergency call is received by the ambulance service and classified to be of a life-threatening nature, details will automatically be sent through to the GoodSAM app to alert the nearest approved volunteer responder. They will shortly be relaunching the GoodSAM app in Wales, which was paused during the pandemic, and this will open up being a GoodSAM responder to all eligible individuals who have signed up and been approved by GoodSAM and partner organisations. This will be a huge step forward in Wales.

We have made substantial progress over the course of the last twelve months and have heard stories of the differences this work is making to people’s lives. We know that every second counts when someone goes into cardiac arrest. We can all help raise awareness of the importance of dialling 999 and giving early CPR and defibrillation.

The statement made by Eluned Morgan, the Minister for Health and Social Services, on 11 October 2022.

I am pleased to update Members on our planning approach to support resilient urgent and emergency care services this winter.

It is likely the winter period will present additional challenges to an already stretched urgent and emergency care system if there are increases in prevalence of both COVID-19 and influenza, and within the context of the cost of living and energy crises. Members will know there are plans in progress focusing on COVID-19 and influenza vaccination, and additional support for vulnerable people most likely to feel the impact of rising costs this winter.

Planning for seasonal peaks in pressure is a year-round exercise and development of interventions that will enable additional resilience commenced many months ago. Additionally, a winter planning framework has been issued to NHS Wales organisations and Regional Partnership Boards to support them to plan and deliver resilient urgent and emergency care services this winter.

Since Spring 2022, Health Boards have been working with partners to develop local urgent and emergency care plans focused on a small number of priorities set by the Welsh Government that will support people to access the right care, in the right place, first time. To support consistency and harness momentum, the winter planning framework sets out expectations for Health Boards to work with partners to build on these priorities and develop enhanced interventions for the winter period. These priorities include:

• • A national communications campaign to raise awareness of NHS 111 Wales, encouraging the public to use the 111 service as a first port of call for free, trusted health information to help ensure they access the right service, first time;
  • Optimising the role of third sector services to improve experience and outcomes for vulnerable people who access care in Emergency Departments or hospitals;
  • Increasing opportunities for people with urgent care complaints to be assessed and treated away from the Emergency Department and within Urgent Primary Care Centres;
  • £3m for the recruitment of 100 new ambulance clinicians expected to be operational by the end of December;
  • Increasing emergency ambulance response capacity through implementation of new staff rosters to deliver efficiency equivalent to around 70 whole time equivalents;
  • Reducing long ambulance patient handover delays to improve experience and unlock ambulance capacity;
  • A further £2m has been made available for health boards to improve their emergency department environments, to enhance patient experiences this winter; and
  • Extending same day emergency care services to seven-day accessibility to help people who may have ordinarily been admitted to hospital to return home to sleep in their own bed.

In addition, Health Boards and Local Authorities have developed plans to increase community bed or bed equivalent capacity ahead of the winter period. These plans will aim to deliver additional step down to recover provision and community responses through a shared endeavour amongst partners.

This additional capacity will be delivered alongside additional measures to boost the community care workforce, and is a key element of our enhanced winter planning approach. It will support people to return home or to their local communities when ready and as a consequence it should improve timeliness of care in other parts of the urgent and emergency care system.

I expect Health Boards to work collaboratively with partners through Regional Partnership Boards to refine plans, drawing on learning from the previous winter and the ongoing challenges of the pandemic, with a focus on patient safety and wellbeing.

Health Boards will be expected to submit winter resilience plans to their respective Boards for approval, and a review of each Health Board’s plan will form part of Welsh Government Integrated Quality Planning and Delivery meetings in October.

I will provide Members with further updates throughout the winter period.