Eluned Morgan MS, Minister for Health and Social Services
In April 2023 we formally launched our updated reporting framework to measure pathways of care delays in our hospitals and social care services. The new monthly reports provide us with a snapshot of discharge delays that are preventing people from returning home or to their usual place of residence.
Since its implementation we have been working closely with health boards and local authorities to review their data and support activity to reduce discharge delays. We have already seen an improvement on overall numbers since the reporting began and we have seen evidence of reductions in those awaiting health and social care assessments as well as those people waiting for a social worker to be allocated. There have been improvements in a number of other areas, but we know that there is still work to be done. We will continue to work closely with our health boards and local authorities to drive further improvements and tackle our winter pressures.
Officials and NHS Executive colleagues have recently held a review and future planning session with stakeholders to reflect on the development process of the reporting framework as well as how this can be expanded and improved further. The outcome of this is currently being worked on and we hope to be able to share details of the forward work plan early in the new year.
Since May this year we have published high level figures on Pathways of Care Delays, broken down by health board and local authority. I am pleased to report that we are now able to publish the data with a more comprehensive range of breakdowns, allowing users to view data for health boards and local authorities by specific reasons for delays.
As part of our winter planning, NHS organisations continually review their winter resilience arrangements including work through their Regional Partnership Boards to identify where joint action is required. A whole system approach will be required with expectations on primary, planned, social and acute services to enhance capacity. There will be more focus on improving system flow through Same Day Emergency Care, patient discharge action plans, the trusted assessor model and use of ‘pathways of care delay’ data.
This data will be utilised regionally to identify priority areas for action. Expectations will be set for health boards to reduce the volumes of patients spending over three weeks in a hospital bed to free up bed capacity. In cases where a person also needs new or additional support, we want to ensure that services are lined up and available to give them the right level of assistance that they need. Regions will be supported to use their pathways of care delay data to ensure that people are discharged in a safe and timely manner.
To support staff, we have recently published updated hospital discharge guidance on the Welsh Government website. This replaces the previous guidance that was developed during the pandemic and has a revised focus on work emerging from the 6 Goals of Urgent and Emergency Care programme including Discharge to Recover then Assess (D2RA), SAFER and Red to Green. These processes are aimed at supporting patients through the hospital pathways and making sure that they are prepared and ready for discharge as soon as they are clinically optimised. The updated guidance also has a stronger link to guidance for staff, patients, their families, and carers on social care services that they may need. For some people, this may be the first time that they will need to access supportive care services so we wanted to ensure that staff have key information that can be shared to help that person, or their families/carers, with understanding what happens next.
This programme of work undertaken during the year is ensuring we are working towards having clear, measurable and effective hospital discharge arrangements in place across Wales that will help support winter pressures over the coming months.
This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Senedd returns I would be happy to do so.