Written Statement: Six Goals for Urgent and Emergency Care Programme Update

Following my recent statement, I am pleased to provide Members with a further update, about the progress of the Six Goals for Urgent and Emergency Care programme.

I launched the programme in April, as the NHS was emerging from a winter dominated by the coronavirus pandemic and emergency pressures. The NHS is continuing to work under intense pressure, as we see a fresh surge in coronavirus cases in the community and as staff work incredibly hard to provide planned care and reduce waiting times, which built up over the pandemic.

The Six Goals programme is supported by a £25m annual budget – this year, health boards and NHS trusts can access up to £20m. Each health board will have up to £2.96m towards the delivery of their local programme plans and a £4m Six Goals for Urgent and Emergency Care Programme Innovation and Delivery Fund will be available for nationally-coordinated projects.

Our key priorities for this year are to increase capacity in urgent primary care and same-day emergency care services to help people access care closer to home without needing to visit an emergency department or be admitted to hospital. I have been encouraged by the early progress and the whole system transformation taking place through the programme. 

There are currently nine urgent primary care centres across Wales - and a practice-based approach in Powys - with coverage spanning 256 practices, 39 clusters and a total population of 1.8m people across Wales being able to be referred into these services.  The Programme team continues to work with health boards to expand the number of urgent primary care models available and I have been encouraged by the positive feedback received from staff and patients on the benefits of this approach.

All health boards have committed to expanding and extending same-day emergency care services, through a mix of medical, surgical and community-based models. Welsh Government funding has supported increased staffing and hours of operation, enabling more people to be assessed, undergo diagnostic tests and have treatment without being admitted to hospital or staying overnight.

In April, we issued national guidance to enable paramedics to make direct referrals to same-day emergency care services. 

I expect health boards to accelerate the development and delivery of these same-day services as we plan for winter. Welsh Government funding will enable Cardiff and Vale University Health Board to open its dedicated surgical same-day emergency unit at the University Hospital of Wales later this month, and Aneurin Bevan University Health Board to open its dedicated same-day emergency centre at the Grange University Hospital next month.

The roll out of the NHS 111 Wales telephone service is another important milestone and provides a consistent 24/7 free-to-access service to support people with urgent health needs across Wales. For many people, this will mean they have access to community services without attending an emergency department. More than 260,000 people have used the service since it became available nationally.   

The emergency ambulance service continues to be under pressure across Wales. We are investing an extra £3m to help the Welsh Ambulance Service increase its response capacity as quickly as possible through the recruitment of between 100-150 frontline staff. This funding is in addition to £1.8m of non-recurrent funding from the Emergency Ambulance Services Committee earlier this year to continue support from St John Ambulance Cymru and provide other additional capacity to meet demand.

The Emergency Ambulance Services Committee is working with health boards and the Welsh Ambulance Services Trust to develop a refreshed and enhanced integrated improvement plan for ambulance services.  I expect it to include a clear focus on joint actions to improve response times and reduce ambulance patient handover delays at hospitals, as well as better managing people in the community.

Ambulance handover improvement plans have been developed for each emergency department in Wales. We have started to see improvement in handover performance in some areas – further improvement will not only free up ambulances to respond to urgent calls in the community, it will also improve patient experience and outcomes.

Finally, all health boards have committed to work with Local Authorities and partners to create additional community care beds – or their equivalents – by October to improve flow through the health and care system. The work is being supported by the Six Goals team and a renewed focus on a discharge to recover then assess (D2RA) model. It will support people to return home or to their local communities when ready and improve timeliness of care in other parts of the urgent and emergency care system.

I have given health board leaders the challenge to establish an additional 1,000 bed spaces or their equivalents to support people who have become “stuck” in hospital because of the lack of capacity in D2RA services, social and community care. This is the first element of our enhanced winter planning approach, which will be supported by our continued commitment to Six Goals priorities.

I will provide a further update about progress in the autumn.